Minnesota Guidelines for Medication Administration in Schools - May 2005

(Updated: September 2005)

Maternal and Child Health Section graphic of an outline of a parent with a child in the middle of the outline of Minnesota.

Support from the Literature with Selected Annotations for the Minnesota Medication Administration Guidelines for Schools.

Cady, R. (March/April 2002). Are There Legal Issues of Concern for Nurses When Patients Use Complimentary and Alternative Medicine? MCN, The American Journal of Maternal Child Nursing, 27, 2: 119.

Calabrese, B., Nanda, J., Huss, K., Winkelstein, M., Quartey, R., & Rand, C. (1999). Asthma knowledge, roles, functions, and educational needs of school nurses. The Journal of School Health, 69, 233-238.

This article described a qualitative research study done with school nurses in Maryland and the District of Columbia to determine their skills, functions, and needs related to asthma management with students. The study identified problems with time available for school nurses (they spend more time and effort being reactive than proactive). School nurses also did not communicate consistently with students, staff, parents, and health care providers about health needs of students with asthma.

Care of Children with Diabetes in the School and Day Care Setting. (2002). Diabetes Care, Supplement I 25, S122-S126.

The purpose of this position statement was to provide recommendations for management of children’s diabetes in the school and day care setting. The general guidelines covered include a health care plan, responsibilities of the various care providers, expectations of the student in diabetic care, and monitoring blood glucose in the classroom. It concluded with background information on diabetes for school personnel.

Caruso, D.B. (February 4, 2003). Study recommends limits for herb linked to deaths. Associated Press. Retrieved February 4, 2003, from http://www.startribune.com/stories/484/3630890.html.

Carter, R. (January 29, 1999). Nurses say their role is changing: Responsibilities broadened by poverty, more kids on medication, families with health care affiliations. The Atlantic Journal and Constitution.

Center for the Future of Children. (Winter 1997). The Future of Children. Financing Schools. 7, 3. The David and Lucile Packard Foundation.

CD-ROM Based Training Preparation for Administering Meds to Schoolchildren. (2003). Synchrony Solutions, LLC. Retrieved January 24, 2005 from, http://www.training-classes.com/

According to the authors, this research plan was for the development and implementation of a comprehensive multimedia training program that would be available to schools on a national level and could help to reduce the medication error rate when medications are administered by unlicensed assistive personnel (UAPs). During Phase 1 research, the authors sought to show that the training and support needs of school nurses and the UAPs delegated the responsibility for administering medications to school children could be met through this program. The proposed research would involve focus groups with school nurses and UAPs and developing and test training modules for UAPs and for school nurses.

Center for Mental Health in Schools at UCLA. (2003). A resource and packet on students and psychotropic medication: The school’s role. Los Angles, CA: Author.

Centers for Disease Control and Prevention. (2002). Strategies for addressing asthma within a coordinated school health program. Atlanta: Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention Division of Adolescent and School Health. (2000). Fact Sheet: Health services. Centers for Disease Control School Health Policies and Programs Study (SHPPS) 2000. Atlanta: Centers for Disease Control and Prevention.

This national survey assessed school health programs and policies at the state, district, and school level. While the article gave statistics on medical staff members in schools, HIV/AIDS policies, school health centers, and screening and prevention services, the key statistics were those about administering medications in schools. Faculty and staff members were allowed to administer prescription drugs 92-97% of the time and students were allowed to self-medicate 83-93% of the time (specifically, 68% with inhalers, 42% with insulin, 34% with epinephrine, 20% other medications, and 20% with over-the-counter medications).

Chambers C., Reid, J., McGrath, P., & Finley, G. (1997). Self-administration of over-the-counter medication for pain among adolescents. Archives of Pediatric and Adolescent Medicine, 151, 449-455.

This study published in May 1997 included 651 junior high (seventh-ninth grade) students from three public schools in Halifax, Nova Scotia. Students were asked to answer questions regarding use of over-the-counter (OTC) medications for pain in the previous three-month period. Questions were about the type of pain, type of OTC analgesics, frequency of use, source of OTC medications, and decisions on self-administration. The report noted study flaws including Canada vs. North America and forgetting and bias due to retrospective self-reporting.

Chapter 67-11-14: Certificate of Completion for Paraprofessionals. (n.d.). Retrieved August 16, 2002, from http://www.state.nd.us/lr/information/acdata/pdf/67-11-14.pdf.

