Knox County Career Center
Administrative Guidelines
 

5330 - USE OF MEDICATIONS

The medications and/or treatments which may be administered are defined in Policy 5330. In those circumstances where a student must take prescribed medication during the school day, the following guidelines are to be observed:

 A.Parents should cooperatively determine with the counsel of their child’s prescriber whether the medication schedule can be adjusted to avoid administering medication during school hours.
  Before the student will be permitted to take medication during school hours, use an inhaler to self-administer asthma medication, or use an epinephrine autoinjector (epi-pen), Form 5330 F1, Parent Request and Authorization to Administer a Prescribed Medication/Drug or Treatment, or Form 5330 F3, Authorization for the Possession and Use of Asthma Inhaler/Other Emergency Medication(s), or Form 5330 F4, Authorization for the Possession and Use of Epinephrine Autoinjector (epi-pen) must be filed annually and as necessary for any change in medication order with the director and, to the School Nurse if one is assigned to the student’s building.
  1.Form 5330 F1, Parent Request and Authorization to Administer a Prescribed Medication/Drug or Treatment, shall include the following:
   a.student's name and address;
   b.name of the medication/drug and dosage to be administered and/or procedure required to be followed;
   c.the time or intervals at which each dosage of the medication/drug is to be administered;
   d.any severe adverse reactions that should be reported to the physician and one or more telephone numbers at which the prescriber can be reached in an emergency; a signed parental release that allows direct contact with the prescriber in such emergency reaction situations will not supersede nor abrogate the "Emergency Medical Form";
   e.special instructions for administration of the medication/drug, including sterile conditions and storage;
   f.the date administration of the prescribed medication/drug is to begin;
   g.the date administration of the prescribed medication/drug is to cease;
   h.authorization for school personnel to administer the prescribed medication;
   i.agreement/satisfactory arrangement to deliver the medication/drug to/from school (i.e., the medication/drug must be received by the person authorized to administer it to the student for whom it is prescribed in the container in which it was dispensed by the prescriber or a licensed pharmacist);
   j.agreement to re-submit Form 5330 F1, Parent Request and Authorization to Administer a Prescribed Medication/Drug or Treatment, if the medication, dosage, schedule, procedure or any other information contained on the licensed prescriber’s statement is changed or eliminated;
   k.the prescriber’s name, address, and telephone number;
   l.probable side affects;
   m.agreement to re-submit Form 5330 F1, Authorization for Prescribed Medication or Treatment, if the medication, dosage, schedule, or procedure is changed or eliminated.
  2.Form 5330 F3, Authorization for the Possession and Use of Asthma Inhalers, shall include the following:
   a.the student’s name and address;
   b.the names and dose of the medication contained in the inhaler;
   c.the date the administration of the medication is to begin;
   d.the date, if known, that the administration of the medication is to cease;
   e.written instructions that outline procedures school personnel should follow in the event that the asthma medication does not produce the expected relief from the student’s asthma attack;
   f.any severe adverse reactions that may occur to the child using the inhaler and that should be reported to the prescriber;
   g.any severe adverse reactions that may occur to another child for whom the inhaler is not prescribed, should such a child receive a dose of the medication;
   h.at least one (1) emergency telephone number at which the prescriber may be contacted in an emergency;
   i.at least one (1) emergency telephone number for contacting the parent, guardian, or other person having care or charge of the student in an emergency; and
   j.any other special instructions from the prescriber.
  3.Form 5330 F4, Authorization for the Possession and Use of Epinephrine Autoinjector (Epi-Pen), shall include the following:
   a.student's name and address
   b.name of the medication/drug contained in the autoinjector and dosage to be administered
   c.the date administration of the prescribed medication/drug is to begin
   d.the date administration of the prescribed medication/drug is to cease (if known)
   e.acknowledgement that the prescriber has determined that the student is capable of possessing and using the autoinjector appropriately and has provided the student with training in the proper use of the autoinjector
   f.circumstances in which the autoinjector should be used
   g.written instructions that outline procedures school personnel should follow in the event that the student is unable to administer the anaphylaxis medication
   h.written instructions that outline procedures school personnel should follow in the event that the anaphylaxis medication does not produce the expected relief from the student's anaphylaxis;

