Administer OTC medications or No?

  1. 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)

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

    Joined: Apr '08; Posts: 22; Likes: 24
    Registered Nurse
    Specialty: 13 year(s) of experience in Telemetry, Orthopedic, M Surg, School RN

    27 Comments

  3. by   pedi_nurse
    We have a med authorization form for any and all meds. RX or OTC (no herbal/holistic meds without MD order). Parent must provide the med in the original container and we will follow manufacturer label or RX label. I know of private schools that do a general med auth for IBU/tylenol/benadryl, but most public schools I'm aware of don't do this. OTC meds given more than 10 days in a row must have an MD signature.
  4. by   RNTadaaaa
    Quote from pedi_nurse
    We have a med authorization form for any and all meds. RX or OTC (no herbal/holistic meds without MD order). Parent must provide the med in the original container and we will follow manufacturer label or RX label. I know of private schools that do a general med auth for IBU/tylenol/benadryl, but most public schools I'm aware of don't do this. OTC meds given more than 10 days in a row must have an MD signature.
    Yes! Feels like the specific med authorization form is the way to go.
  5. by   BettyGirard
    Years ago we had a special form for Acetaminophen only that the parents could sign.
    That went by the wayside. Anything we administer now, OTC or prescription, needs the regular med authorization.
  6. by   RNTadaaaa
    Quote from BettyGirard
    Years ago we had a special form for Acetaminophen only that the parents could sign.
    That went by the wayside. Anything we administer now, OTC or prescription, needs the regular med authorization.
    Thank you. I think I will have to brave the storm and not implement the previous form!
  7. by   Flare
    in my state otcs require an order. Some schools get the school md to sign off on a standing type order so that all is needed is a parent's signature, but i don't have that in place here.
  8. by   BiscuitRN
    I'm in Illinois and we require a physician's order for all OTC medications. I do fax over a lot of sheets for parents who forget to bring it to the pediatrician. Defer to your state law. If you're unsure look online and see if you can find an email for a nurse rep from your department of health or board of education.
  9. by   Eleven011
    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.
  10. by   kbrn2002
    I'm not a school nurse but in LTC we have a set of standing orders that among other things allows for administration of a specific list of OTC meds per manufacturer directions. If the med is administered 3 times that triggers a call to the MD to activate that med as an order for that resident. I'm not sure how state regulations differ for schools and LTC facilities but can something similar be implemented in a school district?
  11. by   CampyCamp
    Your form sounds a lot like the various forms used at camps. My view is that if the physican selects or deselects the meds of their choice on the form and signs, that are giving an order set for the duration listed on the form. At my school, we do have a doctor covering our standing orders so our form is only for parents to sign consent.
  12. by   RNTadaaaa
    Quote from BiscuitRN
    I'm in Illinois and we require a physician's order for all OTC medications. I do fax over a lot of sheets for parents who forget to bring it to the pediatrician. Defer to your state law. If you're unsure look online and see if you can find an email for a nurse rep from your department of health or board of education.
    I read the office of school health website but I didn't see much pertaining to my search. I will do what you suggested. Thank you!
  13. by   RNTadaaaa
    Quote from CampyCamp
    Your form sounds a lot like the various forms used at camps. My view is that if the physican selects or deselects the meds of their choice on the form and signs, that are giving an order set for the duration listed on the form. At my school, we do have a doctor covering our standing orders so our form is only for parents to sign consent.
    Hmmmm good point! I didnt think of it that way. Thank you for this perspective. I don't have a doctor covering or standing orders but I like this idea too and maybe that's a suggestion I can present for discussion and implementation
  14. by   RNTadaaaa
    Quote from Eleven011
    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

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