Cheek, J. (1997). Nurses and the administration of medications: Broadening the focus. Clinical Nursing Research, 6, 253-74.

In an attempt to broaden the focus of the discussion about nurses and medication administration, this study used Critical Incident Technique (C.I.T.) to identify registered nurses’ perceptions of factors affecting the quality administration of medications in their practice setting. Five categories of themes emerged as having an impact on nurses and the administration of medications: the context, the procedures, the groups of professionals involved, the personal attributes of individual staff members, and the client. The author concluded that research indicated that simply to focus on drug errors and individual nurses when exploring the role of the nurse in quality administration of medications was too narrow an approach. The administration of medications occurs in specific contexts, aspects of which have an impact on the way in which medications are administered. This Australian study supported Gill and Blight’s (1995) assertion of the need for more broadly focused studies about aspects of medication administration.

Children, insulin pens and self-injection at school. (1996). Professional Care of Mother & Child 6, 158-160.

This article summarized a small British survey of 10-16-year-old students self-injecting insulin at school every day at lunchtime. All students responding carried their own insulin pens while at school. The researchers were interested in learning whether there was dissatisfaction at the students’ self-injecting or the location of injecting or of supervision of the students. They found that the students and staff were unanimously pleased with the arrangements. Supervision was not needed.

Childs, M. (2002, January 29). UGA education researchers say study suggests teachers should be trained to manage students with asthma. The University of Georgia - News Bureau.

Seventy-eight percent of elementary teachers in this study felt unprepared to teach students with asthma. Studies also indicated a lack of adequate ratio of school nurses to students. Only three states complied with the recommended ratio of 1 nurse per 750 students, thereby placing part of the burden on those same teachers to assist in caring for chronically ill children.

The article also discussed the alarming rate at which children are being diagnosed with asthma and the increasing death rate among asthmatics. The researchers recommended that teachers be educated and responsible for student asthma management.

Chiodini, J. (October 2001). Best practice in vaccine administration. Nursing Standard, 16, 7: 35-38.

Chow, E.L. & Cherry J. D. (December 2003). Reassessing Reye Syndrome. Archives of Pediatric Adolescent Medicine. 157:www.archpediatrics.com.

Christian, L. (1999). Direct service staff and their perceptions of psychotropic medication in non-institutional settings for people with intellectual disability. Journal of Intellectual Disability Research, 43, 88-93.

The purpose of this study was to collect the views of direct service staff on their perceptions, knowledge, and opinions on the use of psychotropic medications in non-institutional settings for people with developmental disabilities. Job coaches, residential aides, and community support staff were surveyed using a 39-item questionnaire. The majority of respondents reported that they had not received adequate training in the area of drug treatment. The knowledge and skills deficits of direct service staff presented a significant barrier to appropriate monitoring and management of pharmacotherapy for individuals with developmental disabilities.

Class specifications for noncertified public school employees. (2001). Raleigh: Public Schools of North Carolina, State Board of Education, & Department of Public Instruction.

A closer look: A report of select findings from the National School Health Survey 1993-1994. (1995). Denver: Office of School Health, University of Colorado Health Sciences Center.

Code of Virginia: Nursing, Chapter 30 of Title 54.1. (n.d.). Retrieved July 26, 2004, from

Cohen, M.R. (January 1999). Medication errors. Nursing. Retrieved June 11, 2002, from http://www.findarticles.com.

Cohen, M.R. (September 2000). Medication errors. Nursing. Retrieved June 11, 2002, from http://www.findarticles.com.

Cohen, M.R. (June 2001). Medication errors. Nursing. Retrieved June 11, 2002, from http://www.findarticles.com.

Colorado Department of Education, Exceptional Student Services Unit. (2003). Medication administration in the school setting: guidelines. Denver, CO: Author.

Colorado Nurse Practice Act, Title 12, Professions and Occupations, Article 38. (n.d.). Denver: Department of Regulatory Agencies.

Colorado Rules and Regulations Regarding the Delegation of Nursing Tasks Chapter XIII, Sections 1-9. (n.d.).. Denver: Department of Regulatory Agencies.

Colorado State Board of Nursing. (1997). Medication administration: An instructional program for teaching unlicensed personnel to give medication in school and out-of-home child care settings. Denver: Colorado State Board of Nursing.

