Children may need medicine to treat an acute illness, such as an infection, or a chronic medical condition (e.g., diabetes, attention-deficit/hyperactivity disorder [ADHD]). So, there may be times when someone else must give your child their medicine. During school hours, a school nurse or sometimes a teacher will give the medicine to your child. No matter where medicines are taken or administered there is always a possibility of a mistake happening. This means even when your child is in school, there is a potential for an error to occur. There are steps parents or caregivers can take to reduce the risk of error and protect your child.
Educate Yourself. Know the most common types of mistakes that occur when students are given medicines during school hours. Below is a description of what these are:
Did you know?
The National Association of School Nurses (NASN) advocates for every school to have an emergency plan in place in the event of an opioid-related overdose on school grounds. Even if you don’t think this will ever happen to your child, ask your school what their policy is for a suspected opioid overdose in a school setting. Is Narcan available in your school building and who will be trained to administer it. Also, be certain to ask what additional procedures will be in place if Narcan is administered.
- Missed doses, especially when students do not show up in the nurse’s office for the medicine at the scheduled time and they are mistakenly thought to be absent
- Dosing errors, especially double doses and overdoses
- Giving the wrong medicine to the wrong student, especially for medicines or students with similar names
- Giving a medicine without the parent’s permission and/or a doctor’s authorization
- Failing to administer an emergency medicine in a timely manner
- Failing to document giving a medicine
- Failing to notice or check for signs and symptoms requiring further medical evaluation
Speak with Your Doctor First. Ask your child’s doctor if there are ways to avoid taking doses during the school day. Some medicines have a long-acting form that can be taken before and/or after school.
Ask Questions. Before you send your child to school with medicine, be sure to have important safety information. Ask the school for a copy of their policy for administering medicines. Use the list below to help guide you on what questions to ask:
- Who will be giving medicine to your child? Find out if a registered nurse is on duty every day, and if not, who will be giving the medicine to your child.
- What process does the school have in place to verify the right student is getting the correct medicine and dose?
- What is the process to ensure my child arrives at the school health office to receive his or her medicine on time?
- Can students carry and take their own medicine? For example, an asthma rescue inhaler or an insulin pen?
- How will your child’s medicine be stored? Ask to see the refrigerator if your child’s medicine requires refrigeration.
- Can you come to the school to give the medicine to your child? How would these arrangements be made? Who do you call if you cannot come to the school?
- How does the school handle a medicine that is a controlled substance? For example, medicine used for ADHD. How will this be locked up differently from other controlled substances (e.g., opioids)? Will a tablet/capsule count be recorded? If so, how often?
- What happens to the unused medicines? For example, if my child no longer needs to take a medicine at school or at the end of the school year.
- What is the policy if my child needs medicine during a field trip, sport event, or extracurricular activity away from the school building or property? How will the medicine be transported, stored, and given to your child during the trip?
- What is the school policy if an error with the medicine occurs involving my child?
- What types of emergency medicines are kept in the school for all student? Epinephrine autoinjectors for allergic reactions? Narcan (naloxone) for opioid overdoses?
- Will your child have immediate access to emergency medicines? 1
- Does the school require your written permission for school personnel to administer an emergency medicine to your child?
Preparing Your Child. No matter how young, your school-aged child can be taught how to detect an error. Here are some steps on how to prepare your child when they need to take medicine at school:
- Provide older children with basic information about the medicines they take. Make sure they know the name of each medicine, the dose, when and how it should be taken, why it is taken, side effects, and whether any food or beverages should or should not be restricted.
- Before sending medicine to school, show the child what the medicine will look like (color, shape, size). Tell them not to take any medicine they do not recognize. If you send new medicine to school, or change the brand of medicine be sure to show your child what the new medicine will look like.
- Be sure children know when to arrive at the school health office for their medicine, where it is located, and how to get there.
- Encourage your child to question anything that doesn’t seem right. Tell your child to call (or ask the person giving them the medicine to call) a parent if they think it is not right.
- Teach children to never share their medicine with others (including medicine patches) and to only take medicine from an authorized adult.
Bringing Medicines to the School. While every school will have its own unique policy, below are recommendations to follow when sending your child to school with any medicine.
- Complete any required school forms. Provide as much information as possible, including allergies and how your child prefers to take the medicine.
- Provide written consent regarding who can give medicine to your child during school.
- Provide authorization (if required) for the school to contact the child’s doctor.
- Check all prescription medicines to be sure they were filled properly before bringing them to the school.
- Bring all medicines to the school in the original labeled container from the pharmacy, doctor, or pharmaceutical company (e.g., no envelopes, baggies). Be sure the label includes the following information:
• Child’s name
• Name of the medicine
• Strength of a liquid medicine (e.g., 5 mg/mL)
• Dose of medicine to be given
• Time and how often to give it
• Route of administration
• Name of doctor ordering the medicine
• Expiration date•
• How long it should be given (e.g., during the school year, for 1 week)
- Make a note of the expiration date of the medicine so it can be replaced if needed during the school year.
- Have an adult bring the medicine to the school and hand it directly to the school nurse or school official.1
- If providing the school with medicine devices like an asthma inhaler, an epinephrine autoinjector, or an insulin pen, don’t assume school personnel know how to use it. Write out the instructions and go over them with personnel who will be giving the medicine.
- Provide a picture of your child to keep with any medicine that must be administered.
- If your child needs medicine for a chronic condition, provide the school with any medical action plans that have been created for the child (e.g., an asthma plan that specifies when to use inhalers, www.ismp.org/ext/73).
- Let the school nurse or school personnel know if your child will be wearing a medicine patch or using a medicine pump (e.g., insulin pump) during school hours, even if the medicine will not be administered by school personnel.
- Ask to be notified if your child does not show up for any scheduled medicine, refuses to take it, or shows symptoms related to their condition or the medicine they are taking.
- Make sure any changes in a medicine, dose, or frequency are communicated immediately and directly to the school nurse or school official. If the medicine is stopped, or at the end of the school year, pick up any unused medicine.
Follow Up. Communicate often with the school nurse (or individual responsible for administering medicines at the school).
- On a regular basis, ask your child if there are any problems with getting to the school health office or getting their medicine. If you have any questions, call the school nurse or other school official.
- If your child no longer needs medicine at the school, and there are leftovers of it, be certain to arrange a time to pick up the remainder of the medicine.
- If your child’s school does not have a full-time registered nurse onsite every day, attend parent teacher association (PTA) and school board meetings to advocate for a school nurse.
1 American Academy of Pediatrics (AAP).Administering medication at school: tips for parents. AAP Council on SchoolHealth. HealthyChildren.org. 2016. www.ismp.org/ext/76