Info for Child Care Providers Medication Administration

many children have medical conditions that require medication to be given while they are receiving child care services however most child care programs do not have medically trained staff on-site who are licensed to administer medication fortunately the regulations that govern licensed child care programs allow for staff to be trained and approved to administer medication to children provided certain requirements are satisfied this presentation will help you understand the requirements that must be satisfied when trained and approved staff administer medications in licensed childcare centers group childcare homes and family childcare homes this presentation will address the basic requirements that pertain to the administration of medications the presentation will cover what is a medication and what is not a medication different types of medications the impact of the Americans with Disabilities Act on medication administration in child care programs the requirements for policies and procedures the requirements for the administration of non prescription topical medications and other medications self administration of medications and petitions for special medication authorization before we begin it is important to understand what a medication is a medication is any medicinal preparation prescription or non-prescription drug including controlled substances sunscreens insect repellents and Vaseline for instance are not considered medications therefore the requirements outlined in this presentation do not apply to these products it is recommended however that child care programs choosing to use these products obtain written parent permission and incorporate their use into the programs policies there are many different types of medication the first type of medication are those that are taken orally or by mouth these are the most common and are generally in the form of a capsule tablet or liquid next we have topical medications which are applied directly to the skin these are generally in the form of a lotion pointment cream or patch inhalant medications are those that you breathe directly into your lungs examples are inhalers and nebulizers injectable medications are liquids that are put into the body usually with a needle which pierces through the skin some examples of injectable medications are epi pens insulin and glucagon lastly we have rectal medications which are generally in the form of a suppository or enema which is inserted directly into the rectum in addition to distinguishing medication by the route they are administered medications fall into two categories first there are those that are non prescription or more commonly referred to as over-the-counter medication these medications can be bought without a prescription examples of non prescription medications include tylenol aspirin cough syrup and benadryl the second category of medications are those that are prescribed by a medical provider a person cannot go into a store and buy these medications without a prescription examples of prescription medications include ritalin concerta and asthma medication deciding whether or not your program will administer medications is not always a choice the licensing regulations prohibit a licensed childcare center or group childcare home from denying child care services to a child because of a known or suspected allergy diagnosis of asthma or diabetes in these cases the program has three weeks from the child's enrollment to Train staff in the administration of such medications and necessary equipment and they must ensure such trained staff are on-site during all hours the child is present the licensing regulations for family child care homes do not specifically require providers to administer medications however it is important to recognize that all providers must comply with the Americans with Disabilities Act otherwise known as the a DA this federal law specifies that no child with a disability such as diabetes may be excluded from participation in child care simply because of that disability when deciding whether to administer medication you should always consider the licensing requirements and the requirements of a DA you may also wish to consult with an attorney programs that administer any type of medication must have written policies and procedures that outline how the program will manage medication administration the policies and procedures shall include the types of medication that will be administered parental responsibilities staff responsibilities proper storage and labeling of medication and record-keeping these policies and procedures shall be maintained on-site at the child care program so that they are readily available to program staff and also licensing staff during site inspections child care centers and group child care homes wish to use their health consultant for assistance in developing these policies and procedures once developed programs are then required to follow these policies and procedures the most common types of medications that are used in child care programs are non prescription topical medications examples of non prescription topical medications are diaper changing ointments free of antibiotics antifungal and steroidal components medicated powders and teething gum and lip medications before administering any non prescription topical medication written parental permission must be obtained parental permission must include the child's name address and date of birth the name of the medication a statement indicating that the medication has been previously administered without adversely affecting the child the schedule and site of the medication and the start and stop date of the medication each time the medication is administered this must be documented in the child's file this written record is called a medication administration record or ma are the regulations are very specific of what information must be documented in the MA R this information includes the date time and dosage of each administration of the medication and the signature of the staff person giving the medication parents should be immediately notified in writing of any medication administration error the error should be documented in the record let's discuss proper storage and labeling for non prescription topical medications medication is to be stored in the original container away from food and inaccessible to children also each container or packaging shall contain the individual child's name the name of the medication directions for the medication