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 **Policy JLCD\\
 Administering Medicines to Students\\
-School Board Approved: April 7, 2014**\\
+School Board Approved: December 5, 2022**\\
-The school nurse shall be responsible for establishing specific procedures to protect and control
+**General Provisions for Administration of Medication**\\
-medications administered in schools.\\
+Medication whether prescription or over-the-counter (“OTC”), shall only be administered to or taken by students during the school day in accordance with this policy.\\
-The following policy will be adhered to when a student requires medication during school hours
+This policy shall extend to any school-sponsored activity, event, or program.\\
-and at school-sponsored activities:\\
-Medication is to be administered by the school nurse. In the absence of the school nurse, the principal or principal's designee may assist the student in taking the prescribed medication. This assistance consists of making the medication available to the student, observing and documenting whether the student took the medication or not. If the school must administer the medication, only the school nurse or the school nurse's delegate may administer the medication. If the student requires a comprehensive nursing assessment and/or evaluation, this assessment and/or evaluation must be done by the school nurse and cannot be delegated.\\
+Medication is to be administered by a school nurse, as defined in RSA 200:29 (“the school nurse”). The school nurse may delegate the administration of medication to others only as permitted under the New Hampshire Nurse Practice Act, and N.H. Code of Administrative Regulations Nur 404. If no such person is available, the building principal or the principal’s designee is permitted to assist students in taking required medications by: \\
-In accordance with standard nursing practice, the school nurse may refuse to administer or allow the administration of medication, which based on his/her individual evaluation and professional judgment, has the potential to be harmful, dangerous or inappropriate. In these cases, the school nurse shall notify the parent/guardian and may notify the licensed prescriber of the reason for the refusal which shall be documented in the student’s health record.\\
+  * making such medications available to the student as needed.
+  * observing the student as he/she takes or does not take his/her medication.
+  * recording whether the student did or did not take his/her medication.\\
-Prescribed medication should not be taken during school hours if it is possible to achieve the medical regimen during hours at home. Any student who requires prescription medication administration must have a school medication permission form completed by parent/guardian and a licensed prescriber and placed on file in the health office. The forms shall comply with standards set forth on NH Code of Administrative Rules Ed 311.02.\\
+Whenever possible, medications, should not be taken during the school day. Upon receiving a request from the parent, guardian, or physician relative to a particular student's need for medication during school hours, the school nurse may contact the parent, or guardian to discuss whether the student should remain at home, or whether the medication should be taken before, during, and/or after school. The nurse may also inquire about any other medical conditions requiring medications and any special side effects, contraindications, and adverse reactions to be observed.\\
-Over the counter (OTC) medication should not be encouraged for use while at school. Only the
+Prescription medication will be only be administered in school only after receiving and filing in the student's health record the following:\\
-school nurse with written authorization of the parent/guardian shall administer OTC. At the
-discretion of the school nurse, a written licensed prescriber's order may be required.\\
-Any student who requires herbal medication administration must have a school medication
+  * A written statement from the licensed prescriber conforming to the requirements of N.H. Department of Education Rule 311.02 (i)(1).
-permission form completed by the parent/guardian and licensed prescriber which will be placed
+  * A written authorization from the parent/guardian as provided in N.H. Department of Education Rule 311.02 (i)(2) & (3).\\
-on file in the health office.\\
-A new licensed prescriber's order form must be completed each school year or whenever there is
+Over-the-Counter medication may be administered to a student with previous written authorization from the parent/guardian. The school nurse may, however, require a licensed prescriber’s order, or further information/direction from a licensed health care provider (i.e., physician, advanced registered nurse practitioner, licensed physician’s assistant or dentist), before administering an OTC medication to a student. The authorization shall contain the same information, with the same access, as is required relative to prescription medications.  \\
-a change in medication, dosage, time to be administered or route of administration.\\
-Verbal orders from a licensed health care provider may be accepted followed by a written order.
