Policy JLCD
Administering Medicines to Students
School Board Approved: December 5, 2022
General Provisions for Administration of Medication
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.
This policy shall extend to any school-sponsored activity, event, or program.
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:
- 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.
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.
Prescription medication will be only be administered in school only after receiving and filing in the student's health record the following:
- A written statement from the licensed prescriber conforming to the requirements of N.H. Department of Education Rule 311.02 (i)(1).
- A written authorization from the parent/guardian as provided in N.H. Department of Education Rule 311.02 (i)(2) & (3).
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.
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.
Emergency Administration of Medication
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.
Field Trips and School Sponsored Activities
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.
Other Uses/Administration Prohibited
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.
Delivery, Storage and Disposal of Medication
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.
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.
The school nurse may maintain a supply of asthma related rescue medication and the emergency medication epinephrine.
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.
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.
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.
Implementation: Procedures and Protocols
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.
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.
Legal References:
RSA 200:40-b, Glucagon Injections
RSA 200:42, Possession and Use of Epinephrine Auto-Injectors Permitted
RSA 200:43, Use of Epinephrine Auto-Injector
RSA 200:44, Availability of Epinephrine Auto-Injector
RSA 200:44-a, Anaphylaxis Training Required
RSA 200:45, Student Use of Epinephrine Auto-Injectors - Immunity
RSA 200:46, Possession and Self-Administration of Asthma Inhalers Permitted
RSA 200:47, Use of Asthma Medications by Students - Immunity
RSA 200:54, Supply of Bronchodilators, Spacers or Nebulizers
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
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