Current through Register Vol. XLI, No. 38, September 20, 2024
10.1. Certified
school RNs and LPNs are bound by standards of practice by the West Virginia RN
and LPN boards when administering medication.
10.1.a. Medication administration by RNs,
LPNs, and trained, designated school personnel shall occur in a clean and quiet
environment where privacy is assured and with minimal interruptions.
10.1.b. The initial dose of any medication
should be administered at home, excepting emergency medications, unless
otherwise directed by the licensed prescriber and/or a court order.
10.1.c. Parents/guardians shall provide
completed and signed medication authorization form(s) to be provided by the
county board, indicating the student's name; date; allergies; medication name;
dosage, time, and route; intended effect of medication; other medication(s)
taken by the student; licensed prescriber; and parent/guardian signature.
Parents/guardians shall also replenish long-term and emergency prescribed
medication as needed and retrieve unused or expired medicine from school
personnel no later than 30 days after the authorization to give the medication
expires or on the last day of school.
10.1.d. All medication prescribed by a
physician shall be in the originally labeled container from the pharmacy
stating the student's name, name of the medication, reason(s) for the
medication (if to be given only for specific symptoms), dosage, time, route,
reconstitution directions if applicable, and the date the prescription and/or
medication expires.
10.1.e. All
OTCs falling under the school principal's supervision shall be in the original
manufacturer's container with the student's name and dosage instructions
affixed to the container. The school principal may designate school personnel
as defined in this policy to be trained to administer OTCs. The designated
school personnel should undergo OTC retraining every two years. The WVDE
provides online training for OTC administration.
10.1.f. A county board may choose to develop
a medication policy allowing the administration of OTC medications with the
parent's/guardian's consent.
10.1.g. Designated school personnel shall
receive and review the emergency medication and medication authorization form
and obtain authorization from the certified school RN to administer the
medication. The student shall not attend school until both the administration
form and medication are received to prevent risking the safety and welfare of
the student. The SAT, Section 504, or IEP team shall consider the lack of
emergency lifesaving medication(s) as child neglect.
10.1.h. The certified school RN is to be
contacted immediately when a prescribed medication's appearance or dosage is
questioned. The certified school RN shall take appropriate steps to ensure the
medication is safe to administer.
10.1.i. The certified school RN is to be
contacted immediately when a student's health condition suggests that it may
not be appropriate to administer the medication.
10.1.j. When a student's medical condition
requires a change in the medication dosage or schedule, the parent/guardian
shall provide a new written medication authorization form from a licensed
prescriber and container. The parent/guardian shall give medication changes to
designated personnel within an appropriate timeframe.
10.1.k. Schools may use those stock
medications permitted by W. Va. Code §
18-5-22(c)
(epinephrine) and § 18-5-22(d) (opioid antagonist) if the county board
adopts a policy under sections 12.2 through 12.14. Schools are required to
follow the county board policy and may voluntarily adopt W. Va. Code §
18-5-22(c)
(stock epinephrine) as outlined in section 12.2 and W. Va. Code §
18-5-22(d)
(stock opioid antagonist) as outlined in section 12.10. County boards shall
follow the procedures and protocols for school health and school nursing, as
outlined in W. Va. Code and WVBE policies.
10.1.l. Schools should develop a mechanism to
ensure all students, especially those with specialized health care needs,
participate in school-related field trips. This mechanism should include
advance notification to the certified school RN and/or the county's school
health services director to ensure out-of-state field trip destinations allow
reciprocity and delegation of certain health care procedures by their state
board of nursing laws and practice acts since the certified school RNs are
licensed to practice nursing only in West Virginia. County boards may consider
allowances and reimbursement to certified school RNs and LPNs to hold a compact
nursing license, allowing nursing practice in multiple states to support
classroom field trips.
10.2. Medication administration errors
include, but are not limited to, any deviation from the instructions provided
by the licensed health care provider. The certified school RN and
administrator/principal shall be contacted immediately in the event of a
medication administration error. In the event of a medication administration
error the certified school RN or administrator/principal shall do the
following:
10.2.a. contact the physician,
parent/guardian, and if necessary, emergency medical services;
10.2.b. notify the certified school RN or
administrator recommendation and/or licensed prescriber order in response to a
medication administration error;
10.2.c. document all circumstances, orders
received, actions taken, and student's status; and
10.2.d. submit a written report to the
administrator and county superintendent at the time of the medication
administration error. The report should include the student's name; the
parent/guardian name and phone number; a specific statement of the medication
incident; the person notified; and the remedial actions.
10.3. Self-administration of medication is
permitted under W. Va. Code §§
18-5-22a,
18 5-22b, and 18-2K-1, et seq. when all of the following conditions are met.
10.3.a. A written medication authorization
form is received from the parent/guardian and licensed prescriber permitting
self-administration of medication;
10.3.b. The student has demonstrated the
ability and understanding to self-administer medication by passing an
assessment by the certified school RN evaluating the student's
self-administration technique and understanding the appropriate use of the
medication;
10.3.c. The
parent/guardian has acknowledged in writing that they have read and understood
a notice provided by the county board stating that the county board, school,
and its employees and agents are exempt from any liability, except for willful
and wanton conduct, resulting in injury arising from the self-administration of
medication;
10.3.d. The permission
to self-administer medication shall be sufficient for the school year during
which it is granted. All documents related to the self-administration of
medication shall become part of the student's health record; and
10.3.e. The permission to self-administer
medication may be revoked if the certified school RN finds that the student's
technique and/or understanding of the medication's use is not appropriate or is
being willfully disregarded.