507.02 ADMINISTRATION OF MEDICATION TO STUDENTS

Some students may need prescription and nonprescription medication to participate in their educational program.

 

Medication shall be administered when the student's parent or guardian (hereafter "parent") provides a signed and dated written statement requesting medication administration and the medication is in the original, labeled container, either as dispensed or in the manufacturer's container.

 

When administration of the medication requires ongoing professional health judgment, an individual health plan shall be developed by licensed health personnel working under the auspice of the school with collaboration from the parent or guardian, individual’s health care provider, or education team pursuant to 281.14.2(256) . Students who have demonstrated competence in administering their own medications may self-administer their medication. A written statement by the student's parent shall be on file requesting co-administration of medication when competence has been demonstrated. By law, students with asthma, airway constricting diseases, respiratory distress, or students at risk of anaphylaxis who use epinephrine auto-injectors may self-administer their medication upon approval of their parents and prescribing physician regardless of competency.

 

Persons administering medication shall include the licensed registered nurse, physician, persons who have successfully completed a medication administration course conducted by a registered nurse or pharmacist that is provided by the department of education. The medication administration course is completed every five years with an annual procedural skills check completed with a registered nurse or a pharmacist.  A record of course completion shall be maintained by the school.

 

A written medication administration record shall be on file including:

  • date;
  • student’s name;
  • prescriber or person authorizing administration;
  • medication;
  • medication dosage;
  • administration time;
  • administration method;
  • signature and title of the person administering medication; and
  • any unusual circumstances, actions, or omissions.

 

Medication shall be stored in a secured area unless an alternate provision is documented. The development of emergency protocols for medication-related reactions is required. Medication information shall be confidential information as provided by law.

 

Disposal of unused, discontinued/recalled, or expired abandoned medication shall be in compliance with federal and state law.  Prior to disposal school personnel shall make a reasonable attempt to return medication by providing written notification that expired, discontinued, or unused medications need to be picked up.  If medication is not picked up by the date specified, disposal shall be in accordance with the disposal procedures for the specific category of medication. 

 

 

 

Legal Reference:       Disposing on Behalf of Ultimate Users, 79 Fed. Reg. 53520, 53546 (Sept

9, 2014).

Iowa Code §§ 124.101(1); 147.107; 152.1; 155A.4(2); 280.16; 280.23

655 IAC §6.2(152).

281 IAC §14.1, .2

 

 

 

Cross Reference:       506     Student Records

507     Student Health and Well-Being

603.3  Special Education

607.2  Student Health Services

 

 

 

Approved:                 1/14/96

Reviewed:                 1/11/01; 2/14/08; 1/12/12; 4/11/18

Revised:                    4/6/98; 2/12/09; 7/11/22; 7/11/23

507.02E1 AUTHORIZATION OF ASTHMA OR OTHER AIRWAY CONSTRICTING MEDICATION SELF-ADMINISTRATION CONSENT FORM

Student's Name (Last), (First)(Middle) ______________________________________________ 

Birthday ___/___/___

School                                                                                                                                                 Date ___/___/___

   

In accordance with applicable laws, students with asthma, airway constricting diseases, respiratory distress or students at risk of anaphylaxis who use epinephrine auto-injectors may self-administer their medication upon the written approval of the student’s parents and prescribing licensed health care professional regardless of competency.  The following must occur for a student to self-administer asthma medication, bronchodilator canisters or spacers, other airway constricting disease medication or to self-administer an epinephrine auto-injector:

 

  • Parent/guardian provides signed, dated authorization for student medication self-administration.
  • Parent/guardian provides a written statement from the student's licensed health care professional (A person licensed under chapter 148 to practice medicine and surgery or osteopathic medicine and surgery, an advanced registered nurse practitioner licensed under chapter 152 or 152E and registered with the board of nursing, or a physician assistant licensed to practice under the supervision of a physician as authorized in chapters 147 and 148C) containing the following:
    • Name and purpose of the medication,
    • Prescribed dosage, and
    • Times or special circumstances under which the medication or epinephrine auto-injector is to be administered.
  • The medication is in the original, labeled container as dispensed or the manufacturer's labeled container containing the student name, name of the medication, directions for use, and date.
  • Authorization shall be renewed annually. In addition, if any changes occur in the medication, dosage or time of administration, the parent is to notify school officials immediately. The authorization shall be reviewed as soon as practical.

