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.

Taliaferro, V., & Mazyck, D. (2001). Medication assistant training: A Maryland initiative. Presented at the American School Health Association Conference, November.

Tarkan, L. (2002, November 19). Educating schools about life with asthma. New York Times.

This New York Times article presented the example of an 11-year-old boy who died from an asthma attack because he was unable to access his medication in a timely manner. The report following his death faulted the school policy and inadequate training of teachers to know what to do. Ultimately, the school incurred a $2.2 million liability.

The article went on to give some information about zero-tolerance drug policies in schools and how the incidence of asthma has increased among children. The second half of the article highlighted recommendations that the Centers for Disease Control have published to help schools prevent and treat asthma. These recommendations include: (1) have a full-time nurse, (2) allow children to carry inhalers (if they are too young to carry, give them easy access), (3) all individuals working with school child should be taught information on asthma triggers, symptoms, and emergency care, (4) environmental triggers should be eliminated, including placing a ban on smoking, and (5) each child with asthma should have a treatment plan.

Technical assistance manual for school nurses. (n.d.). Dover: Delaware Department of Education.

Teenage risk from painkillers. (1998). Journal of Advanced Nursing 27, 885.

This article discussed the use of over-the-counter (OTC) painkillers by teenagers. It gave statistics about the prevalence of their use, misconceptions about their safety, procurement by teenagers, and reasons for use. Teenagers do not consider OTC painkillers to be medication. The authors gave examples of potential risks involved, but also stated that most teenagers appear to take OTC painkillers correctly and safely.

Temple, L. (February 15, 2000). Disputed duties: Teaching the disabled. USA TODAY. Retrieved February 15, 2000, from http://www.usatoday.com/life/health/child/lhchi129.htm.

Tennessee Board of Nursing. (2004). 2004 legislation. Retrieved August 8, 2004, from http://www2.state.tn.us/health/Downloads/2004_NursingLegislation.pdf.

Tennessee Board of Nursing. (2002). Position Statements. Retrieved July 26, 2004, from http://www2.state.tn.us/health/Downloads/g4021186.pdf.

Teplitsky, B. (September 2001). Avoiding the hazards of look alike. ISMP Medication Safety Alert. Retrieved June 11, 2002, from http://www.findarticles.com/cf_0/m3231/9_31/78566056/print/jhtml.

Terry, R. (n.d.). Standards of competent performance: Excerpt from California code of regulations, Title 16 – Chapter 14. Sacramento: State of California, State and Consumer Services Agency, Board of Registered Nursing.

Terry, R. (n.d.). School nurse function. Sacramento: State of California, State and Consumer Services Agency, Board of Registered Nursing.

Terry, R. (2000). Complementary and alternative therapies in registered nursing practice. Sacramento: State of California, State and Consumer Services Agency, Board of Registered Nursing.

Terry, R. (1997). Standardized procedure guidelines. Sacramento: State of California, State and Consumer Services Agency, Board of Registered Nursing.

Terry, R. (1994). Unlicensed assistive personnel. Sacramento: State of California, State and Consumer Services Agency, Board of Registered Nursing.

Terry, R. (1991). The RN as supervisor. Sacramento: State of California, State and Consumer Services Agency, Board of Registered Nursing.

Texas Department of Health. (June 29, 1998). Role of the School. Report of the School Health Task Force to the Texas Board of Health. Retrieved November 5, 2003, from http://www.tdh.state.tx.us/schoolhealth/tf_9a.htm.

Texas Education Agency. IDEA (Individuals with Disabilities Education Act) Special Education Law. Retrieved December 17, 2001, from http://www.adda-sr.org.idea.htm.

This is an overview of the special education law, the Individuals with Disabilities Education Act (IDEA), that ensures that all children with disabilities have a free and appropriate public education. Published by the Texas Education Agency, this serves as a general fact sheet listing the overall components of the special education due process and requirements. It does not specifically mention medication administration or the role of the licensed school nurse.

Thacher, A. & Reilly-Chammat, R. (1999). Managing asthma in Rhode Island schools. Medicine and Health/Rhode Island 82, 246-248.

This article discussed asthma care in Rhode Island schools. It focused on interaction between physician and school nurse and student and family, within the legal requirements in Rhode Island.

Thomas, M. (2001). Med error reports to FDA show a mixed bag. Drug Topics.

