Administer OTC medications or No?

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Good Day All!

I'm a couple of weeks into working at a private school and I noticed the previous nurse gave OTC medications if the parents signed a form giving permission to administer. The form has Acetaminophen, Ibuprofen, Benadryl (topical and oral) Tums, Hydrocortisone, Antibiotic ointment, cough drops.

New form created before the previous nurse left includes the same meds but adds a line for the physicians sig and that the nurse would follow the dosage instructions on the box.

My previous school nurse position preferred that OTC medications be given outside of school hours unless there was a specific need. We also needed a medication administration form filled out with a PRN order, MD signature and the medication provided with pharmacy label.

I do want to help the kids feel better, and I want to avoid parent uproar, however the thought of following this current school's OTC form makes me nervous. (litigation:unsure:)

Am I being a nervous nelly or do you feel more schools should implement a process like this?

Specializes in Telemetry, Orthopedic, M Surg, School RN.
We don't need Dr. order for OTC's but do need parents signature and they need to supply the medication. I think the reason we don't have standing orders is because then the school would have to pay to keep stock meds on hand! Not going to happen here.

LOL! soo true

Specializes in IMC, school nursing.

Check your local public schools, they may be able to help you develop a protocol so OTC can be given with just parental approval. I developed my position and reached out to the neighboring county for a copy of their protocols and the nurse I spoke to was so amazing, she got me in touch with her director and next thing I know, not only do I have a copy of their protocols, I have permission to use them with a physician's order. The health department oversees the school nurses, both public and private in my state and their director (whose children happened to be enrolled) signed off. He would sign off even if his children didn't go here, it's what he does. I now only need consent from the parent, and I have a written protocol to back up my decision. I will let parents know if their child's use is excessive and request they buy the meds, I pay for meds out of my own pocket, I work in a small private which requires students to pay x amount yearly towards fundraising and such. I might as well use that money for my own budget.

Specializes in School Nursing.

I work in elementary schools and our policy is every medication (including OTC) must have the Dr and the parent sign administration forms. However I know our middle school will allow OTC with only the parent signing off on it.

Specializes in Pediatrics Retired.

Parent permission only required here.

Specializes in Telemetry, Orthopedic, M Surg, School RN.
Check your local public schools, they may be able to help you develop a protocol so OTC can be given with just parental approval. I developed my position and reached out to the neighboring county for a copy of their protocols and the nurse I spoke to was so amazing, she got me in touch with her director and next thing I know, not only do I have a copy of their protocols, I have permission to use them with a physician's order. The health department oversees the school nurses, both public and private in my state and their director (whose children happened to be enrolled) signed off. He would sign off even if his children didn't go here, it's what he does. I now only need consent from the parent, and I have a written protocol to back up my decision. I will let parents know if their child's use is excessive and request they buy the meds, I pay for meds out of my own pocket, I work in a small private which requires students to pay x amount yearly towards fundraising and such. I might as well use that money for my own budget.

Woooooow! Thats awesome! Thank you for the suggestions.

Good idea to reach out to another nurse! I did but I didnt understand that the counties sometimes have different protocols and so I had to be mindful of that going forward.

Would it be ok to ask you some questions regarding creating protocols for your school? I think going the route you took would be benficial for my site as well.

Specializes in Telemetry, Orthopedic, M Surg, School RN.

So I found this today from the department of health website. I'll have to read it again later because my brain is suffering from end of day fatigue.

Thank you all for your assistance. I love this site.

"Administration of OTC medication must be conducted in accordance with the guideline for

prescription medication. The only exception is if the local school system and local school health

services program has adopted "physician directed nursing protocols" for the administration of OTC

medication in compliance with Board of Nursing regulations. If the local school system and local

school health services program has adopted "physician directed nursing protocols" the following

should be incorporated in the policy:The LSS and the Health Services Program shall identify which OTC medications are to be

administered under its policy;

ï‚· Parental consent is required annually for the administration of the identified OTC

medications;

ï‚· Administration of the identified OTC medications must be part of a nursing protocol which

has been approved by the LSS, the supervisor of health services, and the medical director;

ï‚· Only RNs may make the assessment and the decision to administer an OTC medication

(therefore the LSS and the Health Services Program's "physician directed nursing protocols",

may only be used in schools that are staffed by a fulltime RN); and

ï‚· Medications administered under the LSS and the Health Services Program's "physician

directed nursing protocols" are not to be given for a problem/health concern diagnosed by the

child's primary care physician. The guideline for prescribed medication must be followed

when this occurs. In the absence of an order from an authorized prescriber for a medication

that is included in the "physician directed nursing protocols", the LSS and the Health Services

Program's "physician directed nursing protocols" may be followed if parental permission is

obtained. A student's specific medication order from an authorized prescriber shall take

precedence over the LSS and the Health Services Program's "physician directed nursing

protocols". OTC medication must be brought to school in an original, unopened container."

Specializes in IMC, school nursing.
Woooooow! Thats awesome! Thank you for the suggestions.

Good idea to reach out to another nurse! I did but I didnt understand that the counties sometimes have different protocols and so I had to be mindful of that going forward.

Would it be ok to ask you some questions regarding creating protocols for your school? I think going the route you took would be benficial for my site as well.

Feel free. PM me any questions you have. I may take a day or a few as I split time here with my wife and only check AN when I am here.

Specializes in Psychiatry, Community, Nurse Manager, hospice.

I'm not a school nurse, but wanted to let you know that at my children's high school parents sign a medication consent form at the beginning of the year expressly giving or declining consent for OTC tylenol, ibuprofen, maalox provided by the school RN prn for headache, stomach ache or menstrual cramps only, and given a maximum of 2x in 48 hours. Dosages are listed. The parameters are to ensure that nurses aren't being expected to take care of kids who really should be home or see a doc.

As far as otc's provided by parents and more long term, I think a script is needed. My son had one for ibuprofen when he broke his ankle.

Specializes in Telemetry, Orthopedic, M Surg, School RN.

I like this plan as well. The part about nurses being expected to take care of kids who should probably be at home crossed my mind as well. Its great that this was thought about at your school. Thank you for this suggestion.

Specializes in Telemetry, Orthopedic, M Surg, School RN.
I'm not a school nurse, but wanted to let you know that at my children's high school parents sign a medication consent form at the beginning of the year expressly giving or declining consent for OTC tylenol, ibuprofen, maalox provided by the school RN prn for headache, stomach ache or menstrual cramps only, and given a maximum of 2x in 48 hours. Dosages are listed. The parameters are to ensure that nurses aren't being expected to take care of kids who really should be home or see a doc.

As far as otc's provided by parents and more long term, I think a script is needed. My son had one for ibuprofen when he broke his ankle.

Also I love your name!!! LOL! Yessss.

I have an OTC form that parents can check off the meds they authorize me to use. It must be signed by the parents and their physician.

Specializes in School Nursing.

I might check your school disctrict medication policy and or the nurse practice act there. In my disctrict we cant give anything OTC, MOtrin, Tylenol, anything, without an MD order.. So I would check..

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