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.

United States Department of Health and Human Services, Head Start Program. (n.d.). 45CFT Part 1304.22 (c) Medication Administration. Washington DC: United States Department of Health and Human Services.

United States Department of Health and Human Services. (2003). Helping the student with diabetes succeed: A guide for school personnel. Washington, D.C.: United States Department of Health and Human Services.

United States Department of Health and Human Services. (2000). Healthy people 2010. Rockville, MD: Author.

United States Department of Health and Human Services. (2003). Secretary Thompson Announces Steps to Reduce Medication Errors. FDA Proposals for Medication Bar Coding and Safety Reporting Will Improve Patient Safety. Retrieved 3-25-2003 from http://www.hhs.gov/news/press/2003pres/20030313.html.

United States Department of Justice Drug Enforcement Division. (2000). Stimulant abuse by school age children: A guide for school officials. Retrieved June 20, 2002, from http://www.deadiversion.usdoj.gov/pubs/brochures/stimulant/vaschool_meds.htm.

This article reviewed the use and abuse of two medications commonly prescribed to treat attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) in school-age children. In controlled low dosage, they helped the children to concentrate and relax. When abused, they had negative effects and could be addictive. Seven percent of the study population was found to be abusing, with 2.5% abusing monthly. Several specific recommendations were made to ensure that these medications are not diverted from their purpose, including: not allow children to self-medicate without supervision, not allow children to carry medication to and from school, have one adult be responsible for controlling medication supply, maintain a medication log, and secure drugs under lock and key.

United States Food and Drug Administration. (11-19-2002). Medication Errors. Center for Drug Evaluation and Research. Retrieved from http://www.fda.gov/cder/drug/MedErrors/default.htm.

This article defined “medication error” according to the National Coordinating Council for Medication Error Reporting and Prevention and identified common types of medication errors listed by the American Hospital Association. It emphasized safety in administration and protection of patients. Most of the information was what the Food and Drug Administration (FDA) had done or proposed to do to address medication errors. There was a list of drugs identified that were involved in medication errors in a November 14, 2002, FDA advisory section.

United State Food and Drug Administration. (August 9, 2002). Think It Through: A Guide to Managing the Benefits and Risks of Medicines. Center for Drug Evaluation and Research. Retrieved August 15, 2002, from http://www.fda.gov/cder/consumerinfo/think.htm.

United States Food and Drug Administration. (June 24, 2002). The New Over-the-Counter Medicine Label: Take a Look. Center for Drug and Evaluation Research.

United States Food and Drug Administration. (2000). How to give medicine to children. Retrieved July 23, 2004, from http://www.fda.gov/opacom/lowlit/medchld.html.

United States General Accounting Office. (2001). Attention disorder drugs: Few incidents of diversion or abuse identified by schools (Rep. No. GAO-01-1011). Washington, D.C.: United States General Accounting Office.

This 46-page publication from the U.S. General Accounting Office reports a survey of a random sample of middle and high school principals. They reported little diversion or abuse of attention disorder drugs. For the first seven to nine months of school year 2000-2001, approximately 8% of principals in public middle and high school reported knowing of attention disorder drugs being diverted or abused at their school. Most of those principals reported knowing of only one incident. Approximately 89% of the principals reported that at their school, the diversion or abuse of attention disorder drugs was less of a problem than other illicit drugs (excluding problems with alcohol and marijuana).

Most of the principals reported that school officials administer attention disorder medications, with about 2% of the school’s students on average being administered attention disorder drugs on a typical day. Medications were administered by nurses in about 60% of the schools, and by non-health professionals, such as secretaries in most of the remaining schools. Medications were kept locked in almost all (96%) of the schools, according to the principals, and students are observed while taking their medications.

United States Pharmacopoeia. (1999). Guide to Developing and Evaluating Medicine Education Programs and Materials for Children and Adolescents. Retrieved from http://www.usp.org/pdf/druginformatioon/children/guide.pdf.

United States Pharmacopoeia. (4-13-2000). Lack of guidelines for handling medicines in schools puts students' health at risk. Retrieved from http://www.usp.org/aboutusp/releases/2000pr_2000-13.htm.

The safe handling of medicines in schools was an important issue addressed at the United States Pharmacopoeia’s national meeting in Washington, DC. USP studied the issue and recommended that the handling of medications in schools be done by a licensed school nurse, appropriate procedures and personnel be used to ensure the safe storage and dispensing of medicines in school, and that education be conducted to help parents, teachers, and school nurses support children in becoming responsible for the safe management of their health care.

United States Pharmacopoeia. Position statement: Ten guiding principles for teaching children and adolescents about medicines. Retrieved March 25, 2003, from http://www.usp.org/information/programs/children/principals.htm.

While recognizing the varying abilities of children, the U.S. Pharmacopoeia here outlined principles to encourage children to become active participants in using medication.

University study finds errors in medication administration. (2001). Your School and the Law, 31.

A recent survey of school nurses in Iowa found that medication errors continued to be a problem in school health. Attention deficit hyperactivity disorder (ADHD) medications seemed to be the most prevalent, probably due to the increased number of students identified and treated.

A primary problem, missed doses, caused grave consequences for some students and the personnel who were delegated responsibility for medication administration were often not equipped to assess the students’ conditions.

University of Iowa. (1999). Iowa health book: Managing allergies and asthma at school. Iowa City: University of Iowa.

University of the State of New York. (2002). Administration of medication in the school setting: Guidelines. Albany: The University of the State of New York.

Use of drugs to treat ADHD and depression in youth steadily increased from 1995-1999. (3-28-2002). Research Alert, Agency for Health Care Research and Quality. Retrieved from http://www.ahrq.gov/news/press/pr2002/adhdpr.htm.

This article summarized a research study on use of four drug classes (CNSS, SSRIs, TCAs, and other anti-depressants) and how they vary in use over time, by age, gender, geographic region, and prescribing physician. Study results indicated that, for this group and from 1995-99, central nervous stimulants prescribed increased by 26% in children and youth under 20 years old.

Using medicines in school. (November 17, 1994). Drug and Therapeutics Bulletin, 32, 11: 81-3.

This article discussed the various circumstances that create the need for children and youth to receive medications at school (e.g., diabetes, asthma, anaphylactic reactions), the dilemma of who should administer the medications, and the legal implications. It offered general suggestions and protocols for administering medications at school. It described the need for students to remain as independent as possible with medications in school. Although it accurately described school situations with student medications, it did not offer any specific solutions

USP Supports FDA Proposal for Mandatory Medication Bar Coding. (4-2-2003). Nursing Hands
Web Site. Retrieved 4-13-2003 from http://www.nursinghands.com/News/NewsStory.html?1004714.

Utah Code Section 53A-11-601. (1998). Retrieved August 5, 2004, from http://www.le.state.ut.us/~code/TITLE53A/htm/53A0C029.htm.

Utah Code Section 53A-11-602. (2004). Retrieved August 5, 2004, from
http://www.le.state.ut.us/~code/TITLE53A/htm/53A0C030.htm.

 

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