Medication Administration

A Training for School Personnel

February 2007 Review

Annual
Revised June 2008

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Welcome to KCSD annual medication

administration re-training. This program contains
information required by law to administer medications
to school students. In order to complete this
training, you must have previously attended a course
presented by one of the nurses.
Please read all of the information and complete
the quiz. Following the quiz, there is a survey. This
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information is required and will assist in improving

Goal
This training is intended for non-nurse
school staff who have been assigned
to give medications in school, following
the legal guidelines of ORS 339.867
to 339.870 and OAR 581-021-0037.

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The Law
Administrative rules were adopted by
the Oregon Department of Education
in 1997, and amended by the
legislature in 2007.
School districts must adopt policies
and procedures for this rule including
policies which address student self
medication.
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What the Law Says

Administrator must select regular and
back up staff
Designated school personnel are
REQUIRED to receive training annually
ONLY trained staff can administer
medication
Training program must be approved by
Oregon Department of Education
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Oregon Dept of Education

Initial training must occur face-toface with a nurse
Annual retraining can be completed
online

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Note:
Only non-injectable medications are covered
by this law
Nebulizer treatments, injections and rectal
medication administration will not be taught in
this training

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Three Types

Non-prescription medication

Prescription medication

Student self-administered medications

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Non-Prescription
Medication

Commercially prepared
Original container
Non-alcohol based
Necessary for student to remain in school
Includes cough drops and antacids (e.g.
Tums)

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Non-Prescription
Medication

Require:
Written parent permission &
instructions
Can be faxed

Student name
Medication name
Medication dosage, frequency, route
Must provide own medication
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Prescription Medications
Law requires school personnel to be
responsible only for prescription
medication scheduled to be given
during school hours.

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Prescription Medication
Does not include injectable drugs
Must be prepared and labeled by a U.S.
pharmacist and be in the original
pharmacy container

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Prescription Medication
Requires written instruction from a
physician
Prescription label meets this requirement

Requires signed permission and instruction

from parent
Medication Permission Form

New medication permission form must be

completed each year
Administered only if required during
school hours
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These People Can

Write Orders:
Doctor of
medicine/osteopathy/naturopathy
Physician assistant
Nurse practitioner
Dentist
Optometrist

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Student
Self-Medication
Student must be able to carry and
self-medicate, without assistance
No staff documentation necessary
Must be in original container
May only carry one days supply at a
time

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Self-Medication

Changes for 2008-2009

Can self-medicate at all schools
Requires Self-Medication Permission Form
Requires medical order
Only for prescription medication
Can be on the label

Requires principal permission

Can be revoked

Requires parent to provide back-up

inhalers & EpiPens to be kept in the office
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Routes of Medication
Oral
Tablets, capsules, elixirs or suspensions

Topical
Skin, eyes, ears, nose

Inhaled
Mouth or nose

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Oral Medication
Oral medicine should be followed with
water
Obtain water from a clean source
Do not obtain water from sink where
first aid provided

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Oral Medication
Tablets requiring cutting should be
cut at home and sent to school
Parents should provide pill crusher if
pills need to be crushed
Have parents provide calibrated
spoon/cup if needed for liquid
medication

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Topical Medication
Ointments
Apply to a clean surface
Do not apply with your bare hands
Use a cotton tipped applicator or
gauze pad to apply medication

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Topical Medication
Eye Drops/Ointment
Administer with student laying down or
head tilted back
Apply drops or ointment without
touching container to eye or skin
Do not administer directly to eyeball
Apply to inner portion of eye, close to
nose
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Topical Medication
Ear Drops
Lay child on side opposite of ear you are
medicating
While gently pulling up and back on ear,
instill correct number of drops
Do not touch tip of container to ear or
skin
Leave child on side for a short time
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Topical Medication
Nose Drops
Have student lay with head back over a
rolled pillow
Instill drops in nostril
Keep student in this position for a few
minutes
Observe for signs of choking or
vomiting
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Inhaled Medication
Student should be capable of selfadministering inhaler
If student continues to experience
difficulty breathing 5 minutes after
using inhaler
Call parent and/or 9-1-1

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Five Rights

Right student

Always ask the students name

Right medication
Check the label

Right dose

Check the label

Right time

Can be given 30 min before or after the time stated

on the label

Right route

Check the instruction on the label

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Safe Storage and

Handling
Store medications in a clean, locked cabinet
NEVER administer medications from an unlabeled
container
Narcotics, stimulants, and barbiturates should be
counted upon arrival at school
May be counted with parent or trained school
staff
Check with district nurse if you are unsure