This article presented findings by the Food and Drug Administration (FDA) on the medication errors that were reported in the month of May 2001. Out of 273 reports, 265 cases were reviewed and classified. Each report was reviewed according to the Taxonomy of Medication Errors developed by the National Coordinating Council for Medication Errors Reporting and Prevention. The errors were classified into one of the following areas: (1) communication, (2) name confusion, (3) labeling, (4) human factors, and (5) packaging/design. In this analysis, the most common causes of error were human factors (42%), labeling (20%), and communication (19%). Most errors were for wrong drug (22%) and improper drug administration (17%). Finally, 10 drugs were listed that had the most errors, with the top drug being morphine sulfate (8%).

Timmons, K. (2000). On their own: school and community management of pediatric asthma. Advance for Nurse Practitioners, 53-54, 74.

This article explained each step to take as an asthma patient. First, the patient and family form a self-management plan. Next, school staff members, coaches, chaperones, etc., are informed of the plan, what symptoms to look for at the onset of an attack, and how to administer the medication. Environmental prevention in the home and school completed the picture.

Quick relief medications are bronchodilators used for coughing and wheezing. Long-term medications include anti-inflammatories and oral steroids. Acute symptoms that require prompt attention are severe coughing, wheezing, difficulty breathing, and chest tightness.

Title XXX Occupations and Professions, Chapter 326-B, Registered Nurses, Licensed Practical Nurses, and Licensed Nursing Assistants, New Hampshire Nurse Practice Act. (n.d.). Concord: New Hampshire Board of Nursing.

Today's school nurse: More than just a person who bandages knees. (2003). Education World.

This short article aimed at school administrators examined the role of the school nurse. Since passage of the 1975 Education for All Handicapped Children Act, which was amended and renamed the Individuals with Disabilities Education Act (IDEA), children with severe disabilities, who would previously have been institutionalized or assigned to special education buildings, are attending public school, and school nurses are expected to meet their needs. Although there are no uniform national staffing standards, many school nurses are responsible for several hundreds of students each day, including those with severe handicaps. The IDEA mandates certain school activities, but adequate funding has not been put behind those mandates.

Truglio-Londrigan, M., Macali, M., Bernstein, M., Kaider, G., Petersen, S., & Tumino, M. (November/December 2002). A Plan for the Delegation of Epinephrine Administration in Nonpublic Schools to Unlicensed Assistive Personnel. Public Health Nursing 19, 6: 412-422.

This article described how public health nurses, the director of public health nursing, and a faculty consultant in the Bergen County Department of Health Services worked together to produce strategies for the safe implementation of New Jersey’s Public Law 1997, Chapter 368. The law requires each educational board or chief school administrator/principal of public and nonpublic schools to develop a policy governing epinephrine administration.

Tryens, E., Coulston, L. & Tlush, E. (January 2003). Understanding the Complexities of Herbal Medicine. Nursing Spectrum Midwestern Edition. 26-28.

Tsong, N. (September 6, 2001). Nurses in small doses. Their time is divided among several schools; leaving others to tend scrapes, pass out pills. The Seattle Times. Scene Section p E1.

Turber F., Berry, B., & Cameron, M. (May-June 1991). The Role of School Nursing in the United States. Journal of Pediatric Health Care. 5, 3: 135-140.

Tuscano, A. (2000). Is it more than the blues? Children can suffer from depression, too. Our Children 26, 6-8.

Changes in a child’s behavior are the best indications of a problem, and they aren’t always negative changes. Parents should trust their instincts. It is important to seek help. Depression is very treatable with a combination of medication and learning better coping skills. The author discussed the importance of listening when communicating with children. Depression can be caused by many things––genetics, environment, circumstances, etc. There is an increased risk of depression if one or both parents suffered from depression.

Twedt, Steve (1997). Student health needs on rise: Schools ill at ease giving medicines. Pittsburgh Post-Gazette.

The author, a Pittsburgh Post Gazette writer, made the point that distribution of medications in schools, especially medications for asthma and attention deficit hyperactivity disorder (ADHD), was a growing phenomenon. Pittsburgh city schools were looking to reduce the number of medications that students took at school. He also noted that school nurse staffing levels varied widely across the state of Pennsylvania and the nation, and that increasing medical needs and students pose challenges to the health and safety of students. There was a desire to shift the responsibility back to physicians to reevaluate what is needed and why.


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