Policy Statement—Guidance for the Administration of Medication in School

Abstract

Many children who take medications require them during the school day. This policy statement is designed to guide prescribing health care professionals, school physicians, and school health councils on the administration of medications to children at school. All districts and schools need to have policies and plans in place for safe, effective, and efficient administration of medications at school. Having full-time licensed registered nurses administering all routine and emergency medications in schools is the best situation. When a licensed registered nurse is not available, a licensed practical nurse may administer medications. When a nurse cannot administer medication in school, the American Academy of Pediatrics supports appropriate delegation of nursing services in the school setting. Delegation is a tool that may be used by the licensed registered school nurse to allow unlicensed assistive personnel to provide standardized, routine health services under the supervision of the nurse and on the basis of physician guidance and school nursing assessment of the unique needs of the individual child and the suitability of delegation of specific nursing tasks. Any delegation of nursing duties must be consistent with the requirements of state nurse practice acts, state regulations, and guidelines provided by professional nursing organizations. Long-term, emergency, and short-term medications; over-the-counter medications; alternative medications; and experimental drugs that are administered as part of a clinical trial are discussed in this statement. This statement has been endorsed by the American School Health Association. Pediatrics 2009;124:1244-1251 INTRODUCTIONSchool boards and districts are responsible for policies and procedures for administration of medications to students who require them during the school day. The health circumstances that require medication are diverse. Medical advances have enabled many students with special health care needs or chronic health conditions to be included in classes with their peers. 1 Some schools struggle to balance the need for health care services for increasing numbers of children with special health care needs with the current resources available to provide those services. [2][3][4][5][6][7][8][9][10][11][12] The presence in schools of a full-time licensed registered school nurse is strongly endorsed. 13 Registered nurses (RNs) have the knowledge and skills required for the delivery of medication, the clinical knowledge of the student's health, and the responsibility to protect the health

Parental Perspectives of Barriers to Physical Activity in Urban Schoolchildren With Asthma

“…Parental reports of the absence of clear policy around in-school asthma medication management was consistent with other studies. 10,11 The child should be allowed to carry and self-administer the inhaler in school if the proper documentation (AMAF) is provided 29 and the child’s physician, parent, and school nurse agree that the child can do so “in a responsible and secure manner.” 30 Quick access to asthma medications may positively contribute to the pre-exercise medication administration and provide rapid relief if the child develops EIA during PE class or recess.…”

The treatment-related experiences of parents, children and young people with regular prescribed medication

“…Challenges were identified with medication taken at school reflecting those previously described including access to medication and not wanting to take in front of peers [6, 17, 18]. Despite there being national guidance on medication in schools in the UK [19] and USA [20] poor experiences remain. A survey in Finland found inconsistencies in local school policies on medication [21].…”

Diabetes Care in the School and Day Care Setting

“…To facilitate the appropriate care of the student with diabetes, the school nurse as well as other school and day care personnel must have an understanding of diabetes and must be trained in its management and in the treatment of diabetes emergencies (3,18,19,20,34,36). Knowledgeable trained personnel are essential if the student is to avoid the immediate health risks of low blood glucose and to achieve the metabolic control required to decrease risks for later development of diabetes complications (3,20).…”