Medication management guidelines

Medication Management Guidelines
Standards of Practice
Performances Expectation
Accomplished
Process in place to communicate medication The licensed nurse will collaborate with the Office of procedures with parents, staff and administration. Health Services and principal information regarding current medication administration procedures for students, parents and staff in school handbook, newsletter, PTA meetings, and etc. Prescriber’s Medication Order Form (PMOF) will be Upon receipt of the PMOF the licensed nurse or evaluated for compliance with (Administrative CMT will validate the order is completed in its Procedure #5163: Medication Procedures) entirety (i.e. parent and health care provider signatures, etc). In the event a PMOF is received Please Note: **Medications without a current PMOF and not accompanied by medication the licensed
will not be accepted.
inability to verify or follow as directed by the health care provider • Instruct parent/guardian to retain PMOF until medication is available and provided for administration Clarification of medication order is obtained as Contacts parent and or authorized prescribed to correct PMOF”s to adhere to school system policy • Drug strength or frequency not specified • Reason or side-effects for medication not • Temperature for antipyretic (i.e. Tylenol)
Licensed nurse will document
communication with parent/health care
provider regarding medication order
clarification.
Verify the PMOF for prescription medications and Upon receipt licensed nurse or CMT will verify that the unaltered pharmacy label of the medication
received matches the PMOF. All nurses can accept: Please note: **any order-label mismatches
• Brand or generic substitutions for PMOFs identified by CMT must be reported to the received (i.e. Albuterol-ProAir, Ritalin- professional school nurse or Health Services • Pharmacy label specifies give as directed • Request to be provided with the most • Sample Medications which are not labeled The PMOF for non-prescription medications (over- Upon receipt the licensed nurse or CMT will verify the-counter) matches the medication provided by that the non-prescription medication received is the • Brand or generic substitutions (only the
• All non-prescription (over-the-counter) medications must be received in the original unopened package. • Medication is labeled with Name of Student Controlled substances are counted when received Upon receipt of control substances the licensed and administered
nurse or CMT with the parent/guardian will:
• Document on the Medication Inventory for Please Note:**Discrepancies in medication count
Controlled Drug in RED as required.
MUST be reported as a medication error and When administering control substances the professional nurse or CMT will: • Count the medication with another adult
staff member twice (2x) a day
• Document on the appropriate form in RED
Medication Orders Are Transcribed on MAR Licensed nurse or CMT will transcribe order onto the medication administration record (MAR) prior to administration. The following must be documented: • Transcribe ONLY in black or blue ink • Student’s Name, Birth date, and allergies • Document date received (Month/year, draw • Enter X for dates which correspond with
school closed (i.e. weekends, holidays, etc) • Sign with entire legal name (no stamps), Medication is stored as required by AP #5163 Professional nurse or CMT will store medication as • ALL medication will be kept in a locked cabinet, drawer, or lockbox in the refrigerator • Controlled substances wil kept under available to those staff authorized to administer medication. Medication Manual will be maintained per Health Medication assessment should be performed prior to Licensed nurse will perform a nursing assessment to administration/delegation to a non-licensed person establish baseline norms for students requiring medication and every 45 calendar days there after.
Please Note: **Medication delegation will comply
• Must be completed prior to administration or delegation of medication administration to an authorized person. • Initial assessment should be documented on the medication assessment form, while ongoing assessments will be documented on the flow sheet or with a narrative note as appropriate Medication wil be administered safely in accordance Medication will ONLY be administered to students
with the Maryland Nurse Practice Act and AP #5163 by those authorized to do so. Nurse and authorized person(s) with EVERY medication administration
The procedure will ensure the six (6) rights are practiced when administering medications in • Wash hands with soap and water prior to
• RIGHT person
• RIGHT medication
• RIGHT dose
• RIGHT time
medication/pharmacy label (see variations • RIGHT route
• RIGHT documentation procedures
• Validate medication is in date by checking • Administers medication by fol owing six (6) • Document onto MAR by: initialing in the correct square or using key located above the signature section • Should medication be omitted, document • Every PRN medication administration wil be documented by: circling initials on MAR and completing appropriate flow sheet or narrative note which includes signs, symptoms, final outcome and communication with parent/guardian • Sign your complete name at the end of the Medication errors will be identified, reported, and Upon identification of ANY medication error the
• Immediately report the error to Health
• WRONG person
• WRONG medication
• Take the following actions. 1.) The Nurse • WRONG or OMITTED dose
will contact the parent/guardian and health • WRONG time
care provider. 2) CMT will remain with the • WRONG route
student and follow instructions provided by • WRONG documentation procedures
• WRONG medication count
sheet/narrative note. 4.) Student should remain in health room observed by CMT or WRONG reason
Administering WITHOUT order
Administering medication to person with a If Student vomits medication: 1.) DO NOT repeat the dose. 2.) CMT MUST notify Health Services or the nurse for instructions. 3.) Complete a note with the date, time, medication vomited and action that was implemented. 4.) Document on the MAR by circling your initials.

Source: http://www.pgcps.pg.k12.md.us/~procedur/5000/Attachment%207%20to%20A.P.%205163.pdf