Prescription and Non-Prescription Medication Management

Objective

To meet the Division’s responsibility of safely administering prescription and non-prescription medication to students.

Definitions

Regulated Prescribers – any medical practitioner who has been granted the authority, by the statute or regulation of Alberta, to prescribe medication. Examples may include, but are not limited to; physicians, nurse practitioners, pharmacists, and dentists.

Regulation

1. A principal, in consultation with the student's parents/guardian, is responsible for making a decision regarding a parent/guardian's request to have a school staff member administer physician prescribed medication during school hours.
   
   
2. All parents/guardians requesting medication management for prescribed medication, from a regulated prescriber, are required to submit a completed Edmonton Public Schools' Authorization Form for the Administration of Prescription Medication on an annual basis. In cases where a student requires prescription medication and/or blood glucose testing, the school principal shall ensure a Prescription Medication Management Plan (located in PowerSchool) is completed in consultation with the parent/guardian, to ensure that medical information is complete and accurate.
   
   
3. The principal shall ensure the Prescription Medication Management Plan is updated on an annual basis and when there is any change in prescribed medication or its administration, for example:
   • name of medication as labeled
   • dosage
   • time of administration
   • how medication is to be administered/route of administration
   • expected effect and side effects
   • response to an emergency situation

         Parents/guardians are to be given a copy of the initial plan and any revised or updated plan(s).

4. Copies of the Edmonton Public Schools’ Authorization Form and the Prescription Medication Management Plan shall be provided to the parent/guardian. The Prescription Medication Management Plans must be reflected in the school's emergency preparedness plan. 

5. Schools that have students who may experience a medical emergency due to anaphylaxis, diabetes, epilepsy or other serious or life-threatening conditions shall:

1. have written procedures for responding to emergency situations involving students with identified serious or life-threatening conditions. Schools shall establish a method of informing staff of students with life-threatening conditions using photographs displayed in private, but visible locations;
2. alert all staff members of the procedures for responding to emergency medical situations;
3. provide training to all staff members, who may be in a position of responsibility for students with serious or life-threatening conditions, in how to respond to emergency situations;
4. have a process in place to confidentially inform adults who work with students (substitute teachers, practicum students, lunch supervisors, exempt staff, coaches, volunteers, etc.) of the identity of any student with a severe medical condition and the identity of staff members to contact immediately in case of an emergency;
5. inform parents/guardians immediately when there has been a serious incident such as low blood sugar causing hypoglycemia, anaphylactic shock or tonic-clonic (formerly grand-mal) seizure. 

6. When a staff member or members are requested to administer prescribed medication from a regulated prescriber, in addition to Sections 1 through 5, the following guidelines and procedures shall be observed:
   1. on an annual basis, the principal shall require a signed request form from the parent/guardian and from the regulated prescriber (see Edmonton Public Schools' Authorization Form for the Administration of Prescription Medication, also see Prescription Medication Management Plan located within PowerSchool) must include the following information:
      • name of medication to be administered
      • required dosage, route (oral, time of administration, etc.)
      • expected effect(s) and side effect(s)
      • action to be taken in the event of missed dose(s)
      • response to an emergency situation.
   2. A record shall be kept for each occasion medication is administered to a student. Time of administration is to be recorded. The staff member or members assigned to this task shall immediately sign, on every occasion, to confirm that medication was administered. In accordance with the District Retention Schedule, records are to be retained by the school for 10 years after the student leaves the school.
   3. Medications shall be stored in secure original pharmacy labeled containers to which access is restricted. Disposal of sharps, blood glucose test strips or other medical waste will be completed according to occupational health and safety standards.
   4. Parents/guardians shall personally deliver medication to the school where it will be duly noted as received and the amount confirmed. Any unused medication shall be directly returned to the parent/guardian at the end of the school year or if the student transfers out of the school.
   5. Parents/guardians are responsible to ensure that adequate amounts of medication are supplied to the school in pharmacy-labeled containers clearly marked with the student's name, the dosage amount, and the desired time of medication administration. School staff is not expected to break pills, caplets or capsules. Syringes or cups for dispensing oral medications must be marked with the student's name and the fill level permanently indicated.
   6. The principal shall designate a permanent staff member to administer the prescribed medication and to return it to the secured location where it is stored. When a temporary staff member is working with a student on a long-term basis, that staff member can be responsible for administering medication to a student. Hourly support staff members are not responsible for administering medication. Parents/guardians are expected to assist in preparing staff to administer medication.
   7. A minimum of two alternate staff members must be identified and trained to administer medication. 

