Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration in Medication Administration in Ohio Schools: Ohio Schools:
Training for Training for School PersonnelSchool Personnel
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
OverviewOverview Background, goals and objectivesBackground, goals and objectives Law and legal considerationsLaw and legal considerations Medication overview Medication overview Forms and proceduresForms and procedures Hand hygieneHand hygiene Field tripsField trips Six rights of medication administrationSix rights of medication administration The role of the designated employee who is The role of the designated employee who is
not a licensed health professional not a licensed health professional administering medication in schoolsadministering medication in schools
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
GoalGoal
The goal or purpose of the ODH The goal or purpose of the ODH Medication Administration in Ohio’s Medication Administration in Ohio’s Schools: Training for School Personnel Schools: Training for School Personnel is is to provide designated employees who to provide designated employees who are not licensed health professionals are not licensed health professionals (school personnel) administering (school personnel) administering medications in schools with the medications in schools with the knowledge, skills and resources to safely knowledge, skills and resources to safely administer medication prescribed for administer medication prescribed for Ohio school children.Ohio school children.
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Course ObjectivesCourse Objectives
At the completion of this training course, the At the completion of this training course, the designated employee who is not a licensed designated employee who is not a licensed health professional will be able to:health professional will be able to:
1.1. Identify the requirements of ORC 3313.713 Identify the requirements of ORC 3313.713 2.2. Explain how federal confidentiality law (FERPA and HIPAA) Explain how federal confidentiality law (FERPA and HIPAA)
effect medication administrationeffect medication administration3.3. Locate the local school district’s medication administration Locate the local school district’s medication administration
policypolicy4.4. List the components of the local school district’s medication List the components of the local school district’s medication
administration policyadministration policy5.5. Tell the general procedures for administering medications Tell the general procedures for administering medications
in the school, including the six rights of medication in the school, including the six rights of medication administrationadministration
6.6. Successfully pass the medication administration post-testSuccessfully pass the medication administration post-test
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
BackgroundBackground Children with chronic and acute health Children with chronic and acute health
conditions may require medication conditions may require medication administration during the school day in order to administration during the school day in order to be academically successfulbe academically successful
In 2009, Ohio House Bill 1 updated school In 2009, Ohio House Bill 1 updated school medication administration law (ORC 3313.713) medication administration law (ORC 3313.713) to require school employees administering to require school employees administering medications after July 1, 2011 be:medications after July 1, 2011 be:– A licensed health professional A licensed health professional OROR– Complete a drug administration training program Complete a drug administration training program
conducted by a licensed health professional and conducted by a licensed health professional and considered appropriate by the boardconsidered appropriate by the board
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration in Medication Administration in Schools is Guided by Federal LawsSchools is Guided by Federal Laws
Federal Law: FERPAFederal Law: FERPA
Family Educational Rights and Privacy Family Educational Rights and Privacy ActAct
Ensures confidentiality of student Ensures confidentiality of student recordsrecords
Records must NOT be disclosed to Records must NOT be disclosed to anyone without consentanyone without consent
If confidentiality is breached, it can lead If confidentiality is breached, it can lead to liability and lawsuitsto liability and lawsuits
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
What is Disclosure?What is Disclosure?
Sharing information with Sharing information with – Personally identifiable Personally identifiable
informationinformation– By any means (including oral, By any means (including oral,
written, electronic, etc.)written, electronic, etc.)– To anyone elseTo anyone else
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
ExceptionsExceptions
There are a few exceptions There are a few exceptions regarding disclosure:regarding disclosure:1. School officials with 1. School officials with “legitimate educational interest”“legitimate educational interest”2. Transferring schools2. Transferring schools3. Emergency situations3. Emergency situations4. Directory information4. Directory information
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
““Legitimate Educational Legitimate Educational Interest”Interest”
While many are interested in students’ personal While many are interested in students’ personal health information, few may access it. health information, few may access it.
Only those: Only those: Designated responsible for an emergency Designated responsible for an emergency
responseresponse Who require it to fulfill professional Who require it to fulfill professional
responsibilitiesresponsibilities With educational need – Am I going to change With educational need – Am I going to change
the way I teach or interact with the student the way I teach or interact with the student because of the information?because of the information?
If in doubt, informed consent would always be If in doubt, informed consent would always be best.best.
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration in Medication Administration in Schools is Guided by Schools is Guided by
Federal LawsFederal LawsFederal Law: HIPAAFederal Law: HIPAA
Health Insurance Portability Health Insurance Portability Accountability ActAccountability Act
Generally, does not apply to schoolsGenerally, does not apply to schools– Does apply to health care providers with Does apply to health care providers with
whom schools may workwhom schools may work FERPA is the confidentiality law that FERPA is the confidentiality law that
schools must followschools must follow
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration in Medication Administration in Schools is Guided by State LawSchools is Guided by State Law
Ohio Law: Ohio Revised Code (ORC) Ohio Law: Ohio Revised Code (ORC) 3313.7133313.713
Refers only to prescription medication:Refers only to prescription medication: Requires school boards to have a policy Requires school boards to have a policy
for medication administrationfor medication administration Requires training for employees who Requires training for employees who
administer medicationadminister medication Describes authorization needed to Describes authorization needed to
administer medicationadminister medication Describes proper storage of medicationDescribes proper storage of medication
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Who Can Administer Medication in Who Can Administer Medication in School?School?
