Medication Administration in Schools. Position Statement. Revised
Author: Hinkson, Elizabeth
Date: 2017-02-00
Type: Reports - Descriptive
Subjects: School Nurses,Drug Therapy,School Health Services,Guidelines,Administrative Policy

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) be responsible for medication administration in the school setting, leading the development of written medication administration policies and procedures that focus on safe and efficient medication administration at school. Well-written policies and procedures will enable schools to fulfill their obligations to provide health-related services to all children, including those with special healthcare needs under the Individuals with Disabilities Education Improvement Act (2004) and Section 504 of the Rehabilitation Act (1973) as amended through the Americans with Disabilities Amendment Act [ADAA] in 2008. Policies and procedures should address (Ryan, Katsiyannis, Losinski, Reid, &amp; Ellis, 2013; U.S. Food and Drug Administration [FDA], 2013): (1) delegation (when permissible by state law), training and supervision of unlicensed assistive personnel (UAP); (2) student confidentiality; (3) medication orders; (4) medication doses that exceed manufacturer's guidelines; (5) proper labeling, storage, disposal, and transportation of medication to and from school; documentation of medication administration; (6) proper labeling, storage, disposal, and transportation of medication to and from school; documentation of medication administration; (7) off-label medications and investigational drugs; (8) prescription and over-the-counter (OTC) medications; (9) complementary and alternative medications; and (10) psychotropic medications and controlled substances. The administration of medication by non-nursing school staff, when allowed, should be addressed (Ryan et al., 2013). These policies and procedures shall be consistent with federal and state laws including state nurse practice acts, rules, regulations, and any other laws that may apply, as well as standards and established safe, evidencebased information (Ryan et al., 2013; Bobo, 2014).Medication administration to students is one of the most common health-related activities performed in school. Historically, administering medication within the school setting has been a school nurse responsibility. However, as many districts and schools struggle financially, it is not uncommon for students to receive medication from nonnursing school employees who have had no medical training. This trend has caused an alarming increase in the number of medication errors made by UAP (Institute for Safe Medication Practices [ISMP], 2012). It is especially important that evidence-based medication policies and procedures be in place in those schools where a registered nurse is not present every day. The school nurse should lead the development of school district policies and procedures relating to medication administration in the school setting and, where delegation of medication is permitted, the school nurse should be responsible for the delegation, training and supervision of UAP. [For the 2012 statement, &quot;Medication Administration in the School Setting. Position Statement. Amended,&quot; see ED540400.]