Carthage R-IX

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R 2870 Administering Medicines to Students

The district prohibits the use, sale, transfer, possession or self-administration of any medications by students while on district grounds, on district transportation or during district activities unless explicitly authorized in accordance with this regulation. Therefore, administrative procedures have been established for storing and administering medications in compliance with this regulation and pursuant to state and federal law. Medications will only be administered at school when it is not possible or not effective for the student to receive the medication at home.

Students who possess or consume medications in violation of this regulation while on district grounds, on district transportation or during a district activity may be disciplined up to and including suspension or expulsion. Employees who violate this regulation may be disciplined up to and including termination. District administrators will notify law enforcement when they believe a crime has occurred.

Prescription Medication

The student's parent shall provide a written request that the student be given medication during school hours. The request shall state the name of the student, name of drug, dosage, frequency of administration, route of administration, and the parent's signature. The diagnosis/indication for use of the medicine shall be provided. When possible, the parent should state adverse effects and applicable emergency instructions.

The District will accept only a medication with the prescription label properly affixed to the medication. The label must contain the name of the student, name of the drug, dosage, frequency of administration, route of administration, and the prescriber's name.

The District will not administer the initial dose of any new prescription except in an emergency.

No more than a month's supply of prescription medication will be kept at school.

Prescription medication is to be in the most current pharmacy-labeled bottle. Prescription drugs will be administered up to one (1) year after the date on the prescription label.

Injectable medications will be administered by the nurse unless written permission is received from the physician and the parent/guardian that the student may self-administer. The self-administration of medication form must be signed by the physician, parent and student. Should an injectable medication be necessary when the school nurse is not available, the 911 (EMS) system should be activated.

Over-the-Counter Medication

The District will not supply over-the-counter medications at any time.

Administration of over-the-counter medication does not require a prescription provided one administers the medication according to the specific directions outlined on the manufacturer's label and the annual permission form has been signed by the parent/guardian.

The District will not administer the initial dose of any over-the-counter medications except in an emergency. Unless a written doctor's order is provided, no aspirin or medication containing aspirin (salicylate) will be administered due to the possibility of Reye's Syndrome, a serious illness reported to be associated with aspirin use in children and teenagers.

Over-the-counter medication must be in the original container with the original label and instructions for administration intact.

Emergency Medication

Written standing orders will be obtained annually for the administration of emergency medication.

Epi-pens may be administered by nonlicensed personnel provided a registered nurse has delegated the responsibility and provided appropriate training on an annual basis. Trained employees administering life-saving methods will be immune from civil liability for administering life-saving methods in good faith consistent with standard medical practices.

Storage and Administration of Medication

A parent/guardian or other responsible adult party designated by the parent/guardian will deliver all medication to be administered at school to the school nurse or designee for students pre-kindergarten through eighth grade with the exception of metered dose inhalers. All medication, prescription or over-the-counter, must be in a pharmacy or manufacturer-labeled container. The District shall provide secure, locked storage for medication to prevent diversion, misuse, or ingestion by another individual.

The administration of medication, including over-the-counter medications, is a nursing activity, governed by the State of Missouri Nursing Practice Act. It must be performed by the registered professional school nurse. The nurse may delegate and supervise the administration of medication by unlicensed personnel who are qualified by education, knowledge and skill to do so. The registered nurse must provide and document the requisite education, training, and competency verification. The nurse is also empowered to contact the prescriber or pharmacist filling the prescription to discuss the prescription if the nurse has questions regarding the administration of such medication. Qualified employees will be held harmless and immune from civil liability for administering medication or medical services in good faith and according to standard medical practices.

School employees who are not qualified according to standard medical practices will not be required to administer medications or medical services. Such unqualified employees who refuse to administer medications or medical services will not be subject to disciplinary action for such refusal.

