How do you prepare/package meds for coverage staff?

[guest464345]

I'm wondering about practices at other schools for setting up meds to be given by coverage staff.

When I'm out of the office, we have no nurse or health assistant coverage. Instead, I'm supposed to have trained school staff, usually front office admins, who can give scheduled medications in my absence. I'm wondering how others handle scheduled meds in this situation.

I have meds in clear hanging pharmacy bags that are labeled with the student's name, DOB, ID number, and photo. Meds are inside, in their original containers. When the kid arrives, I take the pill bottle out of the bag and dispense into a med cup - verifying that the med bag label, the pill bottle info, and the kid's ID match. Most kids are just taking a single pill or capsule, but others have multiple meds including tablets that need to be split in half.

Theoretically the coverage person could follow the same steps. However, in reality, they are usually giving the meds from their offices in other parts of the campus - and often two are dividing my caseload (each person is giving meds to half the kids). Some of them don't have keys to my room. And they are already extremely busy.

I think that the previous nurse pre-packaged meds in little coin envelopes, labeled with the name, DOB, ID# and med name/dose/instructions. When she knew she would be off, she'd give these packaged doses to the staff the day before her absence. The coverage staff would lock them up in their work areas (we all have locking cabinets), give them out in the AM, and document the time.

I don't like the idea of repackaging/relabeling meds. What I would like is substitute coverage, but that ain't happening. What do you all do?

[SchoolNurse91, BSN, RN]

I have three schools so the secretaries are giving meds most of the time anyway. I have a rolling, locking cabinet. It sits by the secretaries usually and I walk into the front office to give meds. I could roll it into my office, but it throws kiddos off.

[guest83140]

Back about 4 years ago I worked for two small DAEP schools and the secretaries at each were already trained to give medications in the nurse's absence. I had a clear tote with a handle that was approx. 8 inches wide and about 14 inches tall and long. Inside was the folders and marked paper cups with medication bottles and clinic slips, first aide stuff, etc. When I returned to that school, I would go to the office and pick it up from her. She kept it locked in her office cabinet when I was not there.

[JustJai, ADN, LPN, RN, EMT-I]

Each student has an gallon zip lock bag with their medication packaging and the written doctors' orders. Everything is kept in a locked cabinet in alphabetical order. Epi pens are on one shelf. All other PRN meds another shelf. And daily meds on a third shelf. I have a 7 day medication pill box for each student marked with their name, etc. On Monday mornings I "pour" my meds for the week. In my sub notes I give my nurse sub the option of using the pill box I filled or administering the medication directly from the individual pill bottles. Personally, I wouldn't be comfortable given a medication that I did not package. For field trips, or when the main office has to cover me, I fill small med envelopes with the pill, no one receives multiples at this time, write the who, what, when (time and date) on the envelope and seal the envelopes. Compared to many stateside schools, and my student population of 650+, I have a low daily med count. During our two hour lunch/recess period I have two inhalers prior to recess and five oral medications to give. One student receives an additional medication at the end of the school day.

[Flare, ASN, BSN]

in my state only an RN is permitted to medicate a student (unless it's a trained delegate giving Epi or glucagon, but that's not what we're talking here) so if i'm out and there's no nurse then the kiddo's not getting that med unless a parent or legal guardian come in. If I'm sending a nurse on a trip and there is a daily pill, i place it in a paper med envelope that i write all the details on and make the bottle and original order available for the sub to review prior. If it's a straight office cover, then they can admin from the original rx containers as i do daily.

[LikeTheDeadSea, MSN, RN]

I'm in a nurse-only meds state except for Epi/Inhaler. I'm interested in the comments, though. It's amazing how different things go state-to-state.

[BrisketRN, BSN, RN]

I rarely have anyone but me give medication, but in the case I feel I'm getting sick (I'm never sent on field trips) I'll put the medications in small pill bags and label them. I keep all daily meds in one bin in my locked cabinet (2 other bins for Epi/Benadryl, 1 bin for asthma meds & PRN meds) for easy finding for a sub nurse. In my sub folder I have detailed instructions and photos of each of my daily med kids.

We have a few members of staff trained to give meds under my instruction in case of emergency.

[Eleven011]

This is my 5th year here and I've never had a day that either myself, my sub, or one of our med aids weren't here to give meds from my office. It may be coming, but haven't had it happen yet. For field trips, I do package the meds in the small white envelopes with all the information needed and send it along with staff.