IV Medication at School

SnowyJ, RN · Sep 3, 2015

I'm pretty sure my district wouldn't allow it due to potential side effects.

antihemophilic factor intravenous : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD

OldDude · Sep 3, 2015

I don't have much of an imagination anymore, but, I can't imagine why that would HAVE to be administered during the school day. And there are probably some liability issues to discuss. Regardless, in regard to being a patient advocate, if I was the kid's physician or parent, I'd want him/her to have IV therapy in an environment that offers the least chance of contracting an infection as well as wanting the infusion to be "totally" supervised; neither of which would be optimal in a busy school clinic full of coughing, sneezing, distracting kids. Plus, who's gonna tend to the infusion if the nurse has to leave for an emergency? So, my opinion is, if it has to be done at school a dedicated RN should be utilized for administration in the cleanest area available...otherwise you're opening a can of worms and risking the wrath of Murphy's Law.

kidzcare · Sep 3, 2015

I don't have much of an imagination anymore, but, I can't imagine why that would HAVE to be administered during the school day. And there are probably some liability issues to discuss. Regardless, in regard to being a patient advocate, if I was the kid's physician or parent, I'd want him/her to have IV therapy in an environment that offers the least chance of contracting an infection as well as wanting the infusion to be "totally" supervised; neither of which would be optimal in a busy school clinic full of coughing, sneezing, distracting kids. Plus, who's gonna tend to the infusion if the nurse has to leave for an emergency? So, my opinion is, if it has to be done at school a dedicated RN should be utilized for administration in the cleanest area available...otherwise you're opening a can of worms and risking the wrath of Murphy's Law.

Well put.

KelRN215, BSN, RN · Sep 3, 2015

Hello Everyone!! Happy 2015-2016 School year.
Has anyone of you given IV Medication to a student in school, this one student in one of my schools has an MD order for IV Medication while at school. Should i allow the child in school? the nurse at the school has already told me she would not be administering the medication we have no official policy in this matter.
Thank you!!

Who is going to administer the medication? More importantly, why does factor have to be administered during school hours? Isn't this normally a once/day medication? (Or less often.)

That said, I am a home infusion nurse liaison and I can tell you that kids on IVs go to school all the time. A kid with a broviac for cancer treatment goes to school when he is well. Kids on TPN go to school. If a kid is on IV antibiotics with a frequency that they need to be administered at school (q4 or q 6), he may be at school on a continuous infusion pump and will attend school with it. Last year I had a kid on continuous milrinone while awaiting heart transplant- he went to school with it. Heck, kids on chronic vents go to school.

How would you "not allow" him in school? The school district is legally obligated to provide the child with an education. If a 1:1 nurse is required for the child to be able to attend school safely, the school needs to provide that.

JenTheSchoolRN, BSN, RN · Sep 4, 2015

Who is going to administer the medication? More importantly, why does factor have to be administered during school hours? Isn't this normally a once/day medication? (Or less often.)
That said, I am a home infusion nurse liaison and I can tell you that kids on IVs go to school all the time. A kid with a broviac for cancer treatment goes to school when he is well. Kids on TPN go to school. If a kid is on IV antibiotics with a frequency that they need to be administered at school (q4 or q 6), he may be at school on a continuous infusion pump and will attend school with it. Last year I had a kid on continuous milrinone while awaiting heart transplant- he went to school with it. Heck, kids on chronic vents go to school.
How would you "not allow" him in school? The school district is legally obligated to provide the child with an education. If a 1:1 nurse is required for the child to be able to attend school safely, the school needs to provide that.

I agree, but as you mentioned some of these situations may require a 1:1 nurse and I would advocate for that for the student. Because they need to be in the classroom learning, not my office for what could be chunks of the day, as that defeats the idea of them coming back to school. My office can be a mad house, so I can't be a 1:1 nurse and any expectation of that doesn't work.

I have worked with some wonderful 1:1 nurses who have used my office (and sometimes my help) to complete some of their care for more medically-complex students (i.e. trach care). They did not work for the district, instead are provided to the district via a home care agency. I am so glad they are there because often they can get a doc on the line if needed for a student much, much easier and faster than I can.

Flare, ASN, BSN · Sep 4, 2015

i have a student with a bleeding disorder that needs to get infusions of humate from time to time when he gets a prolonged bleed (nosebleed, loose tooth, etc) he typcally doesn't get infused unless he bleeds for longer than 15 minutes. His mom usually comes in to do access his vein (just as she does at home for all his other infusions) and gives him his infusion. Last year in coordination with the state hemophilia center and the administration we determined that he should have permission to access his own vein and learn how to do his own infusions (in school under nurse supervision) since this is a life long condition. Granted, this is not a young child. This is a teenager. he has not yet actually given himself an infusion - as I stated earlier -this isn't something we can actually plan for. Just something we need to be prepared for.

KelRN215, BSN, RN · Sep 4, 2015

I agree, but as you mentioned some of these situations may require a 1:1 nurse and I would advocate for that for the student. Because they need to be in the classroom learning, not my office for what could be chunks of the day, as that defeats the idea of them coming back to school. My office can be a mad house, so I can't be a 1:1 nurse and any expectation of that doesn't work.
I have worked with some wonderful 1:1 nurses who have used my office (and sometimes my help) to complete some of their care for more medically-complex students (i.e. trach care). They did not work for the district, instead are provided to the district via a home care agency. I am so glad they are there because often they can get a doc on the line if needed for a student much, much easier and faster than I can.

Correct, but the agency bills the school district for any nursing hours provided at school. Private health insurance or state Medicaid will not pay for private duty nursing while a child is at school, because the school is responsible for providing that.

I don't actually see that a private duty nurse would be required in the OP's situation, though. The child needs a short infusion of factor. At most, a visiting nurse would come in and use the school nurse's office to administer the medication. Is the child in some sort of extended day program or something that necessitates this medication being given during school hours? Like he's at school from 6A-6P and nurses are only available to visit between 8A-5P?