7. If the child is developmentally capable, a parent/guardian may request that the student be allowed to self-administer prescription medication. The principal shall receive written documentation supporting student self-administration of prescription medication from a regulated prescriber (see Edmonton Public Schools' Authorization Form for the Administration of Prescription Medication). The principal or designate shall be responsible for monitoring and recording the process of self-administration of medication. 

8. Single dosages of a prescription medication shall be supplied to the school in pharmacy labeled containers clearly marked with the student's name, the dosage amount, the desired time of medication administration and any side effects, accompanied by a written request from the parent/guardian. Immediately following administration, a record shall be kept of the time of administration, amount given, and staff member administering medication.  

9. Students' own prescribed EpiPens and inhalers are to be clearly marked and separate from other prescription medication in an accessible location. If the student is developmentally capable, Epi-Pens or inhalers shall be carried by the student on their person in a safe and readily available pouch that must accompany the student at all times. In the event an Epi-Pen is used, parents must be notified and medical attention shall be sought immediately. *See Addendum 1 for further direction about EpiPens in schools.

10. In regards to Type 1 and Type 2 diabetes:
    1. The administration of a quick acting glucose source (e.g., glucose tablets, unsweetened juice, sugared candy) or the provision of follow up snacks (e.g., digestive biscuits, crackers, cheese) is acceptable and can be dispensed by any staff in accordance with written instructions from the parent/guardian (refer to 6a). Parents/guardians should be advised when a quick acting glucose source for low blood sugar has been administered. A record shall be kept of the time the glucose source was administered and the time of parent/guardian contact.
    2. When developmentally capable, students shall be allowed to test their own blood levels upon request of the parent/guardian or student. If requested, students should be allowed to conduct blood testing in the classroom, or schools are to provide an environment of confidentiality that enables and enhances the student's ability to manage their health condition.  

11. If the student travels to and from school on Division-provided transportation, the principal shall ensure that the school bus operator is informed of all potential emergency medical conditions and the appropriate intervention strategies for students on their bus. 

12. Parents/guardians shall be informed if carriers/drivers refuse the request to administer medication. The principal shall make the determination as to whether or not the student is safe to travel in the absence of their medication. If the student is deemed to be unsafe to transport, the principal shall inform the parent/guardian and make arrangements for supervision of the student during transportation. 

13. Non-prescription medications medications such as, but not limited to aspirin, shall not be purchased by the school. Non-prescription medication may be administered to the student provided that the student’s attendance is contingent on taking medication at school and the parent/guardian provides a written request to administer non-prescription medication, indicating dose and frequency of administration, and any action to be taken in an emergency situation. Medication must be in the original manufacturer-labeled container. A record shall be kept of the time the medication was administered and the time of parent/guardian contact.

*Addendum 1
To ensure compliance with provincial legislation Protection of Students with Life-Threatening Allergies Act, Division school principals will:

1. Require all school staff who work closely with students to complete training identified by the Division on the topic of life-threatening allergies on an annual basis.
2. Follow the Division process to obtain the EpiPen(s) appropriate for their school.
3. Store the school EpiPen(s) in a location that is:
   
   1. clearly marked 
   2. easily accessible to staff
   3. not immediately accessible to students
4. Maintain a clear distinction between students’ own prescribed EpiPen and the school EpiPen(s).
5. Dispose of used or expired school EpiPen(s) according to recommended Division protocols.
6. Implement strategies to reduce the risk of exposure to anaphylactic in classrooms and school common areas through providing information, building awareness and setting school policies around anaphylaxis that reduce risk.
7. Share information on life-threatening allergies with parents, students and staff.

When a student without a known allergy or a medical management plan related to life-threatening allergies experiences a medical emergency that a staff member has reason to believe is an anaphylactic reaction, the staff member may administer the school EpiPen to the student. If the school EpiPen is used, parents/guardians must be notified.

The school EpiPen(s) is not intended to replace a prescribed EpiPen(s) for students with a diagnosed allergy. EpiPens belonging to students with a prescription should only ever be used for the student to whom they have been prescribed.

References