Maine statute MRSA Title 20-A § 254(5) requires that school districts develop a policy on medication administration in schools, Chapter 40 Rule for Medication Adminsitration in Maine Schools, outlines what must be included. The policy must address the training by the school nurse of unlicensed school staff that administer medication and must address students who carry and self-administer emergency medication. It is recommended that medication be administered only when it is essential for the student to remain in school.
The school nurse is responsible to oversee medication administration in schools to ensure that medications are administered safely. These responsibilities are to:
- Consult with school administration and school boards in the development/revision of a medication administration policy.
- Develop and update procedures for the administration of medication according to Chapter 40 Rules
- Develop and maintain a record keeping system for obtaining parental consent and a medical provider's order, receiving (and counting scheduled drugs) and administering medication, training of unlicensed school staff, documenting medication errors and disposal of medication not retrieved by parents
- Assure that medication containers have current and adequate information on the label and that when a medication is given greater than 15 consecutive days, a written medical order is obtained
- Develop and conduct training for unlicensed school personnel who are delegated by school administration and who volunteer to be trained for administering medications
- Determine the competency of the unlicensed staff and provide ongoing supervision of the unlicensed staff in the task of medication administration
- Provide annual review of medication administration to previously trained staff
- Develop clear protocol for the unlicensed staff administering medications
- Evaluate a student’s ability to carry and self-administer emergency medication (epinephrine auto-injector, asthma inhaler and glucagon)
- Develop procedure for administering medication on field trips
- Develop a response plan in case of an emergency
- Inform the parent that the medication may be administered by trained unlicensed school personnel
- Identify who has access to the medicine cabinet
- Obtain standing orders from the school health advisor for the school nurse to administer, as appropriate.
The certified school nurse may choose to not oversee some medication administration activities if, in the judgment of the school nurse, the task can not be properly and safely performed by the unlicensed person without jeopardizing the student’s welfare. Oversight of a task carried out by an unlicensed person is determined on a case-bycase basis and is most appropriate when the unlicensed staff is caring for students with routine, repetitive, and ongoing medication administration. When medication administration is not routine and the student’s response to medication is less predictable, nursing oversight should be carefully considered. Please see School Health Manual section on Coordination, Delegation & Oversight.