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Document Sample
<Service name>
Medication Policy
Administering medication to a child should be considered a high risk practice. Authority must
be obtained from a parent or legal guardian before educators administer any medication
(prescribed or non-prescribed).
Families place a high level of trust and responsibility on educators when they are
administering medication to children, or observing older children self-administer. Services
should ensure that their policy and practices regarding medications meet legislative
requirements and seek additional medical advice or opinion as needed.
It is crucial that educators have some form of professional development training or
knowledge of administering medications, in addition to first aid qualifications to ensure that
an adverse reaction to medication can be dealt with quickly and responsibly.
Services should regularly review policies in collaboration with educators, families, and if
appropriate, children; and seek recommendations from recognised authorities. The date the
policy is reviewed should be clearly documented on the policy.
Policy Number <number>
Link to CCQA Principles Family Day Care Quality Assurance (FDCQA)
Quality Practices Guide (2004) – Principle 4.3/
Outside School Hours Care Quality Assurance (OSHCQA)
Quality Practices Guide (2003) – Principle 6.4
Quality Improvement and Accreditation System (QIAS)
Quality Practices Guide (2005) – Principle 5.3
Policy statement
<Service name> has a duty of care to ensure that all persons1 are provided with a
high level of protection during the hours of the service‟s operation.
The service‟s Medication Policy reflects the following principles:
o safe principles and practices to administer medication;
o hygiene practices
o an acute attention to detail
o the maintenance of accurate records
o up to date professional development knowledge of administering techniques;
o first aid qualifications
o licensing and/or legislative requirements
o recommended advice and practices from a medical source
o open communication between educators, families and children
o the accountability of educators when administering medication.
An educator will administer medication based on the following principles:
o The right child
o The right medication
o The right dose
o The right method
o The right date and time
1For the purpose of this policy, 'persons' include <children, families, educators, carers' family, management,
coordination unit staff, ancillary staff (administrative staff, kitchen staff, cleaners, maintenance personnel), students,
volunteers, visitors, local community, school community, licensee, sponsor and/or service owner>.
Current as at September 2010 Page 1 of 7
These basic principles are the first steps in ensuring that medication is administered
safely to any person, and should be documented by the parent or legal guardian
before administering medication to a child. Educators should check a medication‟s
expiry date before administering it to a child.
Medication can only be administered when the service‟s <medication authorisation
form2> has been completed and signed by the child‟s parent or legal guardian.
In this service, medication is administered to a child by a <educator, manager,
coordination unit staff> or in some cases, with parental or guardian consent,
medication can be self-administered by a school age child. When medication is
being self-administered, children are supervised by educators.
The service will endeavour to ensure that educators are witnessed by another person
when administering medication to children.3
It is understood by educators, children and families that there is a shared responsibility
between the service and other stakeholders that the Medication Policy and
procedures are accepted as a high priority.
In meeting the service‟s duty of care, it is a requirement under the Occupational
Health & Safety Act4 that management and educators implement and endorse the
service‟s Medication Policy and procedures.
The service reserves the right to contact a health care professional5 if educators are
unsure about administering medication to a child, even if the parent or legal
guardian has requested the medication to be administered.
Rationale
The rationale represents a statement of reasons that detail why the policy and/or procedures
have been developed and are important to the service.
Please refer to:
National Health and Medical Research Council. (2005). Staying healthy in child care:
Preventing infectious disease in child care (4th Ed.). Canberra: Author.
Strategies and practices
These are examples. Services are encouraged to develop and adapt the following strategies
and practices as required to meet their individual circumstances and daily best practices.
Definition of medication
The service has the opportunity to define „medication‟ in the context of the policy.
The term „medication‟ can be defined either as prescribed or non-prescribed. For the
purpose of this policy, „prescribed‟ medication is:
o authorised by a health care professional
2 For the purpose of this policy, „medication authorisation form‟ is the term used for parents or guardians to grant
written consent for a service to administer medication to a child.