ORC 3313.713 states:ORC 3313.713 states:OnlyOnly employeesemployees of the board who are: of the board who are:
– Licensed health professionals Licensed health professionals OROR– Who have completed a drug Who have completed a drug
administration training program administration training program conducted by a licensed health conducted by a licensed health professional which is considered professional which is considered appropriate by the board mappropriate by the board may ay administer medication prescribed administer medication prescribed for the studentfor the student
Non-Prescriptive or Over-the-Non-Prescriptive or Over-the-Counter (OTC) MedicationCounter (OTC) Medication
To administer OTC medication, school To administer OTC medication, school personnel must follow the local school personnel must follow the local school district OTC medication policy district OTC medication policy
OTC medication policy:OTC medication policy: Is not governed by ORC 3313.713 Is not governed by ORC 3313.713 Each school board must have an OTC policyEach school board must have an OTC policy• This may be different from other districtsThis may be different from other districts
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
General Procedure for General Procedure for Medication AdministrationMedication Administration
ParentsParents– Receive medication order from prescriberReceive medication order from prescriber– Have order filled by pharmacistHave order filled by pharmacist– Parent and physician must complete Parent and physician must complete
medication authorization form (MAF)medication authorization form (MAF)– Provide the medication and MAF to schoolProvide the medication and MAF to school– Tell the school about any changes in Tell the school about any changes in
medicationmedication
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
General Procedure for General Procedure for Medication Administration Medication Administration
continuedcontinued School personnelSchool personnel
– Create a Medication Documentation Create a Medication Documentation Record (MDR)Record (MDR)
– Administer medication according to Administer medication according to order and school policy/procedureorder and school policy/procedure
– Properly dispose of unused medication Properly dispose of unused medication
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
This is NOT acceptable…This is NOT acceptable…
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medical Authorization for Prescriptive Medical Authorization for Prescriptive MedicationsMedications
Prescriptive medication must be Prescriptive medication must be authorized in writing by a licensed authorized in writing by a licensed prescriber such as a:prescriber such as a:– PhysicianPhysician– DentistDentist– Advanced Practice Nurse (APN) with a Advanced Practice Nurse (APN) with a
certificate to prescribecertificate to prescribe– Physician Assistants (PA)Physician Assistants (PA)
A Medication Authorization Form (MAF) A Medication Authorization Form (MAF) must be used to document medication must be used to document medication administration order for the schooladministration order for the school
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Authorization Form Medication Authorization Form (MAF) (MAF)
Required by ORC 3313.713:Required by ORC 3313.713: A written statement signedA written statement signed byby
– The prescriber ANDThe prescriber AND– The parentThe parent
Must include ALL information on Must include ALL information on next slidenext slide
You must have a new MAF each school You must have a new MAF each school yearyear
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Authorization Form Medication Authorization Form (MAF) (MAF) continuedcontinued
1.1. Student’s name and addressStudent’s name and address
2.2. Student’s school and classStudent’s school and class
3.3. Name of the medicationName of the medication
4.4. Dose of the medicationDose of the medication
5.5. Times or intervals to administer the medicationTimes or intervals to administer the medication
6.6. Date to start medication administrationDate to start medication administration
7.7. Date to end medication administrationDate to end medication administration
8.8. Any possible severe reactionsAny possible severe reactions
9.9. Emergency phone number for the prescriberEmergency phone number for the prescriber
10.10. Special instructions for medication administrationSpecial instructions for medication administration
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Prescription Medication in Prescription Medication in SchoolSchool
Must be in the original containerMust be in the original container Must have pharmacy labelMust have pharmacy label Must have an MAF signed by Must have an MAF signed by
prescriber and parentprescriber and parent
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
All Medication ChangesAll Medication Changes
ORC 3313.713 requires parents to tell ORC 3313.713 requires parents to tell the school about any changes in the school about any changes in medications administered at schoolmedications administered at school
Each change will require:Each change will require: A new MAF or update the current A new MAF or update the current
record if applicablerecord if applicable A new prescription label and containerA new prescription label and container
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Drop-Off and Pick-Medication Drop-Off and Pick-Up Instructions Up Instructions
Medication should be Medication should be dropped-off/picked-up by:dropped-off/picked-up by:– The parentThe parent– A parent-designated responsible adult A parent-designated responsible adult
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Documentation Medication Documentation RecordRecord
Contains all information needed for a Contains all information needed for a person to administer medication to a person to administer medication to a studentstudent
Created by school staff (nurse, Created by school staff (nurse, administrator or designated school administrator or designated school personnel)personnel)
Must be clear enough to be understood Must be clear enough to be understood by all (including substitutes) and provide by all (including substitutes) and provide evidence of medication administration evidence of medication administration according to prescriber ordersaccording to prescriber orders
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Storage of Medication Storage of Medication ORC 3313.713ORC 3313.713
All medication must be in a locked All medication must be in a locked storage placestorage place
Medication requiring refrigeration Medication requiring refrigeration must be in a place not accessed by must be in a place not accessed by studentsstudents
Medication should be in a locked Medication should be in a locked container for field tripscontainer for field trips
Emergency medication must be Emergency medication must be accessible at all times accessible at all times
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Unused MedicationUnused Medication
Arrangements must be made for the Arrangements must be made for the safe disposal of unused medication safe disposal of unused medication
Options include: Options include: – Parent pick up in the school Parent pick up in the school
office/clinic office/clinic – Parent may request that the school Parent may request that the school
dispose of any remaining medicationdispose of any remaining medication
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Incident Medication Incident Reporting Reporting
Medication ErrorMedication Error: a deviation from : a deviation from the standards of care owed to student the standards of care owed to student in the area of correct medication in the area of correct medication delivery, including:delivery, including:
Omitted dosesOmitted doses Incorrect dosesIncorrect doses Incorrect time of administrationIncorrect time of administration Incorrect studentIncorrect student Improper injection techniquesImproper injection techniques Incorrect route of administrationIncorrect route of administration
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Incident Medication Incident Reporting Reporting
Follow school policy/procedure for Follow school policy/procedure for “incident” involving medication “incident” involving medication
Report medication errors to the Report medication errors to the school nurseschool nurse
The school nurse and school The school nurse and school administrator should review administrator should review medication incident reports to medication incident reports to analyze patterns and take steps to analyze patterns and take steps to avoid or reduce future incidentsavoid or reduce future incidents
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Six Rights of Medication Six Rights of Medication AdministrationAdministration
Standard safety procedures followed by all people Standard safety procedures followed by all people who administer medicationswho administer medications