administration and the medication date expired or any unused portion of a medication shall be returned to the parents this presentation will now move on to medications other than non prescription topical medications before staff may administer this type of medication they must be trained in the administration of oral topical and inhaling education this training must be taught by a physician physician assistant advanced practice registered nurse or registered nurse and must cover the curriculum areas that are clearly defined in the licensing regulations after that they must complete additional training in the administration of injectable medication before staff may administer injectable medications such as the EpiPen this training provides participants with an understanding of the reason the medication has been ordered any side effects and the handling and the methods of administration for injectable medication this training also must be taught by a physician physician assistant advanced practice registered nurse or registered nurse upon completion of the required training the trainer shall issue a written approval verifying the completion of the training this is a sample approval form that can be found on the OEC website the written approval shall include the signature and identification information of the trainer and trainee the date and location of the training verification that the required curriculum was covered and successfully mastered by the trainee the routes of administration that the staff is approved to administer and the expiration date of the approval approval for the administration of oral topical and inhalants medication training is valid for three years approval for the administration of injectable medication is valid for only one year staff must maintain current approval a copy of this approval along with an outline of the training shall be maintained on-site at the program and available to licensing staff upon request unlike non prescription topical medications an order from an authorized prescriber and written parent permission are required to administer all other types of medications this includes over-the-counter medications such as Tylenol or medication prescribed by a healthcare provider a medication shall not be administered without this documentation furthermore medication shall only be administered in accordance with the written order from the authorized prescriber the parent shall be notified immediately in writing of any medication administration error and the error shall be documented in the record the medication order and parent permission shall be maintained on-site at the facility for at least two years after the child is no longer attending the program like non prescription topical medications a medication administration record or ma are shall be reviewed prior to each dose of medication administration and updated each time the child is given the medication the MA are shall be kept on file at the child care program for at least two years after the child is no longer attending the program medication other than non prescription topical medications shall be stored in the original child resistant safety container these medications shall be stored in a locked area locked container in a refrigerator away from food or locked container according to the manufacturer's directions controlled drugs should be double locked keys should be accessible only to staff authorized to administer those medications the label shall include the child's name name of medication directions and the date of the prescription emergency medications such as EpiPen glucagon or rescue inhalers may be stored unlocked for quick access provided this medication is stored safely and inaccessible to other children all unused or expired medications must be returned to the parent or destroyed within one week in the presence of a witness except for controlled medications you may contact the Department of Consumer Protection for proper instruction regarding disposal of controlled medications the child care program shall keep a written record of all medications destroyed which shall be signed by both parties involved children enrolled at the child care program may self administer medications with the written permission of an authorized prescriber and the child's parents however children who self administer medications must be able to identify and select the appropriate medication by size color amount or other label identification they must also know the frequency and time of day for which the medication is ordered and consume the medication appropriately a written order from an authorized prescriber and a written parent permission must be on file at the program for the specific medication staff trained in medication administration shall be on site whenever a child who self administers is on site a childcare program may submit a written request to the OEC for unlicensed staff to administer medication in a licensed childcare program by a method other than oral topical inhalants or via a pre-measured commercially prepared injectable syringe for example a request may be submitted to administer daya stat by rectum insulin by a syringe pen or pump or glucagon by injection in order to do this a written application would need to be submitted to the OEC this application would include a written order from an authorized prescriber a plan that identifies how the provider and staff will be trained a list of the staff that have been trained written permission from the child's parent and any other information necessary to evaluate the request a checklist of items required for the application for special medication administration can be found at the address shown here we hope this presentation helped you become more familiar with the requirements for unlicensed staff to administer medications in licensed child care programs please remember that this presentation highlighted some of the key requirements of the licensing statutes and regulations but it did not cover all the requirements pertaining to medication administration it is important that you review the child care licensing statutes and regulations to familiarize yourself with all of the requirements these statutes and regulations can be found on the OEC website sample forms that satisfy the documentation requirements referenced in this presentation can also be found on the website if you have any questions please do not hesitate to call the licensing divisions help desk and speak with a licensing specialist

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