   i.any severe adverse reactions that may occur to the child using the autoinjector that should be reported to the prescriber;
   j.any severe adverse reactions that may occur to another child, for whom the autoinjector is not prescribed, should receive a dose of the medication
   k.at least one (1) emergency telephone number at which the prescriber may be contacted in an emergency
   l.at least one (1) emergency telephone number for contacting the parent, guardian or other person having care or charge of the student in an emergency
   m.any other special instructions from the prescriber
  4.A student may possess and use a metered dose inhaler or a dry powder inhaler either before exercise to prevent the onset of asthmatic symptoms or to treat the symptoms once they occur at school, or at any activity, event, or program sponsored by the student’s school or in which the school participates. Additionally, a student may possess and use an epinephrine autoinjector to treat anaphylaxis once it occurs at school, or at any activity, event, or program sponsored by the student's school or in which the school participates. The principal or school nurse, if one is assigned to the student's building shall also be provided with a backup dose of the anaphylaxis medication by the parent/guardian, or student (if s/he is eighteen (18) or older).
  5.Students authorized to possess and use a metered dose or dry powder inhaler or an epinephrine autoinjector under the Board policy may not transfer possession of any inhaler, epinephrine autoinjector or other medication to any student or permit any other student to use the inhaler medication or anaphylaxis medication.
  6.School personnel are not authorized to assist a student in self-administering asthma medication or anaphylaxis medication unless the policy and procedures regulating administration of medication by school personnel have been met. In the event the epinephrine is administered by the student or school personnel at school, or at any activity, event, or program sponsored by the student's school or in which the school participates, a school employee shall immediately request assistance from an emergency medical provider (i.e., 911).
  7.Periodically the administration shall contact the parent(s) of any student whose school records indicate that s/he has asthma and advise them of the option to have said student carry and self-administer approved inhalers in school. A copy of Form 5330 F3, Authorization for the Possession and Use of Asthma Inhaler/Other Emergency Medication(s), is to be enclosed with this communication.
  8.Additionally, the administration shall contact the parent(s)/guardian(s) of any student whose records indicate that s/he has anaphylaxis and advise them of the option to have the student carry and self-administer an epinephrine autoinjector to treat the anaphylaxis. A copy of Form 5330 F4, Authorization for the Possession and Use of Epinephrine Autoinjector (Epi-pen), is to be enclosed with such communication.
 C.Upon receipt, a copy of Form 5330 F1, Parent Request and Authorization to Administer a Prescribed Medication/Drug or Treatment, a copy of Form 5330 F3, Authorization for the Possession and Use of Asthma Inhaler/Other Emergency Medication(s), and/or a copy of Form 5330 F4, Authorization for the Possession and Use of Epinephrine Autoinjector (Epi-pen), shall be filed in the student's permanent record as well as in the binder with the student medication log sheet.
 D.All medications to be administered during school hours must be registered with the guidance office and will be secured in the office. Upon receipt of the medication, the administration shall verify the amount of medication brought to the school and indicate that amount on the student medication log sheet.
 E.Medication that is brought to the office will be properly secured. Medication may be conveyed to school directly by the parent/guardian or other responsible adult at parental request. This should be arranged in advance. Two to four (2-4) weeks supply of medication is recommended. Medication MAY NOT be sent to school in the student's lunch box, pocket, or other means on or about his/her person. An exception to this would be prescriptions for emergency medications for allergies and/or reactions, including an epinephrine autoinjector to treat anaphylaxis, or asthma inhalers.
 F.For each prescribed medication, the container shall have a pharmacist's label with the following information:
  1.student's name;
  2.prescriber 's name;
  3.date issued and expiration date;;
  4.pharmacy name and telephone;
  5.name of medication;
  6.prescribed dosage and frequency
  7.special handling and storage directions.
 G.Any unused medication unclaimed by the parent will be destroyed by administrative personnel when a prescription is no longer to be administered or at the end of a school year.
 H.All medications are to be administered in such a way as to not unduly embarrass the student.
 I.A log for each prescribed medication shall be maintained that records the personnel giving the medication, the date, and the time of day. This log will be maintained along with the prescriber's written request and the parent's written release.
 J.Form 5330 F1 shall be completed and signed by the director authorizing the person(s) who may administer the medication or procedure.
 K.A count of each student's medication is to be made periodically by the guidance office and the amount reconciled with the original amount indicated on the log sheet and the number administered since the last count.
 L.Training will be provided for each person authorized to administer a prescribed medication or treatment.

Nonprescribed (Over-the-Counter) Medications

No student may be allowed to possess and self-administer an over-the-counter medication. No staff member is permitted to dispense any over-the-counter medication to any student at any time.

If a student is found with a medication in his/her possession, his/her record should be checked to determine if the proper authorization is on file. If not, the matter is to be reported to the director for disciplinary action.

The purpose of any disciplinary action on this matter should be to make it clear to all students and parents that, because of its policy on drug use, the school cannot allow possession or use of any form of unauthorized drug or medication at any time.

Revised 11/06
Revised 6/1/07