Category J: Students
Procedure J3: Administering Medications
The Districts’ procedures for administering medications, prescription and non-prescription, shall be consistent with Massachusetts regulations 105 CMR 210.000 and guidelines from the Massachusetts Department of Public Health.
The administration of medications while at school or involved in school activities should take place only when a student’s health would be jeopardized without it. Medications may be administered by District staff or by the student under the following conditions:
Administration of Medications by District Staff
Medications may be administered by a nurse in school as outlined by the Massachusetts Department of Public Health (MDPH) and the Board of Registry of Nursing.
- All medications must be presented in their original containers and stored in the health office. The first dose of any medication cannot be given at school.
- Parent/guardian consent forms must be completed for each medication to be administered. A health care provider (HCP) must complete a written medication order for any medication prescribed for use for longer than a 10-day period. The prescription container will serve as a HCP order for any medication that is prescribed 10 days or fewer.
- Medication orders and parent/guardian consent will be kept on record by the nurse. Documentation of medication administration will be kept for all students who require medications on a regular or as-needed basis.
Delegation and supervision for purposes of administering medications will follow guidelines set by the MDPH.
Students may self-administer prescription medication at school provided that certain conditions are met per Massachusetts Department of Public Health.
- The student, school nurse and parent/guardian must enter into an agreement which specifies the conditions under which prescription medication may be self-administered. The nurse must determine that the student can safely administer the medication at school. The student must agree to see the nurse if he/she is not getting appropriate results from the medication or needs to use the medication in a way other than prescribed.
- The student must identify the appropriate medication, know the frequency and time of day for which the prescription medication is ordered, and agree to proper self-administration.
- The licensed prescriber must provide an order for self-administration of medication and the parent/guardian must provide consent.
- The student, parent/guardian, school nurse and other school personnel, if necessary, must agree to the safe storage of self-administered medication. Students may carry inhalers or other preventive or emergency medications with them, but are requested to provide a back-up supply in the school nurse’s office.
- The school nurse and student will agree to a monitoring plan for the safe use of self-administered medication and with parent/guardian and student permission, the school nurse may inform other school personnel that the student is self-administering a prescriptive medication.
Administration of Epinephrine
- Epinephrine will be given to a student or staff member who has been diagnosed with a life-threatening allergy. If the student or staff does not have a medication administration order on file in the health office, the District’s standing order from the school physician may be used. Properly trained non-licensed school personnel may administer epinephrine in the event of an emergency when a nurse is not available. (An individual health care plan will be developed for each student who has been diagnosed with a life-threatening allergic condition.)
- Epinephrine may be administered to a student or staff who has not been diagnosed with a life-threatening allergic condition by a registered nurse (this process requires an assessment) consistent with DESE guidelines. The District’s standing order from the school physician may be used.
- Upon administration of Epinephrine, 911 will be called immediately to obtain emergency medical care. The student’s or staff’s family, school administration and school nurse leader will be notified as soon as possible.
- The use of Epinephrine will be reported to the Massachusetts Department of Public Health.
Administration of Medications on Field Trips
The nurse should be given advance notice of field trips when trip arrangements are being planned.
The school nurse will prepare and package student medication with the first aid kit when given notice of a field trip. Classroom staff will be responsible for collecting any medication and first aid kit from the nurse’s office and for returning the supplies back to the nurse. The classroom staff will be made aware of any unusual student medical concerns. When necessary for the health and safety of students, a nurse may attend the field trip and administer medications.
With proper training, scheduled medication and Epinephrine may be delegated to unlicensed school staff. The school nurse will make decisions about delegation. The school district will obtain a waiver from the Massachusetts Department of Public Health for unlicensed school personnel to administer prescription medication on field trips and short-term special school events and waiver for unlicensed school personnel to administer Epinephrine in a life-threatening emergency. It will be the responsibility of the designated school staff person to administer the medication at the proper time and in the proper manner. Parent/guardian consent to notify classroom staff of student medication use will be verified.
Non-scheduled or PRN medication cannot be delegated to non-licensed school staff or sent on a fieldtrip when there is not a nurse on the trip.
Students may self-administer asthma inhalers (MDI).
Mass. Regulation 105 CMR 210.000 – The Administration of Prescription Medications in Public and Private Schools
POLICY JLCD: Administration Of Medications