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Safe Storage and

Handling

Medication should be brought to school

and returned home by the parent. Do not
allow students to carry medications home
Changes in medication instructions must
be made by parent and/or physician in
writing. DO NOT act on verbal requests
Only a licensed nurse can take verbal
orders from a physician
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Safe Storage and

Handling
Refrigeration is necessary for some
medications
Many liquid medications need to be
shaken well
Beginning 2008-2009 refrigerated
meds need to be locked
District will provide lock boxes

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Handling Medications
Always wash your hands
Avoid touching medication
Wear gloves if placing medication in
students mouth

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Handling Medications
Do Not leave meds unattended
Prepare for one student at a time
Compare medication label with
Medication Log

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Disposal of Medication
Notify parent of unused medication
Any unclaimed medication should be placed
in sealable container in the presence of two
staff members
Prescription Medication must be counted and
the number of pills documented

Bring sealed container to DO during

secretary check-out
Note parent contact and medication disposal
on Medication Log; sign by both staff
members

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Record Keeping
Legal document

Ink
Students legal name and DOB
Medication Permission Form
Medication Log
Sign initials in log right after giving

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Record Keeping
Only one student on each form
No white-out
If an error is made
Put a single line through it
Initial and date it

If there is a dose change

Begin a new line on the Medication Log

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Retaining Medication
Records
Send completed forms to the DO
If medication is complete
The student moves
At the end of the school year

They will be filed in Student Health

Folder
In SpEd file if student has an IEP

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Three Most Common

Unexpected Situations
1. Student does not come at scheduled time
2. Student refuses medication
3. Student vomits or spits out medication

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Student Does Not Come

at Scheduled Time
Send for Student
Document
Notify
Teacher
Parent
Nurse

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Student Refuses
Medication
Encourage
Document
Notify
Parent
Nurse

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Student Vomits Or
Spits Out Medication
Document
Notify
Parent

Check for symptoms of illness

Fever
Stomachache
Headache

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Side Effects &

Allergic Reactions

All medication can cause side effects

or allergic reactions
Know where EpiPens are kept and who
is certified to use them
Teachers should be aware of students
taking medication
Report promptly any unusual symptoms
or behaviors to district nurse and
parent
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Prevent Errors

Take your time

Do not allow yourself to be rushed
Work with one student at a time
Always follow the 5 rights
Record medication immediately after
giving on the Medication Log
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What Are Medication

Errors?
Dose not given
Medication given to the wrong
student
Inaccurate dose or wrong
medication
Wrong time
Incorrect route
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Medication Errors
Accidents Happen
Report medication errors immediately to
district nurse and building administrator
Nurse will contact parent

Complete Accident/Incident Analysis

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Field Trips and OffCampus Activities

PLAN AHEAD!
Staff person trained in medication
administration must accompany group
if medications will be required
Document administration on a copy of
the Medication Log while on field trip
and on the original when you return
Recommend notifying nurse two weeks
prior to trip if medication training is
necessary
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Field Trip Supplies

Copy of Medication Log

Medication in original container
Hand cleaner
Drinking water
Safe container to transport

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Confidentiality
Student medication files are
CONFIDENTIAL
Access limited to school staff with a
legitimate need to know
Parent/Guardian authorization is
required for release of information

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Remember!
Once KCSD has received a signed
permission slip and medication, it is our
responsibility
To administer it appropriately and on time
(30 mins before or after time on
prescription)
Monitor medication supply

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Parent Communication
Avenues of communication to
parents:
Registration
Student Handbooks
School Newletters
Informational Packets

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Dealing with Concerned

Parent
Validate parent emotions
Remind them - student safety is the
priority
Share written information
Include district nurse and administrator
Set boundaries and ensure your own
safety

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Establishing a
Cooperative School
Environment
Success requires a team effort
Include teacher in planning students
medication needs

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Staff Protection
School staff are protected by careful
observation of regulations of the
medication law, rules, district policy
Nurses responsibility is to provide
proper training
Your responsibility is to follow the
instruction

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Remember!
NO Baggies
NO Envelopes
NO Medication Boxes

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If you have any

questions or concerns
call a nurse before
giving the medication
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Medication Administration
Quiz

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Question #1
Never give medication sent to school in
a baggie.
True
False

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Correct
All medication must be in the original
container properly labeled with the
name of the student, name of the
medication, dose, route, and frequency
of administration.
Next question

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Incorrect
Law states all medication must be in the
original container properly labeled with
the name of the student, name of the
medication, dose, route, and frequency
of administration
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Question #2
If a parent calls saying the doctor has
increased the dose from one pill to two,
always follow the parents instructions.
True
False

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Incorrect
Medication must be given as directed on
the prescription label. Written
instructions from the doctor or a new
prescription label are required to
change the dose.
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Correct
Medication must be given as directed on
the prescription label. Written
instructions from the doctor or a new
prescription label are required to
change the dose.
Next question