Self-Administration of Medication

Students with asthma, anaphylaxis, or any chronic health condition may carry with them for self-administration metered-dose inhalers or auto-injectible epinephrine for self-administration in the event of an asthma or anaphylactic emergency. Possession and self-administration of these prescription medications must comply with the Missouri Safe Schools Act, 1996. The directives of this Act will be given to each parent/guardian who requests that his/her student be permitted to carry and self-administer such medication. A permission form for self-administration (Form 2870) is required. Provided however, that:

  1. A licensed physician has prescribed or ordered such medications for use of the student and has instructed the student in the correct and responsible use of such medications;
  2. The student has demonstrated to the student's licensed physician or designee and the school nurse the skill level necessary to use the medications and any device necessary to administer such medications;
  3. The student's physician has appended and signed a written treatment plan for managing asthma and anaphylaxis episodes of the student and for medications for use by the student. Such plan will include a statement that the student is capable of self-administering the medication under the treatment plan;
  4. The student's parent/guardian has completed and submitted to the school the student's treatment plan and liability statement; and
  5. The student's parent/guardian has signed a statement acknowledging that the District and its employees or agents will incur no liability as a result of any injury arising from self-administration of medication by the student or administration of such medication by school staff. (see Form 2870.1)

The authorization for the possession and self administration of medication to treat a student's asthma or anaphylaxis permits authorized students to possess and self administer such student's medication while in school, at a school sponsored activity, and in transit from school or school sponsored activity. Such authorization will be effective for the school year when issued and for the school attended when the authorization is issued. Such authorization must be renewed each subsequent year in order to remain effective.

Information concerning the student's condition treatment plan, authorization, and related documents will be kept on file in the school nurse's office and be easily accessible in the event of an asthma or anaphylaxis emergency.

It is recommended that duplicate prescribed medication, as described in this policy, be provided by the parent/guardian and kept in the school nurse's office so it will be reasonably accessible to the student and school staff in the event of an asthma or anaphylactic emergency.

Cardiopulmonary Resuscitation Training

Upon Board of Education authorization, the District will provide instruction in cardiopulmonary resuscitation to District students grades 9-12. The instruction will be part of a health educational course and will include hands on practice and skill testing to support cognitive learning. However, the District may elect to develop an agreement with a first responder to provide the required practice and testing. Students with disabilities may participate to the extent appropriate as determined by the student's IEP or 504 Plan.

Administration of Asthma Rescue Medication

The Board of Education, by a majority vote, may authorize a licensed registered nurse to maintain a supply of asthma-related rescue medication at each District school. The nurse will recommend the quantity of such medication to be maintained. The asthma rescue medication will be obtained by prescription written by a licensed physician, a physician's assistant, or nurse practitioner. Such prescription shall list the District as the patient, will contain the nurse's name, and will be filled at a licensed pharmacy. A school nurse or other school employees trained by and supervised by the nurse shall have the discretion to use asthma-related rescue medications on any student the school nurse or trained employee believes is having a life-threatening asthma episode based upon their training in recognizing an acute asthma episode. Immunity, under §167.624, from civil liability for trained employees administering life saving methods shall apply to trained employees administering an asthma-related rescue medication under this policy.

Parent/Guardian Administration

In situations where the above requirements are not met, or any time the parent/guardian chooses, the parent/guardian may come to school to administer medicine to his/her student.

Exception for Potentially Harmful Administration

It shall be the policy of this District that the District will not knowingly administer any medication to a student if the District's registered professional school nurse believes, in his/her professional judgment, that such administration could cause harm to the student, other students, or the District itself. Such cases may include, but are not necessarily limited to, situations in which the District is being asked to administer medication in a dosage that exceeds the highest recommended dosage listed in the current annual volume of the Physician's Desk Reference or other recognized medical or pharmaceutical text.

Medication Disposal

Prescription medication remaining at the end of summer school must be taken home by the parent/guardian or will be destroyed. Over-the-counter medication that is not expired may be kept in lock-up for use the following year if the parent/guardian signs an Administration of Medication form for the following year.

For purposes of this regulation, the following definitions apply:

Medications include prescription, over-the-counter drugs, and for purposes of this policy, herbal preparations.

Authorized prescriber includes a health care provider licensed or otherwise authorized to prescribe medications by state law.


Board Approved Date: October 15, 2012
Last Updated: October 2012