Procedure includes checking the “six rights” of Procedure includes checking the “six rights” of medication administration:medication administration:– Right studentRight student– Right medicationRight medication– Right doseRight dose– Right routeRight route– Right timeRight time– Right documentationRight documentation
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Right StudentRight Student Medication must be given to the Medication must be given to the right studentright student
– Ask the student to state their name orAsk the student to state their name or– Ask another staff person to identify the student orAsk another staff person to identify the student or– Refer to a photograph of the studentRefer to a photograph of the student
Compare the student’s name on MDF with:Compare the student’s name on MDF with:– The student’s name on the pharmacy /medication The student’s name on the pharmacy /medication
container labelcontainer label– If the names match, the medication can be givenIf the names match, the medication can be given
If all names do not match, DO NOT GIVE the If all names do not match, DO NOT GIVE the medicationmedication– Contact the school nurse or supervisor for Contact the school nurse or supervisor for
instructions instructions
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Right MedicationRight Medication The The right medication right medication must be given must be given Check that the names of the medication Check that the names of the medication
match in two places: match in two places: – Pharmacy/medication container labelPharmacy/medication container label– MDRMDR
If all medication names do not match, DO If all medication names do not match, DO NOT GIVE the medicationNOT GIVE the medication– Contact the school nurse or supervisor for Contact the school nurse or supervisor for
instructions instructions
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Right DoseRight Dose
The The right dose right dose of medication must be of medication must be givengiven
Check the exact dose of the medication, Check the exact dose of the medication, the dose must match the:the dose must match the:– MDRMDR– Medication bottleMedication bottle
If all three medication doses do not If all three medication doses do not match, DO NOT GIVE the medicationmatch, DO NOT GIVE the medication– Contact the school nurse or supervisor for Contact the school nurse or supervisor for
instructions instructions
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Dose CalculationDose Calculation To determine the dose, you must know the To determine the dose, you must know the
strength of the medication and the strength of the medication and the amount to be givenamount to be given
The dose is located on the MDF The dose is located on the MDF The The right dose right dose of medication is how much of medication is how much
is given at one timeis given at one time Always use standard measuring devices Always use standard measuring devices
to assure proper doseto assure proper dose
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Right TimeRight Time Medication must be given at the Medication must be given at the right timeright time Compare the time on the MDF with:Compare the time on the MDF with:
– The pharmacy /medication container labelThe pharmacy /medication container label If times do not match, DO NOT GIVE the If times do not match, DO NOT GIVE the
medicationmedication– Contact the school nurse or supervisor for Contact the school nurse or supervisor for
instructions instructions
Medication given within a ½ hour Medication given within a ½ hour before or after the ordered time is before or after the ordered time is considered “on time”considered “on time”
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Right RouteRight Route Medication must be given by the Medication must be given by the right routeright route The route indicates how and where the The route indicates how and where the
medication enters the body medication enters the body Compare the medication route on the MDF Compare the medication route on the MDF
with:with:– The pharmacy /medication container label The pharmacy /medication container label
If all routes do not match, DO NOT GIVE If all routes do not match, DO NOT GIVE the medicationthe medication– Contact the school nurse or supervisor for Contact the school nurse or supervisor for
instructions instructions
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Right DocumentationRight Documentation
While documenting medication While documenting medication administration, once again compare administration, once again compare the pharmacy label while recording the pharmacy label while recording on the MDRon the MDR– Document promptly, but not in advanceDocument promptly, but not in advance– This includes all medication forms, This includes all medication forms,
including error documentationincluding error documentation– Remember: If it is not written, it did not Remember: If it is not written, it did not
happenhappen
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
General Guidelines of General Guidelines of Documentation:Documentation:
Must be readableMust be readable Must be accurateMust be accurate Must be completeMust be complete If on paper, must be written in inkIf on paper, must be written in ink
– NEVER use correction fluid or tape. If an NEVER use correction fluid or tape. If an error is made, draw a single line through the error is made, draw a single line through the error and write “error” above the line and error and write “error” above the line and initialinitial
If electronic, must be overwrite protectedIf electronic, must be overwrite protected
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
School Personnel Administering School Personnel Administering Medication in Schools: Medication in Schools:
NEVER shares confidential information NEVER shares confidential information NEVER gives medication without written NEVER gives medication without written
instructions and a properly labeled containerinstructions and a properly labeled container NEVER gives medication if the written NEVER gives medication if the written
information does not match the labeled containerinformation does not match the labeled container NEVER makes a medical or nursing diagnosis or NEVER makes a medical or nursing diagnosis or
decision about what should or should not be decision about what should or should not be done for a student. Medical decisions are to be done for a student. Medical decisions are to be made by licensed health care professionals. made by licensed health care professionals.
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
NEVER call themselves “the nurse” nor leads others NEVER call themselves “the nurse” nor leads others to think they are a nurse. It is a felony to practice to think they are a nurse. It is a felony to practice nursing without a license or to supervise someone nursing without a license or to supervise someone doing thatdoing that
NEVER performs a task he/she has not been trained NEVER performs a task he/she has not been trained to do or is not competent in performingto do or is not competent in performing
NEVER leaves any medication unattended or within NEVER leaves any medication unattended or within the reach of a studentthe reach of a student
NEVER delegates or designates, or “sub-”delegatesNEVER delegates or designates, or “sub-”delegates NEVER ignores medical orders due to lack of NEVER ignores medical orders due to lack of
understandingunderstanding NEVER refers to medication as candyNEVER refers to medication as candy
School Personnel Administering School Personnel Administering Medication in Schools: Medication in Schools:
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
ALWAYS maintains confidentialityALWAYS maintains confidentiality ALWAYS counts medication and ALWAYS counts medication and
records on appropriate medication records on appropriate medication documentation formdocumentation form
ALWAYS locks up medicationALWAYS locks up medication ALWAYS identifies the studentALWAYS identifies the student ALWAYS triple check the “6 Rights”ALWAYS triple check the “6 Rights”
School Personnel Administering Medication in Schools:
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
ALWAYS observes the student for any unusual ALWAYS observes the student for any unusual behaviors or conditions before and after behaviors or conditions before and after medication administrationmedication administration– Report unusual behaviors to the parents and Report unusual behaviors to the parents and
licensed health providerlicensed health provider ALWAYS ensures proper equipment/supplies ALWAYS ensures proper equipment/supplies
are availableare available ALWAYS explains the procedure to the studentALWAYS explains the procedure to the student ALWAYS, if applicable, positions the student ALWAYS, if applicable, positions the student
appropriately for medication administrationappropriately for medication administration
School Personnel Administering Medication in Schools:
What are Sharps? What are Sharps?