+To the extent consistent with New Hampshire’s Nurse Practices Act, RSA 326-B, the school nurse may at his/her discretion accept verbal instructions from a licensed health care provider relative to administration of a prescription medication, and verbal instructions from a parent/guardian with respect to an OTC medication. In both instances, the verbal instructions shall be followed by written statements as provided above.\\
-Faxed orders are acceptable.\\
-A parent/guardian shall deliver all medication to be administered by school personnel to the
+**Emergency Administration of Medication**\\
-school nurse or other responsible person designated by the school nurse as follows:\\
+The school nurse or other properly designated personnel may administer other medications to students in emergency situations provided such personnel has all training as is required by law, and is consistent with the provisions of Board policy JLCE. \\
-The prescription medication shall be delivered in the original pharmacy or manufacturer labeled
+**Field Trips and School Sponsored Activities**\\
-container, properly labeled with the student’s name, drug strength, dosage, route, the time the
+A single dose of medication may be transferred by the school nurse from the original container to a newly labeled container for the purposes of field trips or school sponsored activities.  For trips or activities necessitating more than one dose, special arrangements for administering medication must be approved by the school nurse or, in the school nurse’s absence, the Principal.\\
-medication is to be administered, the physician’s name, and any specific directions for
-medication use.\\
-The school nurse or principal's designee receiving the prescription medication shall count and
+**Other Uses/Administration Prohibited**\\
-record the amount of the prescription medication received from the parent/guardian.\\
+No person shall share or otherwise administer any prescription or over-the counter medication with any student except as provided in this policy. Notice of this prohibition will be provided in student handbooks. Students acting in violation of this prohibition will be subject to discipline consistent with applicable Board policies.\\
-The medication may be delivered by other adult(s) provided that the nurse is notified in advance
+**Delivery, Storage and Disposal of Medication**\\
-by the parent/guardian of the delivery and the quantity of prescription medication being
+Medications provided by the student’s parent/guardian may only be delivered to the school nurse or principal/principal’s designee. All such medication should be delivered in its original container. The school nurse is directed to keep such medications in a locked cabinet or refrigerator. No more than a 30-day supply will be kept and maintained by the school. The school nurse will contact the parent/guardian regarding any unused medication. \\
-delivered to school is specified.\\
-No more than a 30-day school supply of the prescription medication for a student shall be stored
+Such medication shall be picked up by parent/guardian within ten days after its use is discontinued. If the parent/guardian does not pick up the medication within ten days, the school nurse may dispose of the unused medication and record as such in the student's health record file. \\
-at school.\\
-All medications shall be stored in their original pharmacy or manufacturer labeled container in a securely locked cabinet. The school nurse or principal shall be responsible for the key or combination of the locked cabinet. If at any time the cabinet is broken into resulting in missing medication, the nurse shall immediately notify the principal and the police. The parent/guardian will be notified of the incident and must replenish the supply of medication. Emergency medications may be stored in other locations readily accessible only to those individuals with authorization.\\
+The school nurse may maintain a supply of asthma related rescue medication and the emergency medication epinephrine.\\
-Student’s medications may be retrieved from the health office by the parent/guardian or a designated adult at any time during regular school hours. Medication will be discarded if not picked up within 10 days after medication is discontinued or by the last day of school.\\
+**Administration and Self-Administration of Epinephrine Auto-Injectors and Inhalers**\\
