Prior to the administration of any medication, including any dietary supplement or other perceived health remedy not regulated by the US Food and Drug Administration, to any student under the age of eighteen (18), written parental consent and medical provider's order are required. The consent form shall include authorization to administer the medication and relieve the Board and its employees of civil liability for damages or injuries resulting from the administration of medication to students in accordance with this policy. All signed medication consent forms are to be maintained by the school nurse.
Unless authorized to self-administer, students are not allowed to carry any medications, including over-the-counter (OTC) medications or any dietary supplement or other perceived health remedy not regulated by the US Food and Drug Administration, while at school. The parent or legal guardian shall bring the student’s medication to the school nurse. When medications are brought to the school nurse, the nurse shall document, in the presence of the parent, the quantity of the medication(s). Each person present shall sign a form verifying the quantity of the medication(s).
Medications, including those for self-administration, must be in the original container and be properly labeled with the student’s name, the ordering provider’s name, the name of the medication, the dosage, frequency, and instructions for the administration of the medication (including times). Additional information accompanying the medication shall state the purpose for the medication, its possible side effects, and any other pertinent instructions (such as special storage requirements) or warnings. Schedule II medications that are permitted by this policy to be brought to school shall be stored in a double-locked cabinet.
Students with an individualized health plan(IHP) may be given over-the-counter medications to the extent giving such medications are included in the student's IHP.
Students taking Schedule II medications methylphenidate (e.g. Ritalin or closely related medications as determined by the school nurse), dextroamphetamine (Dexedrine), and amphetamine sulfate (e.g.Adderall or closely related medications as determined by the school nurse) shall be allowed to attend school.
Students taking Schedule II medications not included in the previous sentence shall be allowed to bring them to school under the provisions of this policy and shall be permitted to attend and participate in classes only to the extent the student’s doctor has specifically authorized such attendance and participation. A doctor’s prescription for a student’s Schedule II medication is not an authorization. Attendance authorization shall specifically state the degree and potential danger of physical exertion the student is permitted to undertake in the student's classes and extracurricular activities. Without a doctor’s written authorization, a student taking Schedule II medications, other than those specifically authorized in this policy, shall not be eligible to attend classes but shall be eligible for homebound instruction if provided for in their IEP or 504 plans.
The District's supervising registered nurse shall be responsible for creating both on-campus and off-campus procedures for administering medications.
Students who have written permission from their parent or guardian and a licensed health care practitioner on file with the District may:
Self-administer either a rescue inhaler or auto-injectable epinephrine;
Perform his/her own blood glucose checks;
Administer insulin through the insulin delivery system the student uses;
Treat the student's own hypoglycemia and hyperglycemia; or
Possess on his or her person:
A rescue inhaler or auto-injectable epinephrine; or
The necessary supplies and equipment to perform his/her own diabetes monitoring and treatment functions.
A student may be authorized to self-administer a stress dose medication to treat the student’s adrenal insufficiency with:
The written authorization of the student's parent, legal guardian, or person standing in loco parentis; and
A written order from the student's treating physician stating that the student:
Is capable of completing the proper method of self-administration of the stress dose medication,; and
Has been instructed on the details of the student’s medical condition and the events that may lead to an adrenal crisis.
The parent, legal guardian, or person standing in loco parentis of a student who is authorized to self-administer a stress dose medication shall sign an IHP developed by the school nurse for the school where the student is enrolled. The IHP shall include a requirement for the notification of appropriate staff following the self-administration of a stress dose medication, which shall include the school nurse, teacher of the classroom where the stress dose medication was administered, and a school administrator.
Students who have a current consent form on file shall be allowed to carry and self-administer such medication while:
In school;
At an on-site school-sponsored activity;
While traveling to or from school; or
At an off-site school-sponsored activity.
A student is prohibited from sharing, transferring, or in any way diverting his/her medications to any other person. The fact that a student with a completed consent form on file is allowed to carry a rescue inhaler, auto-injectable epinephrine, diabetes medication, stress dose medication, or combination does not require the student to have such on the student's person. The parent or guardian of a student who qualifies under this policy to self-carry a rescue inhaler, auto-injectable epinephrine, diabetes medication, stress dose medication, or any combination on the student's person shall provide the school with the appropriate medication, which shall be immediately available to the student in an emergency.