Definition in Ohio Administrative Code Definition in Ohio Administrative Code
3745-27-01(6)(g): 3745-27-01(6)(g): Sharp wastes used in the treatment…of Sharp wastes used in the treatment…of human beings…that have… come in human beings…that have… come in contact with infectious agents… contact with infectious agents… including… hypodermic needles and including… hypodermic needles and syringes, scalpel blades, and glass articles syringes, scalpel blades, and glass articles that have been broken. Such wastes are …that have been broken. Such wastes are …referred to as “sharp infectious waste” or referred to as “sharp infectious waste” or “sharps.” “sharps.”
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Sharps ContainersSharps Containers
Must be: Must be: Puncture resistantPuncture resistant Leak proofLeak proof CloseableCloseable Properly labeledProperly labeled
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Sharps DisposalSharps Disposal
Ohio Environmental Protection Agency Ohio Environmental Protection Agency states:states:
If you create less than 50 pounds of If you create less than 50 pounds of sharps a yearsharps a year
You may place the full sharps You may place the full sharps container in the trashcontainer in the trash
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Preventing Injuries from Preventing Injuries from SharpsSharps
Always:Always: Have student discard the sharp if possibleHave student discard the sharp if possible Replace a sharps container when 75% fullReplace a sharps container when 75% full Pay complete attention when handling a sharp-Pay complete attention when handling a sharp-
no multi-tasking!no multi-tasking! Alert your supervisor if no sharps container is Alert your supervisor if no sharps container is
availableavailable Keep the sharps container no more than “arms-Keep the sharps container no more than “arms-
length” awaylength” awayNever:Never: Recap or bend a sharp/needleRecap or bend a sharp/needle Shake a sharps container Shake a sharps container Place your hand under or in a trash bagPlace your hand under or in a trash bag
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
How to Care for a Sharps How to Care for a Sharps Injury Injury
Run under warm water immediatelyRun under warm water immediately Wash thoroughly with warm water Wash thoroughly with warm water
and soapand soap Rinse very wellRinse very well Follow district’s Bloodborne Follow district’s Bloodborne
Pathogen Policy for whom to notify Pathogen Policy for whom to notify and what to doand what to do
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
HandwashingHandwashing
Handwashing before and after each Handwashing before and after each student contact is the single most student contact is the single most important routine practice in the important routine practice in the control of infectionscontrol of infections
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Alternative: Alcohol-based Alternative: Alcohol-based Hand SanitizersHand Sanitizers
If soap and water are not available, use an If soap and water are not available, use an alcohol-based hand sanitizer to clean alcohol-based hand sanitizer to clean handshands
Must be 60% alcohol to be effectiveMust be 60% alcohol to be effective
When using an alcohol-based hand sanitizer: When using an alcohol-based hand sanitizer: Apply product to the palm of one hand Apply product to the palm of one hand Rub hands togetherRub hands together Rub the product over all surfaces of hands and Rub the product over all surfaces of hands and
fingers until hands are dryfingers until hands are dryOhio Department of Health Medication Administration in Ohio Schools: Training for School
Personnel
Click on the link Click on the link below and view the below and view the
entire videoentire video
H:\Medication Administration video
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Basic Guidelines for Basic Guidelines for Medication Medication
AdministrationAdministration
The following steps should be The following steps should be followed each time medication is followed each time medication is administeredadministered
If interrupted at any time in this If interrupted at any time in this process, restart from the beginningprocess, restart from the beginning
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration Medication Administration ProcedureProcedure
1. Wash hands well 1. Wash hands well
2. Start at the beginning of the MAR, review and 2. Start at the beginning of the MAR, review and check each of the following (check each of the following (11stst Check Check):):– 6 Rights of Medication Administration:6 Rights of Medication Administration:
Right StudentRight Student Right MedicationRight Medication Right DoseRight Dose Right TimeRight Time Right RouteRight Route Right DocumentationRight Documentation
– Order is currentOrder is current– Any known allergiesAny known allergies– Special instructionsSpecial instructions
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration Medication Administration Procedure Procedure continuedcontinued
3.3. Gather all equipment neededGather all equipment needed
4.4. Get medication from the locked storage areaGet medication from the locked storage area
5.5. Check the expiration date on the medication containerCheck the expiration date on the medication container
6.6. Compare and confirm that the container label, the MAR Compare and confirm that the container label, the MAR and the MDR and the MDR all match (2nd Check)all match (2nd Check)
7.7. Identify student verballyIdentify student verbally
8.8. Administer medication as orderedAdminister medication as ordered
9.9. Assure that the student leaves in a safe and Assure that the student leaves in a safe and comfortable mannercomfortable manner
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration Medication Administration Procedure Procedure continuedcontinued
1010. If gloves are worn, remove and dispose of . If gloves are worn, remove and dispose of gloves properly. Wash handsgloves properly. Wash hands
11.11. Document: Document:a.a. Write your initials and exact time the medication was given Write your initials and exact time the medication was given
in the dated square on the MDR or on the electronic recordin the dated square on the MDR or on the electronic record
b.b. While documenting, compare the container label to the MAR While documenting, compare the container label to the MAR and MDR again (and MDR again (44thth check check) and return to locked storage) and return to locked storage
c.c. Write your full name/signature, initials and title in space Write your full name/signature, initials and title in space provided on the MDRprovided on the MDR
d.d. Record any unusual complaints, concerns, errors and Record any unusual complaints, concerns, errors and action(s) takenaction(s) taken
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration Medication Administration Procedure Procedure continuedcontinued
1212.. Clean and return used equipment Clean and return used equipment to proper storage areato proper storage area
