Administration of Medications in Schools

Brookline Public Schools requires medical orders and parental consent for all medications, which are managed by school nurses and can only be delegated to trained staff under specific conditions.

SECTION E STUDENT SERVICES E 2 d. Administration of Medications in Schools and Delegation of Administration of Prescription Medications: (11/10/11, #11-72; 3/26/26, #26-39) The purpose of this policy is to provide minimum standards for the safe and proper administration of medications to students in the Public Schools of Brookline (“PSB”), consistent with G.L. c. 94C, s. 7(g); G.L. c. 71, s. 54B, and 105 CMR 210.000, et seq. I. MANAGEMENT AND APPLICATION OF THE MEDICATION ADMINISTRATION PROGRAM This policy applies to the administration of all prescription medications, “over the counter” medications, investigational new drugs, and herbal, vitamin or holistic supplements or remedies (herein, collectively referred to as, “medications”) by PSB personnel to students during school or during school sponsored day or overnight field trips, and to the self-administration of such medications, drugs and supplements or remedies by PSB students during school or at such school sponsored events. The PSB Coordinator of School Health Services shall serve as the Medication Program Manager, managing and supervising the medication administration program in the PSB. The school nurse shall manage and supervise the medication administration program in each school [210 CMR 210.003(A)(1)]. II. POLICY FOR THE ADMINISTRATION OF MEDICATION AT SCHOOL Medications will be administered to students at school only when such administration is determined by the Coordinator of School Health Services, after consultation with the school physician, to be medically necessary to permit a student to access his or her educational program. A. Responsibility for Policy and Procedure Development and Approval The Coordinator of School Health Services, in consultation with the school physician, shall develop and propose, for approval by the School Committee, policies and procedures for the administration of medication and self-administration of medication within the PSB. These policies and procedures shall be consistent with the provisions of G.L. c. 94C, s. 7(g); G.L. c. 71, s. 54B, and 105 CMR 210.000, and shall be reviewed and revised as needed, but at least every two years [105 CMR 210.003(A)]. B. Documentation of the Administration of Prescription Medication Each school where medications are administered by school personnel shall maintain a medication administration record for each student who receives medication during school hours. The medication administration record shall be maintained by the school nurse and shall include a daily log and a medication administration plan, including the medication order and parent/guardian authorization. [105 CMR 210.009] C. Response to Medication Emergencies Consistent with 105 CMR 210.005(F)(4), the school nurse shall develop procedures for responding to medication emergencies, including any reaction or condition related to medication administration, which poses an immediate threat to the health or well-being of the student. Such procedures shall include maintaining a list of persons, with their telephone numbers, to be contacted as appropriate, including, but not limited to, the student’s parent/guardian, school nurse, licensed prescriber and other persons designated in the student’s medication administration plan. Such persons may include other school personnel, the school physician, clinic or emergency room staff, ambulance services and the local poison control center. D. Storage of Prescription Medications Consistent with 105 CMR 210.003(A)(4), the coordinator of School Health Services shall develop procedures for the proper storage of medications at school. E. Reporting and Documentation of Medication Errors Consistent with 105 CMR 210.005(F)(5), the school nurse shall develop procedures and forms for documenting and reporting medication errors. F. Self-Administration of Medication Consistent with 105 CMR 210.006, students may self-administer medications at school, provided the requirements of 105 CMR 210.006 are met. The Coordinator of School Health Services shall develop procedures for the self-administration of medications at school. G. Dissemination of Information to Parents/Guardians An outline of the school’s medication policies shall be made available to parents/guardians upon request. [105 CMR 210.003(A)(6)] Such outline shall be posted on the PSB website and shall be available in accessible format in each school clinic. H. Dispute Resolution In accordance with standard nursing practice, the school nurse may refuse to administer or allow to be administered any medication, which, based on her/his individual assessment and professional judgment, has the potential to be harmful, dangerous or inappropriate. In these cases, the parent and licensed prescriber shall be notified immediately by the school nurse and the reason for refusal explained. In the event of a dispute concerning the administration of a medication, the disputing party shall make a written request for review of the dispute to the Coordinator of School Health Services, who will investigate the matter and, following consultation with the school nurse and the school physician (as defined in 105 CMR 210.002), issue a decision. The decision of the Coordinator of School Health Services shall be final. III. POLICY REGARDING THE DELEGATION OF PRESCRIPTION MEDICATION ADMINISTRATION A. Delegation and Supervision During such time as the PSB continues to be registered with the Department of Public Health pursuant to the applicable provisions of 105 CMR 700.000 and is otherwise in compliance with the requirements of 105 CMR 210.000, the school nurse may delegate the administration of non- parenteral medications to students during regular school activities, including but not limited to school sponsored day or overnight field trips. The administration of parenteral medications may not be delegated or administered by training with the exception of epinephrine or injectable glucagon in an FDA pre-approved, pre-dosed autoinjector administered in accordance with 105CMR210.100. These unlicensed school personnel must meet the requirements of 105 CMR 210.004, be trained and tested for competency in accordance with 105 CMR 210.100 and 210.007, be supervised by the school nurse and be listed on the student’s medication administration plan developed in accordance with 105 CMR 210.005 and 210.007. The school nurse may rescind the delegation of specific personnel at any time [210.005(G)(1)]. Neither prescription medication nor over-the-counter medications can be administered by delegation by unlicensed school personnel without student-specific medications from a licensed prescriber. A school nurse shall be on duty while medications are being administered by designated unlicensed school personnel, and available telephonic or virtually should consultation be required. B. Training of School Personnel School personnel who are responsible for administering medications at school shall be trained in accordance with 105 CMR 210.007.