Students may possess and use a topical sunscreen that is approved by the United States Food and Drug Administration for OTC use to avoid overexposure to the sun without written authorization from a parent, legal guardian, or healthcare professional while the student is on school property or at a school-related event or activity. The parent or guardian of a student may provide written documentation authorizing specifically named District employees(s) to assist a student in the application of sunscreen. The District employee(s) named in the parent or legal guardian's written authorization shall not be required to assist the student in the application of sunscreen.
Students may be administered Glucagon, insulin, or both in emergency situations by the school nurse or, in the absence of the school nurse, a trained volunteer school employee designated as a care provider, provided the student has:
an IHP that provides for the administration of Glucagon, insulin, or both in emergency situations; and
a current, valid consent form on file from their parent or guardian.
When the nurse is unavailable, the trained volunteer school employee who is responsible for a student shall be released from other duties during:
The time scheduled for a dose of insulin in the student’s IHP; and
Glucagon or non-scheduled insulin administration once other staff have relieved him/her from other duties until a parent, guardian, and other responsible adult, or medical personnel has arrived
A student shall have access to a private area to perform diabetes monitoring and treatment functions as outlined in the student's IHP.
Emergency Administration of Epinephrine
The school nurse or other school employees designated by the school nurse as a care provider who have been trained 1 and certified by a licensed physician may administer an epinephrine auto-injector in emergency situations to students who have an IHP developed under Section 504 of the Rehabilitation Act of 1973 which provides for the administration of an epinephrine auto-injector in emergency situations.
The parent of a student who has an authorizing IHP, or the student if over the age of eighteen (18), shall annually complete and sign a written consent form provided by the student's school nurse authorizing the nurse or other school employee certified to administer auto-injector epinephrine to the student when the employee believes the student is having a life-threatening anaphylactic reaction.
Students with an order from and a licensed health care provider to self-administer auto-injectable epinephrine and who have written permission from their parent or guardian shall provide the school nurse an epinephrine auto-injector. This epinephrine will be used in the event the school nurse, or other school employee certified to administer auto-injector epinephrine, in good faith professionally believes the student is having a life-threatening anaphylactic reaction and the student is either not self-carrying his/her /epinephrine auto-injector or the nurse is unable to locate it.
The school nurse for each District school shall keep epinephrine auto-injectors on hand that are suitable for the students the school serves. The school nurse or other school employee designated by the school nurse as a care provider who has been trained and certified by a licensed physician may administer auto-injector epinephrine to those students who the school nurse, or other school employee certified to administer auto-injector epinephrine, in good faith professionally believes is having a life-threatening anaphylactic reaction.
The school nurse in grades 7-12 shall keep anti-opioid injectors on hand. The school nurse, other trained employee may administer anti-opioid in accordance with the District's procedures to a student who the school nurse, or other observer, in good faith believes is having an opioid overdose.
Emergency Administration of Emergency Adrenal Insufficiency Medication
The school nurse or other school employees designated by the school nurse as a care provider who have been trained6 and certified by a licensed physician may administer an injectable emergency dose medication in emergency situations to students who have an IHP that provides for the administration of an injectible emergency dose medication in emergency situations.
The parent of a student who has an authorizing IHP, or the student if over the age of eighteen (18), shall annually complete and sign a written consent form provided by the student's school nurse authorizing the nurse or other school employee(s) certified to administer an injectable emergency dose medication to administer an injectable emergency dose medication to the student when the employee believes the student is having an adrenal crisis due to adrenal insufficiency.
Students who have met the requirements to be authorized to self-administer a stress dose medication for adrenal insufficiency under this policy shall provide the school nurse an emergency injectable dose of the student’s medication. This emergency injectable dose will be used in the event the school nurse, or other school employee certified to administer an injectable emergency dose medication, in good faith professionally believes the student is having an adrenal crisis due to adrenal insufficiency.
The school shall not keep outdated medications or any medications past the end of the school year. Parents shall be notified in advance of the school’s intention to dispose of any medication. Medications not picked up by the parents or legal guardians one(1) day following the last day of student attendance, shall be disposed of by the school nurse in accordance with current law and regulations.
Additional Reference:
ASBA Model Policies
Ark. State Board of Nursing: School Nurse Roles and Responsibilities.
Arkansas Department of Education and Arkansas State Board of Nursing Rules Governing the Administration of Insulin and Glucagon to Arkansas Public School Students with Diabetes
Legal