13.13. Wash hands before contact with Wash hands before contact with another student or procedure in the another student or procedure in the clinicclinic
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Oral Medication Administration Oral Medication Administration
Follow steps 1-8 of the Basic Follow steps 1-8 of the Basic Guidelines for Medication Guidelines for Medication
Administration Procedure, then: Administration Procedure, then:
A.A.Get a new medication cup for each Get a new medication cup for each studentstudent– If medication is a tablet, the student must If medication is a tablet, the student must
have water to drink to take ithave water to drink to take itB.B. Compare medication container label Compare medication container label
and MAR and MAR (3(3rdrd check) check)
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Oral Medication Oral Medication Administration Administration continuedcontinued
C.C. Prepare the medication: Prepare the medication:1.1. FOR TABLETS: FOR TABLETS: – Pour tablet from the bottle into the lid of Pour tablet from the bottle into the lid of
the container and then into the the container and then into the dispensing cup or the student’s washed dispensing cup or the student’s washed hand. Do not touch the tablethand. Do not touch the tablet
2.2. FOR LIQUIDS: FOR LIQUIDS:– Pour liquid medicine by setting the Pour liquid medicine by setting the
measuring cup on a firm surface at eye measuring cup on a firm surface at eye level to pour, reading the fluid level level to pour, reading the fluid level carefullycarefully
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Oral Medication Oral Medication Administration Administration continuedcontinued
D.D. Watch the student take the medication Watch the student take the medication – With water if a tabletWith water if a tablet– Confirm that the medication was taken Confirm that the medication was taken
(swallowed). If uncertain, check (swallowed). If uncertain, check student’s mouthstudent’s mouth
Return to the Basic Guidelines for Return to the Basic Guidelines for Medication Administration Medication Administration
Procedure and complete steps Procedure and complete steps 10-14 10-14
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Ophthalmic (Eye) Medication Ophthalmic (Eye) Medication AdministrationAdministration
Follow steps 1-8 of the Basic Guidelines for Follow steps 1-8 of the Basic Guidelines for
Medication Administration Procedure, then:Medication Administration Procedure, then:
A.A. Compare medication container label and MAR Compare medication container label and MAR (3(3rdrd check)check)
B.B. Put on glovesPut on gloves
C.C. If needed, wipe the eye while closed with a tissueIf needed, wipe the eye while closed with a tissue• Wipe from the inner corner of eye outward once Wipe from the inner corner of eye outward once • If working with both eyes, use a If working with both eyes, use a separateseparate clean clean
tissue for each eye tissue for each eye
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Ophthalmic (Eye) Ophthalmic (Eye) Medication Administration Medication Administration
continuedcontinued
D.D. Prepare the medication for Prepare the medication for administrationadministration
E.E. Tilt the student’s head back and Tilt the student’s head back and have student look up and awayhave student look up and away
F.F. Gently pull down the lower lid to Gently pull down the lower lid to administer the medicationadminister the medication
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
FOR DROPS:FOR DROPS: DO NOT touch the any part of the eye medication DO NOT touch the any part of the eye medication
against anything (including the eye)against anything (including the eye) Instill drops into the inner corner of the eye, not directly Instill drops into the inner corner of the eye, not directly
onto the eyeball.onto the eyeball. Have the student open their eye and tilt head so drops roll Have the student open their eye and tilt head so drops roll
into eyeinto eye Approach the eye from below, yet level, with the dropper Approach the eye from below, yet level, with the dropper
remaining outside the student’s field of visionremaining outside the student’s field of vision Do not point dropper toward the eye or touch the eye at Do not point dropper toward the eye or touch the eye at
any timeany time
Ophthalmic (Eye) Ophthalmic (Eye) Medication Administration Medication Administration
continuedcontinued
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
FOR OINTMENT: FOR OINTMENT: Apply by squeezing a small layer along the Apply by squeezing a small layer along the
inner, lower lidinner, lower lid Apply amount of ointment prescribed Apply amount of ointment prescribed
(usually about ½ inch long “ribbon” of (usually about ½ inch long “ribbon” of ointment)ointment)
Break off ribbon of ointment from the tube Break off ribbon of ointment from the tube by relaxing the pressure on the tubeby relaxing the pressure on the tube
Do NOT use your fingers!Do NOT use your fingers!
Ophthalmic (Eye) Ophthalmic (Eye) Medication Administration Medication Administration
continuedcontinued
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
IF BOTH EYES INVOLVED:IF BOTH EYES INVOLVED: Give the student a separate clean tissue Give the student a separate clean tissue
for each eyefor each eye Change gloves between eyes to avoid Change gloves between eyes to avoid
cross contamination cross contamination
Ophthalmic (Eye) Ophthalmic (Eye) Medication Administration Medication Administration
continuedcontinued
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
G.G. After putting in medication, allow the After putting in medication, allow the student to close the eye gently for a few student to close the eye gently for a few minutesminutes– Discourage rubbing the eyeDiscourage rubbing the eye– If needed, wipe eye with a tissue, using If needed, wipe eye with a tissue, using
separate tissue for each eyeseparate tissue for each eye
Return to the Basic Guidelines for Return to the Basic Guidelines for Medication Administration Procedure and Medication Administration Procedure and
complete steps 10-14 complete steps 10-14
Ophthalmic (Eye) Ophthalmic (Eye) Medication Administration Medication Administration
continuedcontinued
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Otic (Ear) Medication Otic (Ear) Medication AdministrationAdministration
Follow steps 1-8 of the Basic Guidelines for Follow steps 1-8 of the Basic Guidelines for Medication Administration Procedure, then: Medication Administration Procedure, then:
A.A. Compare medication container label and Compare medication container label and MAR MAR (3(3rdrd check) check)
B.B. Position the student by sitting or lying Position the student by sitting or lying down, tilting head sideways until ear is as down, tilting head sideways until ear is as horizontal as possiblehorizontal as possible
C.C. Put on glovesPut on gloves
D.D. If needed, clean the entry to the ear canal If needed, clean the entry to the ear canal with a tissue. with a tissue.
