Medication Administration David Leard

Topics

• Governance (Regulations & Standards)

• Administration

• Documentation

• Medication Storage & Disposal

• Administration Errors & Adverse Reactions

• Parent/Guardian & Physician Review

• Questions & AnswersNACOG Head Start

Medication Administration

Governance(Regulations & Performance Standards)

• Arizona Administrative Code– Office of Child Care Licensure

• Title 9, Chapter 5, Article 5, R9-5-516

– Effective date – September 30, 2000

• Head Start Performance Standards– Standard 1304.22(c) Sections 1 - 6

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Administration• Who can administer a child’s medications?

– Only the Center Director, or a staff member designated in writing

– Center Director will ensure that all staff designated to administer medications has been properly trained

• What documentation do I need before I can give a medication to a child?– Written authorization signed by the enrolled child’s parent and

health care provider

– Prescription Medications must contain basic information and bottle must have original pharmacy or manufacturers label

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Administration… continued

• What do I do if a doctor changes the dosage?– Changes in medication dosages must be documented in writing

from the physician or nurse practitioner on letterhead or prescription pad.

• When do I let the child return to normal activities?– Direct all staff to closely monitor the child for a period not less

than 15 minutes after giving the medication.

• What are some types of adverse drug reactions?– Difficulty in breathing– Lethargy (sleepiness, unresponsive)– Changes in coloring– Development of rashes on the body

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Documentation• Where do I document medication administrations?

– Medication Administration Form

• When do I document that I have given any medications?– Immediately after giving the child their medication

• What am I required to write down on the Medication Administration Form?– First & Last name of child– Name, prescription number & amount of the medication (dosage)– Date & time the medication was given– Refusal of medication or any adverse/allergic reactions– Changes in the dosage as prescribed by a physician or nurse practitioner– Parent/Guardian review of Medication Administration Form

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Documentation… continued

• Do I have to complete a separate Medication Administration Form if the child is taking more than one (1) medication?– Yes … you should complete a Medication Administration

Form for each of the medications the child is currently being given.

• How long do I have to keep the Medication Administration Forms on file?– Twelve (12) months from the date the medication was

administered

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Medication Storage & Disposal

• Where do I place the medication?– All enrolled children’s medication must be kept in a locked, leak

proof storage cabinet or container that is maintained out of reach of the children

• Can staff members keep their medication locked up in the same cabinet or container?– NO … staff members medications must be kept in a locked, leak

proof storage cabinet or container that is separate from the children’s.

• Where should I keep the fluoride supplement tablets?– Fluoride treatment tablets will be locked in the same storage cabinet

or container designated for staff member medications

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Medication Storage & Disposal…continued

• Should we keep other medications on hand?– NO … the facility should not maintain any type of prescription or

nonprescription medicationThis includes:

Aspirin Acetaminophen (Tylenol)Ibuprofen (Advil) Cough syrups

• When do I get rid of the medications?– Return all unused prescription and nonprescription medications to

the parent– Medication that has expired– Destroy any medication that remains after a child has disenrolled

and you are unable to locate the parent

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Administration Errors& Adverse Reactions

• I’ve given the wrong amount of Medication now what do I do? Or I’ve given the child someone else’s medication, now what do I do?– Center Director or designated staff members will immediately call

the child’s primary care physicianIf the primary care physician is not available you should call (911) for additional guidance.

– Document on the Medication Administration Form the error and fill out an Accident Report

– Notify the parents according to NACOG Head Start policy on accident reporting

– Contact the Health Coordinator

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Administration Errors& Adverse Reactions… Continued

• Five Minutes ago I gave the child the medication and now she seems to be breaking out with a rash….What should I do?– Center Director or designated staff members will

immediately call the child’s primary care physicianIf the primary care physician is not available you should call (911) for additional guidance.

– Document on the Medication Administration Form the reaction and the instructions given by medical personnel

– Notify the parents according to NACOG Head Start policy on accident reporting

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Parent/Guardian & Physician Review

• When a child is being given medication should the parents see and review the Medication Administration Form?– YES … Head Start Performance Standard 1304.22( C)(4)

states that parents should routinely review the Medication Administration Form

• How often should they review the form?– Parents should be encouraged and provided with the

opportunity to review the Medication Administration Form on a weekly basis

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Parent/Guardian & Physician Review…continued

• Should others be reviewing the form?– Upon request or as events warrant, the center should

provide copies of the Medication Administration Form to parents, primary care physicians, or other emergency medical personnel.

– Doctors should review the form when an adverse reaction occurs.

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Questions &

AnswersNACOG Head Start


Medication Administration David Leard

Technology

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