3 In family day care schemes and single staff model outside school hours care services, ensuring that a witness can
observe another educator administer medication is difficult or not an option. In this situation, services may need to
develop practices or strategies that protect educators and reduce the likelihood of a potential incident.
4 There are legislative Acts and regulations for each state and territory that address the issue of Occupational Health
and Safety. Services are advised to seek information that is relevant to their jurisdiction.
5 For the purpose of this policy, „health care professional‟ can include the child‟s: medical practitioner (or doctor of
medicine), allied health professional, such as a speech therapist, nutritionist or child psychologist.
Current as at September 2010 Page 2 of 7
o dispensed by a pharmacist with a printed label, which includes the name of
the child being prescribed the medication, the medication dosage and
expiry date.
Medication that does not meet the criteria for prescribed medication, can be
considered non-prescribed. This includes over-the-counter medication; medication
dispensed by a naturopath/homeopath; or considered complementary or alternative
such as vitamins and cultural herbs or remedies.
Examples of prescribed medication include antibiotics; Ventolin for asthma; or Ritalin
for Attention-Deficit Hyperactivity Disorder.
Examples of non-prescribed medication include topical or antifungal creams for
nappy rash or eczema; paracetamol; ibuprofen; antihistamine for an allergy; or
teething gel.
Handwashing and hygiene practices
Services should consider the following reflective questions:
o Why do educators or children need to wash their hands before administering
medication?
o Are there situations when handwashing may not occur before administering
medication? For example, school age children may self-administer asthma
medication. How can the service encourage children to remember to wash
their hands?
o Can the service identify when educators may require gloves when
administering medication?
Maintaining clean and hygienic environments
The service can state how some environments need to be hygienically maintained
when medication is applied or administered. For example, a baby who has thrush
needs to have an antifungal cream applied at each nappy change. Educators will
need to follow hygiene practices to ensure that the nappy change mat is safe to use
for other children.
Services should consider the following reflective questions:
o How does the service ensure that hygiene practices are maintained when
medication needs to be applied?
o How does the service‟s hygiene practice change when a child is known to
have an infectious illness or condition and medication is required? If so, in
what situation and why?
o Is there specific equipment required when administering or applying
medication which may need to be cleaned? How is this process carried out?
Assessing the need for administering medication
Services should consider the following reflective questions:
o If the medication is non-prescribed, is it appropriate for the child‟s signs and
symptoms? For example, if the child is coughing and wheezing, how will a
paracetamol help the child‟s condition if there is no pain or fever observed? Is
a decongestant more appropriate? How does the service communicate this
respectfully to the child‟s family?
o If the child is being medicated for an infectious illness or disease, does the
child need to continue to be excluded from the service, as per the exclusion
guidelines?
o How do educators assess a child‟s health?
o What strategies are in place that support educators when they have decided
a child is too ill for care but the family insist that the child should attend care
with medication?
o Do educators feel comfortable or confident administering the medication?
Services can link this section by stating:
Please refer to the service‟s Illness Policy.
Current as at September 2010 Page 3 of 7
Exclusion guidelines
The service can state when children can return to the service after an infectious
disease or illness, where medication is still being administered. For example, a child
can attend care after being diagnosed with impetigo as long as the sores are not
weeping and an antibiotic has been administered for more than 24 hours. Services
should refer to their relevant state or territory health authority for exclusion guidelines.
Services can link this section by stating:
Please refer to the service‟s Illness Policy.
Please refer to the service‟s Immunisation and Health Related Exclusion Policy.
Assessing the need to administer fever reducing medication
Services should consider the implications of administering fever-reducing medication,
such as paracetamol, when children are experiencing a high temperature.
Services should consult with medical practitioners or hospitalswhen deciding on the
practice of administering fever-reducing medications such as paracetamol
Authorising the administration of medication
This is one of the most important steps in the administration of medication. If the
service has not received parental or guardianship authority to administer medication
to a child, then it needs to consider the risks of administering medication without
consent.