Committee on Pediatric Emergency Medicine. (1999). Emergency preparedness for children with special health care needs. Pediatrics, 104(4), 53-58.

The Commonwealth of Massachusetts. (n.d.). Guidelines for the storage and administration of medications in camps. Retrieved August 15, 2002, from http://www.mass.gov/dph/dcs/pdfs/dcsguidelines.pdf.

The Commonwealth of Massachusetts. Executive Office of Health and Human Services. Department of Public Health, Bureau of Family and Community Health, School Health Unit. (1995). The comprehensive school health guide. Boston, MA: Author.

Complaint investigation summary, complaint number 2012.03. (2002). Indianapolis: Indiana Department of Education.

Complaint investigation summary, complaint number 1955.02. (2002). Indianapolis: Indiana Department of Education.

Complaint investigation summary, complaint number 1920.02. (2002). Indianapolis: Indiana Department of Education.

Complaint investigation summary, complaint number 1573. (2000). Indianapolis: Indiana Department of Education.

Comprehensive health education standards. (n.d.). Retrieved July 21, 2004, from http://www.ade.az.gov/standards/health/CompStd2.asp.

Connecticut Department of Health public health code: School nurses and nurse practitioners. (n.d.). Retrieved December 6, 2004, from http://www.dph.state.ct.us/phc/docs/3_School_Nurses_and_Nurse_P.doc.

Connecticut Department of Mental Retardation Nursing Standard. (1997). Retrieved August 21, 2002, from http://www.dmr.state.ct.us/publications/centralofc/hcs_ns97-1.htm.

Connecticut Forbids Teachers to Recommend Psychotropic Drugs for Children. (July 26, 2001). Reuters Health. New York. Retrieved July 30, 2001, from http://pediatrics.medscape.com/reuters/prof/2001/07/07.27/20010726leg1001.html.

Cooper, E. (2000). Guidelines for the use of OTC medications in the high school setting. Athletic Therapy Today, 5, 52-56.

This article examined the legal liabilities of distributing over-the-counter (OTC) medications to high-school athletes. It explained the legal liability the athletic trainer as dispenser of OTC medications has; documentations needed; written protocols to be used when medications are dispersed; and medical knowledge needed regarding each drug dispensed. Athletic trainers and/or therapists administering OTCs must adhere to legal requirements of the state, as well as school board policies, including documentation, which is especially helpful in the case of litigation.

Costante, C. Asthma: Promoting Best Practice in the School Setting. (March 2000). NASN Newsletter.

Costante, C. (2002). Healthy learners: The link between health and student achievement. American School Board Journal, 1-3.

The focus of this article was how a healthy child learns better. It did go into detail about why we need nurses in schools and what school nurses can do to promote a healthy student (physically and mentally), but did not look specifically at medications in schools. It also talked about financial/cost-effective health services.

Cough syrups ordered off the market. (February 27, 2003). Associated Press. Retrieved March 2, 2003, from http://www.msnbc.com/news/878225.asp.

Coyle, P. (July 30, 1994). Nurses want more regulation on school medication plan. The Times – Picayune. Metro Section, B4.

Cramer, B. (June 28, 1996). Panel backs new rules on medication in schools. Milwaukee Sentinel, Section: Waukesha, 2.

Who is responsible for giving non-regulated medications, such as dietary supplements and alternative medicines, to children was talked about in the article. The headline focused on a new medication rule at the school, but half of the article discussed budget issues. The new policy would encourage the parents to give non-regulated medications at home. If the parents felt the medication was needed, the policy also encouraged them to consult their physician on dosage and necessity. Administration during the school hours would be by school physician or nurse. This policy appeared to be a limited occurrence in this school district, which was accepted by the parents that it covered.

Cummins, C. (1997). Schools study using photos in medicine distribution. Denver Rocky
Mountain News.

Following medication errors, the Colorado Health Department and Boulder School Board met to begin reviewing laws on administration. Within a six-week period, four students received the wrong medications resulting in one hospitalization. Concluding that photo identification would have prevented the mix-ups, policy makers decided to require photo identification for those students needing medication administration during the school day. Colorado law required that physicians and parents sign prescriptions and only a school nurse or trained staff members administer medications in the school setting.


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