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Otic (Ear) Medication Otic (Ear) Medication Administration Administration continuedcontinued
E.E. DO NOT touch the dropper against anything, DO NOT touch the dropper against anything, including the earincluding the ear
F.F. Pull the mid-outer ear gently back and up Pull the mid-outer ear gently back and up
G.G. Put the prescribed number of drops into the ear Put the prescribed number of drops into the ear – Encourage student to remain with head tilted Encourage student to remain with head tilted
position for 2-3 minutesposition for 2-3 minutes– If ordered, may place a cotton ball loosely in If ordered, may place a cotton ball loosely in
the ear canal for 30-60 minutesthe ear canal for 30-60 minutesReturn to the Basic Guidelines for Medication Return to the Basic Guidelines for Medication Administration Procedure and complete steps Administration Procedure and complete steps
10-14 10-14
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Nasal (Nose) Medication Nasal (Nose) Medication AdministrationAdministration
Follow steps 1-8 of the Basic Guidelines for Follow steps 1-8 of the Basic Guidelines for
Medication Administration Procedure, then:Medication Administration Procedure, then: A.A. Compare medication container label and Compare medication container label and
Medication Administration Record (MAR) Medication Administration Record (MAR) ((33rdrd check check))
B.B. Put on glovesPut on gloves
C.C. Give tissue for potential excess dripping Give tissue for potential excess dripping on face on face – Tell student not to blow nose for at least 15 Tell student not to blow nose for at least 15
minutes after medication administrationminutes after medication administration
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Nasal (Nose) Medication Nasal (Nose) Medication AdministrationAdministration
D.D. Put drops in nose per manufacturer’s instructionsPut drops in nose per manufacturer’s instructions– If using nasal spray, follow manufacturer’s If using nasal spray, follow manufacturer’s
instructionsinstructions
F.F. Again, remind student not to blow nose for at Again, remind student not to blow nose for at least 15 minutes after medication administrationleast 15 minutes after medication administration
Return to the Basic Guidelines for Medication Return to the Basic Guidelines for Medication Administration Procedure and complete steps Administration Procedure and complete steps
10-14 10-14
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Topical (Skin) Medication Topical (Skin) Medication AdministrationAdministration
Follow steps 1-8 of the Basic Guidelines for Follow steps 1-8 of the Basic Guidelines for
Medication Administration Procedure, then:Medication Administration Procedure, then: A.A. Compare medication container label and MAR Compare medication container label and MAR (3(3rdrd
check)check)
B.B. Put on glovesPut on gloves
C.C. If needed, remove dressing or medication patch If needed, remove dressing or medication patch carefully so as not to tear skincarefully so as not to tear skin– Dispose of properlyDispose of properly
D.D. If ordered, wash the area with soap and water If ordered, wash the area with soap and water and dry welland dry well
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Topical (Skin) Medication Topical (Skin) Medication Administration Administration continuedcontinued
E.E. Put on medication according to prescriber and Put on medication according to prescriber and manufacturer directionsmanufacturer directions
– If directed, put the new patch or dressing in a If directed, put the new patch or dressing in a different placedifferent place
F.F. If the patch or dressing falls off before it is due If the patch or dressing falls off before it is due to be replaced, notify the appropriate health to be replaced, notify the appropriate health care professional or supervisor for instructionscare professional or supervisor for instructions
Return to the Basic Guidelines for Medication Return to the Basic Guidelines for Medication Administration Procedure and complete steps 10-14 Administration Procedure and complete steps 10-14
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Rectal Medication Rectal Medication AdministrationAdministration
Follow steps 1-8 of the Basic Guidelines for Follow steps 1-8 of the Basic Guidelines for
Medication Administration Procedure, then:Medication Administration Procedure, then: A.A. Compare medication container label and MAR Compare medication container label and MAR
(3(3rdrd check) check)
B.B. Ask the student to urinate and/or move Ask the student to urinate and/or move his/her bowels, if possible, before inserting his/her bowels, if possible, before inserting suppository suppository
C.C. Provide privacyProvide privacy
D.D. Encourage relaxation while speaking calmlyEncourage relaxation while speaking calmly
E.E. Put on glovesPut on gloves
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Rectal Medication Rectal Medication Administration Administration continued continued
F.F. Unwrap suppository or prepare cream/gel Unwrap suppository or prepare cream/gel with applicator as directedwith applicator as directed
G.G. Lubricate the suppository or applicator tip Lubricate the suppository or applicator tip with a water-soluble gelwith a water-soluble gel
H.H. Position student according to directions Position student according to directions – If instructions do not specify, have If instructions do not specify, have
student lie on left side facing you student lie on left side facing you
I.I. Lower clothing to expose the buttocks Lower clothing to expose the buttocks
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
J.J. Position, keeping lower leg straight and upper Position, keeping lower leg straight and upper leg bent forwardleg bent forward
K.K. Separate the buttocks to further expose the Separate the buttocks to further expose the rectumrectum
L.L. Gently insert the suppository with a finger or Gently insert the suppository with a finger or insert applicator until suppository or applicator insert applicator until suppository or applicator passes through the rectal sphincter muscle passes through the rectal sphincter muscle
– Approximately ½ inch in children under age Approximately ½ inch in children under age 12 or 1 inch for student over age 1212 or 1 inch for student over age 12
Rectal Medication Administration Rectal Medication Administration continuedcontinued
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
M.M. If applicator is used to insert medication, push the plunger If applicator is used to insert medication, push the plunger to insert the medication and gently remove, holding the to insert the medication and gently remove, holding the student’s buttocks together for 3 to 5 minutesstudent’s buttocks together for 3 to 5 minutes
– Encourage the student to hold the medication inside Encourage the student to hold the medication inside the rectum (without moving bowels) for as long as the rectum (without moving bowels) for as long as possible, or according to the health care provider or possible, or according to the health care provider or medication directionsmedication directions
– Observe student according to health care provider Observe student according to health care provider instructionsinstructions
N.N. Wipe the buttocks with a tissue if needed and dispose of Wipe the buttocks with a tissue if needed and dispose of applicator.applicator.
