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Medications Policies

E-25

POLICY: The Director or designee will assure that all policies and procedures around medications are strictly enforced. This includes but is not limited to accepting, storing, administering, and documenting administration of medications, obtaining appropriate instructions and paperwork for each medication, and appropriately handling medication errors. 

PURPOSE: To safely and accurately administer medication.

To protect the health of the children.

To assist program staff in meeting all children’s needs.

To protect the rights of the family and child.

To protect the staff and organization from legal liability. 

To prevent medication errors and possible serious harm to children. 

PROCEDURE:

  1. The Director or designee will assure:
    1. Medications are safely stored, handled, administered, documented, and disposed of according to policy and procedure.
    2. Medication errors will be reported to the parent and follow-up is done with the responsible employee.
    3. Disaster policies and procedures include how medications will be administered in an emergency or during an evacuation. 
  2. Teachers will administer medications to children attending the childcare, only with approval of the Site Director and after receiving training from the parent/legal guardian or the Nurse Consultant. Only authorized staff members can administer medication to children.
  3. Prescription and over-the-counter (OTC) medication shall be administered in accordance with the label directions. Health care provider instructions shall not conflict with the product label directions.
  4. Prescription medications will be in the original bottle, properly labeled with:
    1. The child’s name
    2. The medication name
    3. The amount to be given (dosage)
    4. The times to be given
    5. How many days it should be given
    6. The prescribing health care provider’s name and number
    7. The expiration date
    8. If the medication is to be given “as needed”, it must state the specific symptoms for which it should be given. 
    9. Warnings regarding safety.
  5. Written consent must be provided from the parent/legal guardian, permitting childcare facility personnel to administer medications to the child. Use LIC 9221.
  6. For non-prescription OTC medications, the parent must complete the parent instructions on form LIC 9221 indicating the medication name, dosage, frequency, and how many days to give the medication. 
    1. Instructions for both prescription and OTC medications cannot simply state “as needed”. Specific symptoms for giving the medication must be listed in writing. 
    2. Instructions for use from the parent/legal guardian shall not conflict with the prescription label or product label directions.
  7. Teachers should not agree to a parent request to give a new medication until it has been confirmed that the required paperwork has been properly completed and submitted to the Director. 
  8. Upon receiving form LIC 9221 and the medication, review the following:
    1. The date the form is signed.
    2. Medication is in its original packaging (including the box). 
    3. Prescription medications have a label with the details specified above in #4. 
    4. Medication is not expired.
    5. The health care provider’s instructions, the parent/legal guardian’s instructions, and the product label are consistent.  
    6. Child's name is the same as the one on the medication bottle.
    7. Name of the medication is the same on the medication bottle and the form.
    8. Dosage and times are correct on the medication label and the form.
    9. Number of days as ordered by the doctor: if not noted, use site's policy.
    10. Any special instructions. Clarify with parent/legal guardian if needed.
    11. Parent has signed the form to give permission.
  9. Medications will be given within 30 minutes of the time specified. Activities, meals, and naps will be carefully planned to ensure that medications are given in a timely manner. 
  10. Every dose given should be documented on an administration log and include the child’s name, medication name, date and time given, and name of staff who gave it. 
  11. Non-refrigerated medications and emergency medications are to be stored in safe place that is inaccessible to children. As a best practice recommendation and per site policy, consider having controlled medications in a locked box that is inaccessible to children and with key readily available
  12. When indicated on the label, medication will be stored in a refrigerator. If stored in a refrigerator, it should be inaccessible to children for safety (e.g. child-proof lock or in a fridge in an area where children do not have access). 
  13. Measuring devices will be used for accurately measuring doses.
  14. All expired or unused medications should be returned to the parent/legal guardian for disposal. If the medication cannot be returned to the parent/legal guardian, it should be disposed of safely. See www.sfenvironment.org/safe-medicine-disposal for a list of drop off locations or how to send them by mail for disposal though the SF Environment Department. You can also visit How to Safely Dispose of Old Medicines - HealthyChildren.org for more information.
  15. Keep a list of medication expiration dates and communicate with parents/legal guardians about expiring medications that will need to be replaced soon. 
  16. All field trips must make it possible for a child's medication to be transported, stored, and given properly in a timely manner. Emergency medications such as asthma inhalers or epi-pens must be brought on all field trips. 
  17. All medications must be taken outside with you during an evacuation, including drills. 
  18. The Health Advocate or designee will determine that every dose is accounted for, including refusals, absences, and any other reason that an anticipated dose was not given.
  19. If 9-1-1 is ever called for a child, EMS should be notified of the child’s medications. 
  20. If a child develops a side effect to the medication that is not life-threating, notify parents/legal guardian immediately and inform them that they must check with the doctor before giving more medication. Ask if they wish to pick up the child or if they want you to monitor. 
  21. In the event of a medication error of any sort:
    1. Contact parents/legal guardians and also the Poison Control Center at 1-800-222-1222. Link: https://calpoison.org/
    2. ALWAYS contact Poison Control immediately if a child received the wrong medication, or the wrong dose, a dose too soon, or is having an adverse reaction to a medication.
    3. If a child shows signs of a severe adverse reaction, call 9-1-1. 
    4. Fill out the Medication Error Form (see E-29) and submit to the Site Director.
    5. Conduct a review of the circumstances that led to the medication error (root cause analysis). Determine what changes to policies, staffing, the environment, or center policies need to occur in order to prevent such medication errors in the future. Review medication policies with all staff. 
  22. For more detailed information on medication policies and care plans for children with medications, you may review and apply the information found at SFUSD notification for administration of student medications at school if applicable. Link and QR code: https://www.sfusd.edu/services/know-your-rights/student-family-handbook/chapter-3-family-resources-and-rights/310-medication-and-emergency-care-plan-forms/3102-notification-administration-student-medications-school