It is absolutely crucial at this point to determine a number of important elements,
especially for non-prescribed medications, that the service may state in the policy:
o Who has recommended the medication? For example, a child‟s parent,
homeopath or a pharmacist.
o Is the medication suitable or recommended for children?
o Is the medication appropriate for the child‟s age? For example, if the
manufacturer‟s advice does not recommend for children under two years of
age, will the service accept responsibility for administering that medication to
a 12 month old (even at the request of the parent)?
o Is the medication appropriate for the symptoms or illness?
o What happens if the dose is different for weight or age? For example, if a child
is heavy for their age, does the service base the dose requirements on the
weight of the child or the child‟s age?
o How does the service respond to a claim “but this is what we always give to
her” or “the pharmacist said it was the right dose” when the manufacturer‟s
recommended dose is not being adhered to?
o Has the medication expiry date lapsed?
o When was the last dose administered to the child? For example, the time
between doses of paracetamol is important. If the parent or guardian requests
a time that is not within the manufacturer‟s recommendations, what is the
action of the service?
o Are the recommendations or instructions written in another language? How
does the service respond to a family‟s request to administer medication that
educators are unable to interpret?
o Is the child taking a combination of medications? What are the potential risks
of administering more than one medication to the same child? Would the
service feel more confident with a letter from the child‟s health care
professional authorising the administration of more than one medication?
Medication authorisation form
This form may have to comply with state/territory licensing requirements.
Services should consider the following reflective questions:
o Does the medication authorisation form include the following details:
Child‟s name who requires the medication
Child‟s parent or guardian‟s name and signature
Name of the medication
Dose required
Current as at September 2010 Page 4 of 7
Method of administration, for example oral, eye, ear, inhaled
Time and date of administration
Expiry date of the medication
Special instructions, such as medication that needs to be administered
an hour before a meal or before a child falls asleep
Known family history to allergies involving medication. If so, what are
the symptoms?6
Storage and disposal of medication
The service should state how medication is stored and disposed of, whether in the
service or carer‟s home.
Services should consider the following reflective questions:
o Does the service have a lockable cupboard, out of reach from children,
where medication can be stored?
o How are self-administered medications stored? For example, how does a
school age child access their asthma puffer if it is in a locked cupboard?
o If medication needs to be refrigerated, is it accessible to children?
o How does the service dispose of medication? Is there a pharmacy that can
dispose of the medication for the service?
o When medication is handed over to the service, does it have the child‟s name
on it? For non-prescribed medication, is it labelled and in its original
packaging? How does the service define „original packaging‟?
o What are the potential risks for the service if it stores medication that is not
clearly labelled and does not indicate which child requires it?
Administering medication to a child
The service should state who is authorised to administer medication in the service.
The service should detail a clear step by step procedure that identifies how
medication is administered.
The procedure should be sourced from either a health care professional or recognised
health authority. This ensures that the service is meeting the state/territory legislative
requirements and recommended best practice form a heath professional.
The importance of a witness
The service may decide to state how it ensures that medication being administered is
done so safely and with the parent or guardian‟s consent by ensuring that there is a
witness to medication administration.
Family day care carers and single model outside school hours care services, should
consider how they ensure that medication is being administered safely and checked
for accuracy.
Self-administration of medication
The service can state, especially for school age children, how it supports the self-
administration of medication.
For example, children with asthma or diabetes may have a history at home and at
school of self-administering their medication.
Services should consider the following reflective questions:
o How does the service support and supervise the practice of self-administering
medication?
o Can children self-administer in a safe and hygienic setting?
o How does the service document and communicate to families when children
have self-administered medication?
o Is there an action plan that assists educators when there is an adverse
reaction to the medication?
6Services should seek advice from a medical practitioner regarding allergies to medications when developing this
policy.