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Question #3
Once a staff member has been trained
to give medication by the nurse, they
only need more training if the laws
regarding medication administration
change.
True
False

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Incorrect
Oregon law states yearly instruction
must be provided to designated school
staff on the administration of
medication.
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Correct
Oregon law states yearly instruction
must be provided to designated school
staff on the administration of
medication.
Next question

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Question #4
A good way to assure the appropriate
students receive their medication each
day is to keep a list on the cabinet or
refrigerator
True
False

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Correct
Student medication information is
confidential and should be shared only
with staff who have a legitimate need
to know
Posting such information where
students, parents, general staff can view
it is a breech of confidentiality
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Incorrect
Student medication information is
confidential and should be shared only
with staff who have a legitimate need
to know
Posting such information where
students, parents, general staff can
view it is a breech of confidentiality
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Question #5
Alcohol-based cough syrup can be given
at school with written permission from a
parent
True
False

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Incorrect
The law defines non-prescription
medication as: commercially prepared, nonalcohol based medication to be taken at
school that is necessary for the child to
remain in school. This includes eyes, nose
and cough drops, cough suppressants,
analgesics, decongestants, antihistamines,
topical antibiotics, anti-inflammatories and
antacids that do not require written or oral
instructions from a physician. Nonprescription medication does not include
dietary food supplements
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Correct
The law defines non-prescription medication
as: commercially prepared, non-alcohol based
medication to be taken at school that is
necessary for the child to remain in school.
This includes eyes, nose and cough drops,
cough suppressants, analgesics,
decongestants, antihistamines, topical
antibiotics, anti-inflammatories and antacids
that do not require written or oral
instructions from a physician. nonprescription medication does not include
dietary food supplements.
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Question #6
If a parent sends a pill bottle with the
students name on it to school and keeps
the original pill bottle at home, it is OK
to give the medicine.
True
False

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Correct
Prescription medication must be in the
original container with a pharmacy label
attached
Only a licensed pharmacist can legally
package and label medication
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Incorrect
Prescription medication must be in the
original container with a pharmacy label
attached
Only a licensed pharmacist can legally
package and label medication
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Question #7
When a parent asks you to give their
child two Childrens Tylenol for a
headache, it is OK to do so if you have
the medicine.
True
False

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Correct
Oregon law requires written permission
and instruction from the students
parent to administer non-prescription
medication
It is the parents responsibility to
provide a students medication
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Incorrect
Oregon law requires written permission
and instruction from the students
parent to administer non-prescription
medication
It is the parents responsibility to
provide a students medication

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Question #8
When the trained medication person is
absent, the principal can have another
staff member give medicine even if they
have not been trained.
True
False

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Incorrect
Law states school staff designated to
administer medication must receive
yearly training
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Correct
Law states school staff designated to
administer medication must receive
yearly training
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Question #9
Any student can carry and administer
their own non-prescription medication if
their parent writes it on the permission
slip.
True
False

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Incorrect
Any student may carry and self-medicate
non-prescription medication with:

Written parental permission Self-Medication

Permission Form
Principal permission

Medication must be in original container

Student may only carry one days supply of
medication at a time
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Correct
Any student may carry and self-medicate
non-prescription medication with:

Written parental permission Self-Medication

Permission Form
Principal permission

Medication must be in original container

Student may only carry one days supply
of medication at a time
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Question #10
Students may carry and self-administer
cough drops as long as their parent
sends them with the student
True
False

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Correct
Cough drops and antacids (e.g. Tums)
are considered non-prescription
medication and require:

Student to provide their own medication

Written parental permission &
instructions to include:
Student name
Medication name
Medication dose, frequency, route

Next question

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Incorrect
Cough drops and anti-acids (Tums)
are considered non-prescription
medication and require:

Student to provide their own medication

Written parental permission &
instructions to include:
Student name
Medication name
Medication dose, frequency, route

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Question #11
All medication should be stored in a
clean, locked cabinet.
True
False

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Correct
All medication should be stored in a
clean, locked cabinet
Refrigerated medication must be stored
in a locked container in the refrigerator

Next question
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Incorrect
All medication should be stored in a
clean, locked cabinet
Refrigerated medication must be stored
in a locked container in the refrigerator
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Question #12
If a student vomits after taking their
medication, be sure to send a note home
to the parent.
True
False

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Incorrect
If a student vomits after taking their
medication
Document
Observe for signs of an allergic reaction
Check for signs of illness
Contact parent
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Correct
If a student vomits after taking their
medication
Document
Observe for signs of an allergic reaction
Check for signs of illness
Contact parent