 

Provided the above requirements are fulfilled, the school shall permit the self-administration of medication by a student with asthma, respiratory distress,  or other airway constricting disease or the use of an epinephrine auto-injector by a student with a risk of anaphylaxis while in school, at school-sponsored activities, under the supervision of school personnel, and before or after normal school activities, such as while in before-school or after-school care on school-operated property. If the student abuses the self-administration policy, the ability to self-administer may be withdrawn by the school or discipline may be imposed, after notification is provided to the student's parent.

 

Pursuant to state law, the school district and its employees are to incur no liability, except for gross negligence, as a result of any injury arising from self-administration of medication or use of an epinephrine auto-injector by the student. The parent or guardian of the student shall sign a statement acknowledging that the school district is to incur no liability, except for gross negligence, as a result of self-administration of medication or an epinephrine auto-injector by the student as provided by law.

******************************************************************************************************

AUTHORIZATION ASTHMA OR OTHER AIRWAY CONSTRICTING MEDICATION

SELF-ADMINISTRATION CONSENT FORM

              

Medication                                                                                      Dosage                                 Route                                 Time                                

Purpose of Medication & Administration Instructions                                                                                                                                                     

                                                                                                                                                                                                                                        

Special Circumstances                                                                                                                                                                                                    

                                                                                                                                                                                                                                        

                               /                      /                        

    Discontinue / Re-Evaluate / Follow-up Date

    

Prescriber's Signature                                                                                        Date ___/___/___

   

  • I request the above-named student possess and self-administer asthma medication, bronchodilators canisters or spacers, or other airway constricting disease medication(s) and/or an epinephrine auto-injector at school and in school activities according to the authorization and instructions.
  • I understand the school district and its employees acting reasonably and in good faith shall incur no liability for any improper use of medication or an epinephrine auto-injector or for supervising, monitoring, or interfering with a student's self-administration of medication or use of an epinephrine auto-injector. I acknowledge that the school district is to incur no liability, except for gross negligence, as a result of self-administration of medication or use of an epinephrine auto-injector by the student.
  • I agree to coordinate and work with school personnel and notify them when questions arise or relevant conditions change.
  • I agree to provide safe delivery of medication and equipment to and from school and to pick up remaining medication and equipment.
  • I agree the information is shared with school personnel in accordance with the Family Education Rights and Privacy Act (FERPA) and any other applicable laws.
  • I agree to provide the school with back-up medication approved in this form.

   

Parent/Guardian Signature ___________________________________                                          

 

Date ___/___/___(agreed to above statement)

Parent/Guardian Address                                                                                                                   

Business Phone                                                                      

Home Phone                                                                                  

    

Self-Administration Authorization Additional Information

507.02E2 PARENTAL AUTHORIZATION AND RELEASE FORM FOR THE ADMINISTRATION OF PRESCRIPTION DRUGS TO STUDENTS

_________________________________            ___/___/___      _________________     ___/___/___

Student's Name (Last), (First),  (Middle)                Birthday                    School                    Date

 

School medications and special health services are administered following these guidelines:

 

  • Parent has provided a signed, dated authorization to administer medication and/or provide special health services listed.  Electronic signatures meet the requirement of written signatures.
  • The prescribed medication is in the original, labeled container as dispensed.
  • The prescription medication label contains the student’s name, name of the medication, the medication dosage, times(s) to administer, route to administer, and date.
  • Authorization is renewed annually and as soon as practical when the parent notifies the school that changes are necessary.

 

                                                                                                                                                             

Prescribed Medication                         Dosage                         Route                           Time at School

 

                                                                                                                                               

 

                                                                                                                                               

Special Health Services and instructions, if indicated:

 

                                                                                                                                               

 

                                                                                                                                               

 

            /           /          

Discontinue/Re-Evaluate/Follow-up Date for Prescribed Medication or Special Health Services listed.

 

                                                                                                /           /          

Prescriber’s Signature                                                   Date

 And credentials (when indicated for health service delivery)

                                                                                                                                   

 

 

                                                                                                            /           /          

Parent's Signature                                                                     Date

 

                                                                                                                                   

Parent's Address                                                                        Home Phone

 

                                                                                                                                   

Additional Information                                                             Business Phone