+Students may possess and self-administer an epinephrine auto-injector if the student suffers from potentially life-threatening allergies. Both the student's parent/guardian and physician must authorize such self-possession and self-administration. If a student finds it necessary to use his/her auto-injector, s/he shall immediately report to the nearest supervising adult. The school nurse or building principal may maintain at least one epinephrine auto-injector, provided by the student, in the nurse's office or other suitable location. Additionally, students may possess and self-administer a metered dose inhaler or a dry powder inhaler to alleviate or prevent asthmatic symptoms, auto-injectors for severe allergic reactions, and other injectable medications necessary to treat life-threatening allergies. Both the student's parent/guardian and physician must authorize such self-possession and self-administration. Such authorization must include the same information required under the first section of this policy.  \\
-A single dose of medication may be transferred by the school nurse from the original container to
+Other emergency medications, such as insulin, may be carried and self-administered by the student only with prior approval by the school nurse and written statements from a licensed health care provider and a parent/guardian and in the same manner as described in the first section of this Policy, and subject to other conditions as the school nurse may require. \\
-a newly labeled container for the purposes of field trips or school related activities. A responsible
-adult designated by the principal or school nurse will assist the student in taking the prescribed
-medication by making the medication available, observing the student taking the medication and
-documenting whether the student took the medication or not. If the student’s parent/guardian is
-chaperoning the field trip, he/she will administer the medication.\\
-Students are not allowed to carry medications during the school day. An exception will be made for inhalers for respiratory concerns and for epinephrine auto injectors for severe allergies which may be possessed by a student and self-administered in accordance with the requirements of RSA 200:42 and RSA 200:46. Inhalers and epinephrine auto injectors must be properly labeled with the student's name and type of medication. The student will be held responsible to keep self-carried medication in a safe place that is not accessible to other students. If a student self-carries medication, the parent/guardian shall be responsible for supplying the health office with a backup medication.\\
+**Medication Records**\\
+The school nurse is responsible for keeping accurate records regarding the administration of medication to students. Such records shall be retained as required under Board policy EHB, Data/Records Retention.\\
-If any student is found to be irresponsible with his/her medication, the school administration and parent/guardian will be notified for further action. At the discretion of the school nurse, other
+**Implementation: Procedures and Protocols**\\
-medications such as insulin, may be carried and self-administered.\\
+The Superintendent, in consultation with the school nurse(s), shall be responsible for establishing specific procedures necessary and appropriate to control (e.g., delivery, storage, authorization, record-keeping, reporting, etc.) medications in the schools. The procedures should be reviewed no less than every two years.  \\
-Immediately after using the epinephrine auto-injector during the school day, the student shall report to the health or principal's office to enable the nurse or principal or principal's designee to provide appropriate follow-up care.\\
+Additionally, and pursuant to N.H. Administrative Rule Ed. 311.02(k), each school nurse shall also develop and implement building specific protocols regarding receipt and safe storage of prescription medications.\\
-It is the responsibility of the parent/guardian to notify the school health office of any changes in their child's health, allergy status or medication changes.\\
+**Legal References:**\\
+//RSA 200:40-b, Glucagon Injections\\
-**Legal References:**\\
+RSA 200:42, Possession and Use of Epinephrine Auto-Injectors Permitted\\
+RSA 200:43, Use of Epinephrine Auto-Injector\\
-//RSA 200:42\\
+RSA 200:44, Availability of Epinephrine Auto-Injector\\
-RSA 200:43\\
+RSA 200:44-a, Anaphylaxis Training Required\\
-RSA 200:44\\
+RSA 200:45, Student Use of Epinephrine Auto-Injectors - Immunity\\
-RSA 200:45\\
+RSA 200:46, Possession and Self-Administration of Asthma Inhalers Permitted\\
-RSA 200:46\\
+RSA 200:47, Use of Asthma Medications by Students - Immunity\\
-RSA 200:47\\
+RSA 200:54, Supply of Bronchodilators, Spacers or Nebulizers\\
-NH Code of Administrative Rules, Section Ed. 306.12 (b)(2)\\//
+RSA 200:55, Administration of Bronchodilator, Space or Nebulizer\\
+RSA 326-B, Nurse Practices Act\\
+N.H. Code of Administrative Rules, Ed. 306.12(b)(2), Special Physical Health Needs of Students\\
+N.H. Code of Administrative Rules, Ed. 311.02(d); Medication During School Day\\
+N.H. Code of Administrative Rules, Nur 404; Ongoing Requirements//\\
 {{ :jlcd_administering_medicines_to_students.pdf |Download}}\\
 [[section_j|Section J]]\\
 [[start|Policy Manual]]

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