Return to the Basic Guidelines for Medication Administration Return to the Basic Guidelines for Medication Administration Procedure and complete steps 10-14 Procedure and complete steps 10-14
Rectal Medication Administration Rectal Medication Administration continuedcontinued
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Inhaler Medication Inhaler Medication AdministrationAdministration
Follow steps 1-8 of the Basic Guidelines for Follow steps 1-8 of the Basic Guidelines for Medication Administration Procedure, Medication Administration Procedure,
then:then: A.A. Compare medication container label and MAR Compare medication container label and MAR
(3(3rdrd check) check)
B.B. Ensure that student is in upright positionEnsure that student is in upright position
C.C. Shake inhaler well for 2-5 secondsShake inhaler well for 2-5 seconds
D.D. Have student take a deep breath and exhale Have student take a deep breath and exhale completelycompletely
E.E. Press lips firmly around inhaler or holding Press lips firmly around inhaler or holding device device
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Inhaler Medication Administration Inhaler Medication Administration continuedcontinued
1.1. Inhale slowlyInhale slowly
2.2. As student is inhaling, press down on As student is inhaling, press down on canistercanister
3.3. After pressing down, have student continue After pressing down, have student continue to inhale for 5 seconds to inhale for 5 seconds
4.4. Hold breath for additional 10 secondsHold breath for additional 10 seconds
5.5. Remove mouth piece Remove mouth piece
6.6. Exhale slowly Exhale slowly
F. Instruct student as follows:
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
I.I. Have student inhale deeply and slowlyHave student inhale deeply and slowly
1.1. ALERT: If student inhales too quickly ALERT: If student inhales too quickly through the spacer, the device will make through the spacer, the device will make a whistling sound. If whistling sound a whistling sound. If whistling sound occurs, remind student to inhale more occurs, remind student to inhale more slowlyslowly
2.2. Have student hold breath for 10 seconds Have student hold breath for 10 seconds and exhale slowly and exhale slowly
3.3. Inhale and exhale once more with spacer Inhale and exhale once more with spacer intactintact
If Using Inhaler with Holding Device If Using Inhaler with Holding Device (Spacer or Chamber) (Spacer or Chamber) continuedcontinued
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Inhaler Medication Administration Inhaler Medication Administration continuedcontinued
J.J. If more than one puff is ordered If more than one puff is ordered – Wait 1-2 minutes between puffsWait 1-2 minutes between puffs– Repeat steps on previous slidesRepeat steps on previous slides
Return to the Basic Guidelines for Return to the Basic Guidelines for Medication Administration Medication Administration
Procedure and complete steps 10-Procedure and complete steps 10-14 14
Emergency Medication Emergency Medication AdministrationAdministration
Some students have a condition that might Some students have a condition that might require administration of emergency require administration of emergency medicationsmedications
These students should have an Individualized These students should have an Individualized Healthcare Plan (IHP) and Emergency Action Healthcare Plan (IHP) and Emergency Action Plan (EAP) written by the school nurse with Plan (EAP) written by the school nurse with the parents, staff and prescriberthe parents, staff and prescriber– The EAP tells school staff how to recognize The EAP tells school staff how to recognize
an emergency situation and how to take an emergency situation and how to take care of the student in that situationcare of the student in that situation
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Emergency Medication Emergency Medication AdministrationAdministration
Common types of illnesses that might Common types of illnesses that might require emergency medication require emergency medication administration include:administration include:– AsthmaAsthma– DiabetesDiabetes– AllergiesAllergies– EpilepsyEpilepsy
Emergency medications may be inhaled, Emergency medications may be inhaled, injected or given rectally or nasallyinjected or given rectally or nasally
All school staff should be trained to All school staff should be trained to administer emergency medicationadminister emergency medicationOhio Department of Health Medication Administration in Ohio Schools: Training for School
Personnel
Emergency Medication Emergency Medication AdministrationAdministration
Ohio law permits some students to self-carry Ohio law permits some students to self-carry selected emergency medicationsselected emergency medications– You must know which students self-carry their You must know which students self-carry their
medications and where they carry themmedications and where they carry them– You must know where the emergency You must know where the emergency
medications are for students who do not self-medications are for students who do not self-carrycarry
– Current law allows students to self-carry Current law allows students to self-carry asthma inhalers and epinephrine autoinjectors asthma inhalers and epinephrine autoinjectors
– Must have MAR in school clinic to self-carryMust have MAR in school clinic to self-carry
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Emergency Medication Emergency Medication AdministrationAdministration
ORC 3313.716 Inhaler PossessionORC 3313.716 Inhaler Possession If conditions are met, the student may If conditions are met, the student may
possess and use the inhaler at schoolpossess and use the inhaler at school Recommend back up inhaler at school Recommend back up inhaler at school
(not required)(not required) Click on the link to view how to Click on the link to view how to
administer an inhaler. administer an inhaler. Administering an inhaler with a spacer.
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Emergency Medication Emergency Medication AdministrationAdministration
ORC 3313.718 Epinephrine ORC 3313.718 Epinephrine Autoinjector PossessionAutoinjector Possession
If conditions are met, the student may If conditions are met, the student may possess and use the epinephrine possess and use the epinephrine autoinjector (Epi-pen) in schoolautoinjector (Epi-pen) in school
Law Law requires requires back-upback-up epinephrine epinephrine autoinjector at schoolautoinjector at school
Law states Law states must must always call 911 after always call 911 after use--no exceptionsuse--no exceptions
Recommend all school staff be trained Recommend all school staff be trained for emergency epinephrine usefor emergency epinephrine use
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Follow steps 1-8 of the Basic Guidelines for Follow steps 1-8 of the Basic Guidelines for Medication Administration Procedure, Medication Administration Procedure,
then: then: A.A. Compare medication container label and MAR Compare medication container label and MAR (3(3rdrd
check)check) – Do not prepare Glucagon until ready to useDo not prepare Glucagon until ready to use
B.B. Put on glovesPut on gloves
C.C. Get Glucagon Emergency Kit from locked storage areaGet Glucagon Emergency Kit from locked storage area
D.D. Remove the flip-off seal from the bottle (vial) of Remove the flip-off seal from the bottle (vial) of Glucagon powderGlucagon powder
E.E. Wipe rubber stopper on bottle with alcohol swabWipe rubber stopper on bottle with alcohol swab
Medication Administration: Medication Administration: Glucagon InjectionGlucagon Injection
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration: Medication Administration: Glucagon Injection Glucagon Injection continuedcontinued
F.F. Remove the needle protector from the syringeRemove the needle protector from the syringe
G.G. Inject the entire contents of the syringe into the Inject the entire contents of the syringe into the bottle of Glucagonbottle of Glucagon
H.H. Swirl bottle gently until Glucagon dissolves Swirl bottle gently until Glucagon dissolves completelycompletely– DO NOT USE unless the solution is clear and DO NOT USE unless the solution is clear and
of a water-like consistency of a water-like consistency – Draw all solution from the vial into the syringeDraw all solution from the vial into the syringe
I.I. Remove syringe from the bottleRemove syringe from the bottle
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration: Medication Administration: Glucagon Injection Glucagon Injection continued continued
Inject Glucagon immediately after mixingInject Glucagon immediately after mixing
J.J. Clean injection site on buttock, arm or thigh Clean injection site on buttock, arm or thigh with alcohol swabwith alcohol swab
K.K. Insert the needle into the loose tissue under Insert the needle into the loose tissue under the cleaned injection sitethe cleaned injection site
L.L. Inject all of the Glucagon solution Inject all of the Glucagon solution – There is no danger of overdoseThere is no danger of overdose
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration: Medication Administration: Glucagon Injection Glucagon Injection continued continued
M.M. Apply light pressure at the injection site and Apply light pressure at the injection site and withdraw the needlewithdraw the needle
N.N. Press an alcohol swab on the injection site Press an alcohol swab on the injection site
O.O. Turn the student on his/her sideTurn the student on his/her side– When an unconscious individual awakens, When an unconscious individual awakens,
he/she may vomithe/she may vomit– Turning the student on his/her side will Turning the student on his/her side will
prevent him/her from chocking when prevent him/her from chocking when vomitingvomiting
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
P.P. Unless you have other orders, feed the student AS Unless you have other orders, feed the student AS SOON as he/she awakens and is able to swallowSOON as he/she awakens and is able to swallow– Give the student a fast-acting source of sugar Give the student a fast-acting source of sugar
(such as a regular soft drink or fruit juice) AND a (such as a regular soft drink or fruit juice) AND a long-acting source of sugar (such as crackers and long-acting source of sugar (such as crackers and cheese)cheese)
Q.Q. Contact Emergency Medical Services (EMS-911) and Contact Emergency Medical Services (EMS-911) and parents immediately. parents immediately. Refer to prescriber’s orders Refer to prescriber’s orders for the student. for the student.