Current as at September 2010 Page 5 of 7
Documenting the administration of medication
Maintaining records
Documenting the administration of medication is important so that educators can
communicate to families about the child‟s health needs.
It is important that all medication documentation is stored safely.
There may be state or territory licensing regulations that require documentation to be
stored for a period of time. Services should state in the policy those requirements.
The person administering and the witness, should sign documentation that identifies
that they were responsible for administering the medication.
Services can link this section by stating:
Please refer to the service‟s Privacy and Confidentiality Policy.
Monitoring after the administration of medication
The service can state how it plans to monitor children after the administration of
medication.
It may be useful to develop a first aid action plan should the child experience an
adverse reaction to the medication.
Services can link this section by stating:
Please refer to the service‟s First Aid Policy.
Communicating with educators and families
Services should consider the following reflective questions:
o How does the service communicate to families when children have been
administered medication?
o How do educators ensure that accurate information is being communicated
during a shift change over?
Prolonged use of medication
Prescribed medication
Brief and concise detail of the service‟s strategy.
Non-prescribed medication
Brief and concise detail of the service‟s strategy.
Experiences
Services should consider the following reflective questions:
o How can play and learning experiences promote safety and responsibility? For
example, a child finds medication in the home and brings it to the service.
o How can the service discuss with children about finding an adult and handing
the medication to them?
o If there is a child who is asthmatic, can educators discuss with children what to
do if they observe the child having difficulty breathing? How can educators
and children discuss what to do? Is there a recognised plan to help the child
assist their peers, such as inform an adult or find the child‟s inhaler?
o What if a staff/carer has a health need that requires medication and they are
alone with children?
Excursions
Services should consider the following reflective questions:
o How does the service ensure that medication can be administered safely and
hygienically while on an excursion?
o Should a first aid kit be taken on excursions?
o What equipment is required while on an excursion to administer medication?
o Does the staffing on the excursion include staff with relevant first aid
qualifications?
o How will the service contact parents/guardians/emergency contact people
should there be a medical emergency?
Current as at September 2010 Page 6 of 7
o How does the service provide the correct administration requirements for the
excursion?
Community
Services should consider the following reflective questions:
o How can the service promote responsible use of medication by using
community role models? For example, the service may decide to build links
with community organisations, such as a doctor or nurse to visit the service and
talk about the safe use of medications. This may be particularly important for
children who have ADHD or who see adults use medications consistently in the
home.
o For services with school age children and operating in areas of high adult drug
use, how can the service be proactive in communicating healthy living
programs and anti-drug use messages? This may be particularly important if
there are high incidences of children seeing used needles in their community.
Links to other policies
The following are a list of examples:
Employment of educators
First aid
Hygiene and infection control
Illness
Occupational health and safety
Privacy and confidentiality
Supporting children‟s individual needs
Sources
National Health and Medical Research Council. (2005). Staying healthy in child care:
Preventing infectious disease in child care (4th ed.). Canberra: Author.
Further reading
Matthews, C. (2004). Healthy children: A guide for child care (2nd ed.). NSW: Elsevier.
Oberklaid, F. (2004). Health in early childhood settings. NSW: Pademelon Press.
Therapeutic Goods Administration. (2007). Scheduling of medicines and poisons:
National Drugs and Poisons Schedule Committee (NDPSC). Retrieved June 28, 2007,
from http://www.tga.gov.au/ndpsc/index.htm
Useful websites
Anaphylaxis Australia – www.allergyfacts.org.au/foodalerts.asp
Asthma Foundations Australia – www.asthmaaustralia.org.au
Immunise Australia Program – www.immunise.health.gov.au
National Health and Medical Research Council – www.nhmrc.gov.au
National Prescribing Service – www.nps.org.au
Policy created date <date>
Policy review date <date>
Signatures <signatures>
Current as at September 2010 Page 7 of 7
