NASN’s Medication Administration Clinical Guideline

Abstract

Despite the volume of medications that are administered in schools, school nurse guidelines for administering medications in schools lacked the support of empirical literature to guide best practices. Some states issue guidelines that summarize state regulations or dictate the standards and processes. However, state school nursing manuals rely on tradition and professional judgment for suggested medication practices. Medication practices may vary significantly from building to building within a school district. The National Association of School Nurses commissioned a uniform clinical practice guideline (CPG) for the administration of medications in schools based on a systematic review of the literature. The CPG for medications administered in schools provides direction for state school nurse consultants, school districts, and nurses working independently in schools by creating the structure and processes of care to lead to optimal outcomes including increased medication adherence, fewer errors, and decreased morbidity and mortality. The School Nursing Evidence-Based Clinical Practice Guideline: Medication Administration in Schools guide school policy and provide evidence for policy changes for state legislation.

School Nursing Guide for student health promotion: construction and validity

“…From this perspective, school nurses need evidence-based Clinical Practice Guides to provide systematic and quality care to students. However, there is a scarcity of school nursing guides ( 8 ) , although there are some protocols and therapeutic guidelines to guide nurses’ practice in the care of students with needs and in specific clinical situations, such as drug administration ( 9 ) , use of epinephrine ( 10 ) , convulsion, epilepsy ( 11 ) and asthma ( 12 ) . We identified only one guideline to increase physical activity in early childhood education schools up to 8th grade, which had the participation of a school nurse ( 13 ) .…”

Guia de Enfermagem Escolar para promoção da saúde de jovens estudantes: construção e validação

“…Nessa perspectiva, os enfermeiros escolares precisam de Guias de Prática Clínica baseadas em evidências, para fornecer atendimento sistemático e de qualidade aos alunos. No entanto, observa-se escassez de guias de enfermagem escolar (8) , apesar de existirem alguns protocolos e diretrizes terapêuticas para orientar as práticas dos enfermeiros no atendimento de estudantes com necessidades e em situações clínicas específicas, como administração de medicamentos (9) , uso de epinefrina (10) , convulsão, epilepsia (11) e asma (12) . Identificamos somente uma diretriz para aumentar a atividade física nas escolas de educação infantil até a 8ª série, que teve a participação de enfermeira escolar (13) .…”

Education is not Enough

“…The key to changing behavior is to alter the environment or processes to make it easier to adopt the new practice or procedure than to continue old habits (Duhigg, 2012; Thaler & Sunstein, 2008 Vogus & Hilligoss, 2016). Some examples of altering the care environment that could prompt nurses to adopt the standard of care for medication in schools are changing forms and electronic health records to only record students’ weights in kilograms; purchasing scales that only measure student weight in kilograms; stocking only medication measuring devices designed for liquid medication dosing (Bergren, 2021). Audits and self-audits of school health offices, activities, and students’ records are also an effective strategy for quality improvement (Bergren, 2021; Cross et al, 2021; Spina et al, 2012).…”

“…Some examples of altering the care environment that could prompt nurses to adopt the standard of care for medication in schools are changing forms and electronic health records to only record students’ weights in kilograms; purchasing scales that only measure student weight in kilograms; stocking only medication measuring devices designed for liquid medication dosing (Bergren, 2021). Audits and self-audits of school health offices, activities, and students’ records are also an effective strategy for quality improvement (Bergren, 2021; Cross et al, 2021; Spina et al, 2012). Checklists for screenings and referrals are trusted tools for reinforcing best practices (Gawande, 2009; School-Located Vaccination: School Nurse Planning Checklist, 2022).…”

“…and students' records are also an effective strategy for quality improvement (Bergren, 2021;Cross et al, 2021;Spina et al, 2012). Checklists for screenings and referrals are trusted tools for reinforcing best practices (Gawande, 2009;School-Located Vaccination: School Nurse Planning Checklist, 2022).…”