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School Health Nursing Program

Report to the Minnesota Legislature: Medications Dispensed in Schools Study

January 15, 2002

Appendix - Workgroup Principles and Next Steps

Work Group Principles With corresponding Next Steps*

There must be school board policies regarding administration of medications in schools.

The law MS 121A.22 and MS 121A.221 currently requires schools to develop policies for medication administration. The state should develop model guidelines to assist school board/districts with this requirement.

A mechanism must be in place for identifying and adopting appropriate statewide standards on which policies are based.

Key stakeholders should be engaged to assist the state in the development of safe medication administration standards in the school setting. These standards should be based on best practice models, current research, and the issues and principles presented in this report by the Commissioner's medication study work group. Individual student/family and district flexibility need to be considered as districts work to adopt and implement statewide standards.

Local school district medication administration procedures must be based on consistent statewide standards and guidelines.

A statewide task force should develop Minnesota model medication administration standards and guidelines. A lead state agency should be given the responsibility to facilitate the development, dissemination, training, and implementation of statewide medication administration standards and guidelines.

Procedures should be student-family centered, individualized, flexible, and culturally responsive.

The use of a task force with broad-based community representation is desirable to discuss and implement best practices related to being student/family centered, flexible, and culturally responsive.

Procedures must be developed with local health care professionals, district personnel, and district families.

School based medication administration procedures will be better accepted if all individuals involved in the process are invited to provide input. A systematic process should be identified to collectively determine goals to be accomplished and a process and timeline for development set forth. It is necessary that financial considerations be addressed at each step in the process. Assisting schools in assessing and obtaining financial resources will strengthen the potential for implementation.

All parties involved, including district administration, must have appropriate knowledge of delegation of medication administration and supervision of personnel to whom medication administration is delegated.

Nursing delegation references and resources should be available specific to medication administration in the school setting. These resources would include a discussion of legislation and legal opinions related to medication administration in the areas of health, education, social services, and nursing practice.

1. Decision-making models and flow charts should be developed and distributed to district superintendents and district school boards, parents, advocates, and school nurses.
2. Instructional materials and training regarding "delegation" would be available in a variety of format to local districts, parents, professional organizations and regional collaborative structures.

All personnel administering medications in school must have appropriate training.

A lead agency should be given responsibility to facilitate the training requirements. This lead agency should be responsible to determine the curriculum content requirements, develop training modules, and create a system for planning, implementation and evaluation of the training. The lead state agency would annually notify school districts of training responsibility regarding administration of medication. School districts could be required to sign and submit an Annual Statement of Assurances that training has been completed.

Information regarding safe medication administration must be provided by the state to key constituents in a clear, consistent and timely manner.

A lead state agency should be identified and given the responsibility to coordinate information dissemination related to safe medication administration in the school setting. All the activities of the lead agencies will be coordinated in collaboration with other appropriate organizations that have an interest in safe medication administration in the schools. Mechanisms for communication should be developed using a multiple media approach that includes newsletters, mail, web site, meetings, conferences, e-mail. The communication structures developed must address the need for routine and episodic contact and be evaluated annually for effectiveness.

Communication among student, parents, school personnel, health care providers and school districts is imperative concerning medication administration in schools.

There should be an assessment and local communication network and system. The assessment would identify what is already in place and what will need to be put in place to have an effective communication concerning medication administration in schools. The state could serve as a clearinghouse for information related to safe medication administration in school.

State and local resources must be available to support safe medication administration in schools.

Methods of determining cost and providing funds for safe medication need to be studied. The lead state agency and key constituents should provide guidance related to cost identification and support the best mechanisms for funding (e.g. incentive, punitive, per pupil dollars). The cost of safe medication administration in the school should take into account the planning and intervention related to student needs, staff resources and state guidelines. Development and review of local medication policy and procedures, requirements for training and supervision are necessary to assure student safety and employee competence.

*The work group developed principles to support safe medication administration in Minnesota schools. The corresponding next steps were developed in small groups and reported back to the workgroup. However, time did not permit discussion and refinement of the next steps by the entire workgroup as was done with the principles.


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