Medication Administration in Schools
Our district is committed to ensuring the health and safety of students requiring medication during school hours or at school-sponsored events.
Key Definitions
- Medication includes prescription drugs, over-the-counter medicines, and nutritional supplements.
- Administration means taking or helping someone take medication by mouth, injection, or application.
- Self-administration is when a student carries and takes their own medication, approved for conditions like asthma, severe allergies, or adrenal insufficiency.
- A life-threatening illness is a condition requiring immediate response to prevent serious harm or loss of life.
- A pre-filled auto-injector mechanism containing epinephrine is a device used for emergency treatment of severe allergic reactions (anaphylaxis).
- A non-certified nurse is a licensed registered nurse employed by the district but not certified as a school nurse by the state.
- A substitute school nurse is a licensed registered nurse serving temporarily in place of a certified school nurse.
- A school physician is a licensed doctor contracted or employed by the district.
- An advanced practice nurse is a licensed nurse practitioner or clinical nurse specialist.
- A certified school nurse is a licensed registered nurse with a specific school nurse certification from the state.
Permission for Medication by School Nurse or Registered Nurse
Medication will only be given at school or school events when absolutely necessary for a student’s health and safety. Students who are too ill or have a contagious disease should not attend school.
Parents must submit a written request and a signed statement from the student’s doctor. This statement needs to include:
- Student’s name.
- Medication name, purpose, dosage, and timing.
- Possible side effects.
- When the medication will be discontinued.
- Confirmation the student is fit for school and free of contagious disease.
- A statement that the student cannot attend school without this medication being given during school hours.
Requests must be approved by the Superintendent or a designated staff member, who may consult with the school nurse and physician. Approved requests are confirmed in writing. Denied requests will include a reason.
Emergency Epinephrine Administration
Parents can authorize emergency epinephrine administration for anaphylaxis. This requires:
- Written parental authorization.
- Written orders from a doctor or advanced practice nurse.
- Parental acknowledgment that the district and its staff are not liable for injuries resulting from epinephrine administration and that the parent will protect the district from such claims.
- Permission is valid for one school year and must be renewed annually.
The Superintendent or designee will ensure:
- Prescribed epinephrine is kept in a secure, unlocked, and easily accessible location for school nurses and trained staff, with its location noted in the student’s emergency care plan. Back-up epinephrine should also be available.
- A school nurse or trained staff member is available at school and school-sponsored functions for allergic emergencies.
- The student is transported to an emergency room after epinephrine administration, even if symptoms seem to resolve.
Additionally, a school nurse or trained staff member may administer epinephrine to any student believed to be having an anaphylactic reaction, even without prior authorization, if they believe in good faith the student is experiencing a reaction. Each school will maintain a supply of epinephrine auto-injectors under a standing doctor’s or advanced practice nurse’s order for emergency use.
The school nurse is primarily responsible for administering epinephrine. They will, in consultation with the Board of Education, train and designate other volunteer staff to administer epinephrine when the nurse is not present. Designated staff must be properly trained using state-established protocols, and parental consent and liability waivers are required. This permission is also renewed annually.
No school employee, nurse, or district official acting in good faith will be held liable for administering epinephrine as outlined.
Emergency Hydrocortisone Sodium Succinate Administration
The district permits emergency hydrocortisone sodium succinate administration for students with adrenal insufficiency, provided:
- Written parental authorization.
- Written orders from a doctor or advanced practice nurse.
- Parental acknowledgment that the district and its staff are not liable for injuries resulting from administration and that the parent will protect the district from such claims.
- Permission is valid for one school year and must be renewed annually.
This medication will be:
- Kept in a secure, unlocked, and easily accessible location for the school nurse and trained staff, with its location noted in the student’s emergency care plan. Back-up medication, provided by the parent, will also be available.
- A school nurse or trained staff member will be promptly available during emergencies.
- The student will be transported to an emergency room after administration, even if symptoms seem to resolve.
The school nurse is primarily responsible and will designate and train other volunteer staff for administration when the nurse is absent. Designated staff must be properly trained, and parental consent and liability waivers are required, renewed annually.
No school employee, nurse, or district official acting in good faith will be held liable for administering hydrocortisone sodium succinate as outlined.
Self-Administration of Medication
Students with asthma, other potentially life-threatening illnesses, severe allergies, or adrenal insufficiency may be allowed to self-administer medication. This requires:
- Written parental authorization.
- Written certification from the student’s doctor confirming the condition and that the student is capable of and trained in self-administration. This includes medication details, possible side effects, and confirmation the student cannot attend school without self-administering.
- Parental acknowledgment that the district and its staff are not liable for injuries from self-administration and that the parent will protect the district from such claims.
The Principal or designee, along with the school nurse and school physician, will review the request to determine if the student is capable. Approved requests are confirmed in writing. Permission for one medication does not extend to others, and permission must be renewed annually.
Medication Storage
- For medication administered by school staff: Parents must deliver all medication in its original, labeled container. The school nurse will store it securely. Unused medication must be picked up by the parent. If not picked up promptly after the school year or two weeks after discontinuing, it will be safely disposed of by the school nurse.
- For self-administered medication: Students must keep their medication in their possession. It must be in a sealed, clearly labeled container with the medication name, dosage, and ordering doctor. The medication should not be severely harmful if accidentally ingested by another person. Students may only carry the amount needed for the school day and are permitted to carry inhalers, epinephrine auto-injectors, or adrenal insufficiency medication at all times, provided they do not misuse it.
Medication Administration Procedures
- Medication will only be administered or taken at school as outlined here.
- Only the school physician, certified or non-certified school nurse, substitute school nurse, approved self-administering students, or trained staff for emergency epinephrine or hydrocortisone sodium succinate will administer medication.
- When possible, self-administration should be observed by the school nurse.
- Students who self-administer must report each instance and any side effects to a staff member, who will then report it to the school nurse within 24 hours.
- If a student requires medication at a school-sponsored event where the school nurse cannot attend, the parent will be invited. If neither can attend and the student is not approved for self-administration, the student may be excused from the event if there’s a risk of injury from lack of medication.
Emergencies
Medical emergencies involving medication will follow established first aid procedures and, when appropriate, the school physician’s standing orders for nurses. Students will be transported to an emergency room after emergency epinephrine or hydrocortisone sodium succinate administration.
Records and Notification
The school nurse will maintain a student’s health record including:
- Approved medication requests.
- A record of each medication administration by school staff.
- Reports of student self-administration.
- Any side effects.
- Information on medication disposal if not retrieved by the parent.
The school nurse may share relevant medication information with the Principal and teachers for the student’s educational benefit. They will provide staff with a list of students approved for self-administration. The school nurse will inform parents of any difficulties or side effects and report any student appearing to be negatively affected by medication to the school physician.
For further clarification, please refer to the North Hunterdon-Voorhees District & Board of Education Policies and Regulations.
