Policy 8670: Administration of Medication by School Personnel (Rules)

Administration of Medication 

Medication may be administered to students only according to the following conditions indicated below. Parents/Guardians are urged to give medications at home and/or on a schedule other than during school hours. If it is necessary that medication be administered to students during school hours, the following regulations must be followed: 

1. Administration by School Personnel

   1. The parent/guardian must request in writing that the school administer medication in compliance with licensed prescriber's written instructions. Written instructions from the parent/guardian and licensed prescriber must include the name of the student, the name of the medication, dosage, time to be administered, route of administration, and the duration of administration and must accompany the medication. The parent/guardian or responsible adult must:
      1. Bring the medication in an original container or current prescription container directly to the school office and give the medication to an adult staff person; or
      2. Have the pharmacy from which the medication was purchased deliver the medication directly to an adult staff person in the school office.
   2. All controlled substance medications will be counted and recorded in the student’s health record upon receipt from the parent/guardian. Medications with expiration dates will also be noted in the student's health record.
   3. Nurses will coordinate administration of medications according to current guidelines found in The Revised School Code of Michigan and the District competency checklist.
   4. The medication must be administered by an administrator or staff person(s) designated by the administrator. Student nurses may administer student medication under constant, direct supervision of a GRPS school nurse
      1. The administrator will designate at least two people to administer all medication in the building with approval from the school nurse. Designation for medications administered via various routes such as inhalation, injections (subcutaneous, intramuscular, or intravenous), optic, otic, rectal, or gastrostomy must comply with the Delegation policy (#8482).
      2. School staff members and student nurses administering medication must satisfactorily complete the training provided by a Grand Rapids Public Schools school nurse. The training is to include District policy and procedures regarding medication administration and documentation of individual completion of training. Staff administering medications may be required to participate in training annually and as needed. Documentation of medication training shall be recorded with competency checklists kept on file with the delegating nurse.
      3. Medication must be administered in an appropriate place so as to preserve the dignity of the student. The school administrator, teacher, student nurse, or other school employee designated by the school administrator to administer the medication to the student, will administer the medication in the presence of another adult unless it is an emergency that threatens the life of the student. Another adult is not necessary if the individual administering medications is a licensed professional nurse as described by Michigan School Code, Section 380.1178.
      4. The individual student log of all medication administered shall be kept in written or electronic format for a period of seven years beyond the expected date of graduation. The log is to include the name of the student, medicine, dosage, time administered, and identification of the person administering the medication.
      5. If an error is made in recording, the individual who administered the medication shall cross out, initial the error, and make correction in the log.
      6. Medication must be kept in a locked container, drawer, or cabinet. Emergency medications may be stored in an area readily accessible to the individual designated to administer them. If emergency medications are NOT stored in the health office, the location where they are stored will be noted on the student's Emergency Action Plan.
      7. Field Trip Procedure- Individual student's medication will be placed in a Field Trip Envelope by a nurse. This envelope will be labeled with the date, student's name, medication name, dosage, and time of administration. This envelope will be carried by an adult staff member certified to administer medication.
      8. The administration of medication must cease at the written request of the parent/guardian or at the end of the time period of the prescription.
      9. Changes in the medication dosage may only be made according to the written instructions of the student's licensed prescriber and parent/guardian.
      10. The student's parent/guardian or adult students shall provide the school with a prescription renewal at least annually for students needing to receive medication over a length of time. Renewal orders and medication supply will be the responsibility of the parent/guardian or adult student.
      11. Medication left over at the end of the school year shall be picked up by the parent/guardian, a responsible adult, or sent home with responsible student after notifying parent. The school will appropriately dispose of the medication that is not picked up and record this disposal in the student health record. Disposals should be witnessed by a second adult and be documented.
      12. If an adverse reaction to the medication occurs, the parent/guardian should be notified and, if necessary, staff should call 911 for emergency services. The school nurse will be consulted first for any non-emergency concerns or questions.
   5. Nurses will evaluate administration of medications and provide annual reports to Student Services and Risk Management to adjust training and practice as indicated.
   6. The administration of emergency medication epinephrine auto-injector is allowable by the school nurse or designated school employee without immediate parental consent. Each school building will have at least 2 epinephrine auto-injectors available to be administered to any individual on school grounds who is believed to be having an anaphylactic reaction per a licensed prescriber's written instructions. A minimum of two staff members in every school building will be trained by the school nurse in the proper use of this medication. If the medication is administered, it is required that immediate notification be made to parent/guardian and 911 for emergency services.
      1. All instances of administration of an epinephrine auto-injector must be made to Michigan Department of Education on an annual basis.
   7. The administration of emergency medication opioid antagonist is allowable by the school nurse or designated school employee without immediate parental consent. Each school building will have at least 1 package of opioid antagonist available to be administered to any individual on school grounds who is believed to be having an opioid-related overdose per a licensed prescriber's written instructions. A minimum of two staff members in every school building will be trained by the school nurse in the proper use of this medication. If the medication is administered, it is required that immediate notification be made to parent/guardian and 911 for emergency services. The parent/guardian should also be encouraged to seek treatment for the individual from a substance use disorder services program.
      1. All instances of administration of an opioid antagonist must be reported to the Michigan Department of Education on an annual basis.

2. Administration by Student 

   While it is recommended that medication be administered according to the above conditions, students may keep medication with them and self-administer it under the following listed conditions. Self-administration shall be disallowed if there is misuse by the student.
   1. The parent/guardian or adult student must inform the school in writing that the student will have said medication (prescribed or non-prescribed) and will be self-administering. Notification must include exact dosage, the name of the student, name of the medication, time to be administered, route of administration, duration, and the written consent for self-administration by the licensed prescriber.
   2. The medication must be carried in a properly labeled container.
   3. Only enough medication for one (1) day may be kept by the student. However, students may carry inhalers or insulin that contain multiple doses.
   4. The medication must not be stored in the student's locker.
   5. A written request for student self-administration must be received annually or episodically. 
   6. Teachers will be informed of students who will be in possession of medications for self-administration.

3. Non-Compliance of Policy and Rules

   1. The parent/guardian will be notified of students observed with or taking medication in violation of this policy and rules.
   2. Discipline Policy #8350 will be followed where appropriate for violations of this policy and rules.
   3. Where the previously described conditions are not satisfied, staff shall refuse to continue the administration of the medication, unless failure to administer the medication would create a life-threatening situation. Where conditions are not satisfied, parents/guardians will be immediately notified that staff will not administer medications until conditions are satisfied.
   4. If an error is made in administering medications, such error must be reported immediately to the building administrator and the school nurse. The parent/guardian must be informed of the error and a physician consultation suggested. An incident report should be filed and a copy sent to Student Services.