Return to the Basic Guidelines for Medication Return to the Basic Guidelines for Medication Administration Procedure and complete steps 10-Administration Procedure and complete steps 10-
14 14
Medication Administration: Medication Administration: Glucagon Injection Glucagon Injection continuedcontinued
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration: Medication Administration: Autoinjector (Epi-Pen)Autoinjector (Epi-Pen)
Epinepherine is a medication used to treat Epinepherine is a medication used to treat SEVERE allergic reactions. SEVERE allergic reactions.
Signs of a SEVERE allergic reaction areSigns of a SEVERE allergic reaction are Frequent clearing of the throat and or Frequent clearing of the throat and or
wheezing with breathingwheezing with breathing Swollen lips/tongueSwollen lips/tongue Severe stomach crampsSevere stomach cramps Pale colored skinPale colored skin
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration: Medication Administration: Autoinjector (Epi-Pen)Autoinjector (Epi-Pen)
Follow steps 1-8 of the Basic Guidelines for Follow steps 1-8 of the Basic Guidelines for Medication Administration Procedure, Medication Administration Procedure,
then: then:
A.A. Compare medication container label and Compare medication container label and MAR MAR (3(3rdrd check) check)
B.B. Put on glovesPut on gloves
The following instructions are for the Epi-The following instructions are for the Epi-pen. If you have a student with another pen. If you have a student with another brand of epinephrine — please follow brand of epinephrine — please follow those manufacturer’s instructionsthose manufacturer’s instructions
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Medication Administration: Medication Administration: Autoinjector (Epi-Pen)Autoinjector (Epi-Pen)
C.C. Remove from protective carrier caseRemove from protective carrier case
D.D. Grasp unit with the orange tip pointing Grasp unit with the orange tip pointing downwarddownward
E.E. Form fist around the unit (orange tip Form fist around the unit (orange tip down)down)
F.F. With the other hand, pull the blue safety With the other hand, pull the blue safety releaserelease
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
G.G. Hold orange tip near outer thighHold orange tip near outer thigh
H.H. Swing and firmly push the Epi-pen against outer Swing and firmly push the Epi-pen against outer thigh until it clicksthigh until it clicks– Should be perpendicular (at 90 degree angle) Should be perpendicular (at 90 degree angle)
against thigh against thigh – It is designed to inject through clothingIt is designed to inject through clothing
I.I. Hold firmly against thigh for approximately 10 Hold firmly against thigh for approximately 10 secondsseconds
J.J. Remove unit from thigh (the orange needle Remove unit from thigh (the orange needle cover will extend to cover needle) and massage cover will extend to cover needle) and massage the injection site for 10 secondsthe injection site for 10 seconds
Medication Administration: Medication Administration: Autoinjector (Epi-Pen)Autoinjector (Epi-Pen)
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
K.K. Always call 911 and seek medical Always call 911 and seek medical attention following administration, even if attention following administration, even if the student seems better. Send the used the student seems better. Send the used auto injector with the student to the auto injector with the student to the hospital.hospital.
Return to the Basic Guidelines for Return to the Basic Guidelines for Medication Administration Procedure Medication Administration Procedure
and complete steps 10-14 and complete steps 10-14
Autoinjector (Epi-Pen), Autoinjector (Epi-Pen), continuedcontinued
Ohio Department of Health Medication Administration in Ohio Schools: Training for School Personnel
Emergency Medication Emergency Medication AdministrationAdministration
ORC 3313.718 Epinephrine ORC 3313.718 Epinephrine Autoinjector PossessionAutoinjector Possession
If conditions are met, the student may If conditions are met, the student may possess and use the epinephrine possess and use the epinephrine autoinjector (Epi-pen) in schoolautoinjector (Epi-pen) in school
Law Law requires requires back-upback-up epinephrine epinephrine autoinjector at schoolautoinjector at school
Law states Law states must must always call 911 after always call 911 after use--no exceptionsuse--no exceptions
Recommend all school staff be trained Recommend all school staff be trained for emergency epinephrine usefor emergency epinephrine use
Thank you for your attention!Thank you for your attention!Please click on this link for a Please click on this link for a
Medication quiz You will need to print the You will need to print the quiz and answer the questions. Give the quiz and answer the questions. Give the completed quiz to the school nurse (Beth completed quiz to the school nurse (Beth Stoller MSN RN). When you are ready to Stoller MSN RN). When you are ready to meet with the school nurse for your final meet with the school nurse for your final
check-off, please schedule a meeting check-off, please schedule a meeting time by calling ext. 1315 or via email to time by calling ext. 1315 or via email to