Next question
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Question #13
When an eighth grade student does not
come for their medication, it is their
own problem; they are old enough to be
responsible.
True
False

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Incorrect
Once we have received medication and a
signed permission slip from a parent, we
are responsible for getting the medication
to the student within hour of the
designated time
If a student does not come for scheduled
medication
Send for the student

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Correct
Once we have received medication and a
signed permission slip from a parent, we are
responsible for getting the medication to
the student within hour of the
designated time
If a student does not come for scheduled
medication
Send for the student
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Question #14
When a student requiring medicine is
going on a field trip, put their pills in a
zip-lock bag with the students name and
instructions, and give them to the
teacher.
True
False
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Incorrect
Prescription medication must be in its
original container with a proper
pharmacy label attached
non-prescription medication must be in
its original container, labeled with the
students name
Anyone dispensing medication at school
must receive annual, ODE approved
training.
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Correct
Prescription medication must be in its
original container with a proper pharmacy
label attached
non-prescription medication must be in
its original container, labeled with the
students name
Anyone dispensing medication at school
must receive annual, ODE approved
training.
Next question
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Question #15
A student is given the wrong medication
in error. The best thing to do is make
the student vomit the medicine.
True
False

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Incorrect
Never induce vomiting
Medication errors must be reported to the
nurse immediately
Medication errors include:

Failing to give a dose

Giving medication to the wrong student
Giving medication at the wrong time
Giving the wrong medication or the wrong dose
Giving the medicine by the wrong route

If a nurse is not immediately available, you

may call Poison Center 1-800-222-1222.
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Correct
Never induce vomiting
Medication errors must be reported to the
nurse immediately
Medication errors include:

Failing to give a dose

Giving medication to the wrong student
Giving medication at the wrong time
Giving the wrong medication or the wrong dose
Giving the medicine by the wrong route

If a nurse is not immediately available, you

may call Poison Center 1-800-222-1222
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Question #16
Teachers should know when their
students are taking medication, in spite
of confidentiality laws.
True
False

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Correct
Teachers have a legitimate
educational interest in students
taking medications
All medication has the potential to
cause side effects
All medication has the potential to
cause an allergic reaction
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Incorrect
Teachers have a legitimate educational
interest in students taking medications
All medication has the potential to cause
side effects
All medication has the potential to cause
an allergic reaction
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Question #17
Always use pencil when recording
medications so that you can make
changes if a mistake is made.
True
False

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Incorrect
Medication records are legal
documents
Must be written in ink
When you write on the medication log,
initial what you have written
If your initials are on the log, place
your initials and signature in the
appropriate spot on the bottom of the
log
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Correct
Medication records are legal documents
Must be written in ink
When you write on the medication log,
initial what you have written
If your initials are on the log, place your
initials and signature in the appropriate
spot on the bottom of the log
Next question
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Question #18
At the end of the year, send all of the
medication logs to Health Services at
the DO.
True
False

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Correct
Send completed Medication Logs to the
DO
If the medication is complete
The student moves
At the end of the school year

Next question

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Incorrect
Send completed Medication Logs to the
DO
If the medication is complete
The student moves
At the end of the school year
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Question #19
When the prescription label says to give
the medicine at 12:00 and lunch is at
11:45, it is OK to give before lunch.
True
False

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Correct
Medication is to be given within hour
before or after the designated time
Next question

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Incorrect

Medication is to be given within hour

before or after the designated time

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Question #20
The 5 Rights of Medication Administration
include:
Right Student
Right Medication
Right Dose
Right Time
Right Route
True
False
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Correct
If the person administering the
medication always follows the 5
Rights, it is unlikely an error will occur.

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Incorrect
Right Student-always ask their name, even if
you know them
Right Medication-read the prescription label
and compare it to the medication log
Right Dose-give the exact amount specified by
the physician on the label
Right Time-check the medication log for the
time it is to be given. Up to 30 minutes before
or after the prescribed time is OK
Right Route-always check the label which will
tell you if it is to be taken by mouth, rubbed
on the skin, or put in an ear
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References
Oregon Department of Education.
www.ode.state.or.us/groups/supportstaff/hklb/school
nurses/medicationadmin.pdf Accessed April 21,2007.
Oregon Administrative Rules, Chapter 581-021-0037.
Administration of Prescription and Nonprescription
Medication to Students (2005).
Oregon Revised Statutes, Chapter 339.869
Administration of medication to students; rules
(2001).
Perry, A. G. & Potter, P. A. (2006). Clinical nursing skills
& techniques (6th ed.). Philadelphia: Mosby.

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 You have now completed the

review. Click next to submit the
results and complete a survey.
The survey must be completed to
document your training.

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