Medication Administration - PowerPoint by 5sk81od

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									Medication Administration
    Annual Review
 A Training for School Personnel
           February 2007
          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
information is required and will assist in improving
this course and developing others. You must include
your name, building, and date. This information is
required for our records.
       If this is your first time completing this
course, allow 1/2 hour to do so. Next        Back Exit
               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-to-
  face 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 self-
  administering 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
  student’s 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 Off-
         Campus 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 student’s
  medication needs




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         Staff Protection
• School staff are protected by careful
  observation of regulations of the
  medication law, rules, district policy
• Nurse’s 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




          Begin         Exit
             Question #1
• Never give medication sent to school in
  a baggie.

 True
 False




                                       Exit
               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




                                      Exit
              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
  Back




                                       Exit
            Question #2
• If a parent calls saying the doctor has
  increased the dose from one pill to two,
  always follow the parent’s instructions.

 True
 False




                                        Exit
              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.

 Back




                                      Exit
               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




                                      Exit
           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



                                      Exit
             Incorrect
• Oregon law states yearly instruction
  must be provided to designated school
  staff on the administration of
  medication.

 Back




                                      Exit
               Correct
• Oregon law states yearly instruction
  must be provided to designated school
  staff on the administration of
  medication.

 Next question




                                      Exit
            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



                                       Exit
               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

 Next question


                                       Exit
              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

 Back
                                       Exit
            Question #5

• Alcohol-based cough syrup can be given
  at school with written permission from a
  parent
     True
     False




                                       Exit
               Incorrect
• 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. Non-
  prescription medication does not include
  dietary food supplements
  Back
                                             Exit
                  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. non-
  prescription medication does not include
  dietary food supplements.
  Next question
                                             Exit
            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




                                          Exit
                Correct
• Prescription medication must be in the
  original container with a pharmacy label
  attached
• Only a licensed pharmacist can legally
  package and label medication
  Next question




                                        Exit
              Incorrect
• Prescription medication must be in the
  original container with a pharmacy label
  attached
• Only a licensed pharmacist can legally
  package and label medication
  Back




                                        Exit
            Question #7
• When a parent asks you to give their
  child two Children’s Tylenol for a
  headache, it is OK to do so if you have
  the medicine.
  True
  False




                                        Exit
               Correct
• Oregon law requires written permission
  and instruction from the student’s
  parent to administer non-prescription
  medication
• It is the parent’s responsibility to
  provide a student’s medication
        Next question



                                      Exit
              Incorrect
• Oregon law requires written permission
  and instruction from the student’s
  parent to administer non-prescription
  medication
• It is the parent’s responsibility to
  provide a student’s medication




         Back
                                      Exit
           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



                                      Exit
              Incorrect
• Law states school staff designated to
  administer medication must receive
  yearly training

 Back




                                          Exit
               Correct
• Law states school staff designated to
  administer medication must receive
  yearly training

 Next question




                                          Exit
            Question #9
• Any student can carry and administer
  their own non-prescription medication if
  their parent writes it on the permission
  slip.
  True
  False



                                       Exit
                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

 Back
                                         Exit
                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
  Next question
                                         Exit
          Question #10

• Students may carry and self-administer
  cough drops as long as their parent
  sends them with the student
 True
 False




                                      Exit
                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
                                          Exit
                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

Back
                                             Exit
           Question #11

• All medication should be stored in a
  clean, locked cabinet.
  True
  False




                                         Exit
                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

                                        Exit
              Incorrect

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

 Back



                                        Exit
           Question #12

• If a student vomits after taking their
  medication, be sure to send a note home
  to the parent.
  True
  False




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

         Back
                                        Exit
              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
                                         Exit
          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



                                      Exit
               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 ½ hour
  of the designated time
• If a student does not come for
  scheduled medication
  – Send for the student
  Back
                                       Exit
              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 ½ hour
  of the designated time
• If a student does not come for
  scheduled medication
   – Send for the student
   Next question
                                      Exit
            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


                                          Exit
              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.
       Back
                                        Exit
                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                           Exit
           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




                                       Exit
                 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.
 Back
                                                  Exit
                   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
  Next question
                                             Exit
           Question #16
• Teachers should know when their
  students are taking medication, in spite
  of confidentiality laws.
  True
  False




                                        Exit
              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

 Next question
                                        Exit
          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

     Back
                                    Exit
          Question #17

• Always use pencil when recording
  medications so that you can make
  changes if a mistake is made.
  True
  False




                                     Exit
             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
  Back
                                      Exit
             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                        Exit
           Question #18
• At the end of the year, send all of the
  medication logs to Health Services at
  the DO.
  True
  False




                                        Exit
                 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




                                     Exit
             Incorrect
Send completed Medication Logs to the
 DO
  – If the medication is complete
  – The student moves
  – At the end of the school year
  Back




                                        Exit
            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




                                        Exit
                Correct

• Medication is to be given within ½ hour
  before or after the designated time

 Next question




                                        Exit
              Incorrect


• Medication is to be given within ½ hour
  before or after the designated time




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




           Next                           Exit
                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
Back
                                               Exit
                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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