Speaking of Epi Pens...

[MHDNURSE]

I would love to hear from all of you how you store and "keep track" of you epi pen kids.

1. Where do the students keep their epi pens?

2. Do you keep a list of some sort so everyone knows which students have epi pens? If so, where do you keep the list and who has access to it?

3. Do you keep track of Lot # amd Expiration date and inform parents the pens are going to expire soon?

My answers:

1. Students keep them in their classrooms in a clear storage container. I have stock Epi in my office for a potential reaction in an undiagnosed person.

2. I have a "Medical Alert List" that I have posted on the inside of my medicine cabinet, mostly for my own easy access. The teachers who have students with epi pens are aware and I do a training with them at the beginning of the year. Massachusetts is very strict about not posting lists anywhere and not telling staff due to privacy issues unless it is a need to know basis. Annoys the heck outta me.

3. I didn't used to since I feel like it is the parent's responsibility to know when their kid's medication expires, but I learned fairly quickly that with my population, I am lucky too even GET an epi pen sent in! I still remember this school year it took me over a month to get one sent in for one particular student. When it finally came in, I did the happy dance, only to discover it had expired three years prior So now I keep a list. Also, after that recall earlier in the year, it was helpful to add Lot# to my list.

[palli]

1. I have a clear shoe holder hanging on one of my doors. Each student has their own slot with their pic, name, epi and benadryl with set of orders

2. My list is in my med book, my sub book, hanging in my office by the epi pens and each teacher knows who has an epi pen and what their allergy is

3. I keep a notebook with each epi pen lot # and expiration date with kids pic, and when date is coming close, I send email home.

[SaltineQueen]

1. I keep them in my office in the med cabinet. I think next year, since the stock is in the office (clinic is right off main office) I might have teachers keep them in the classroom. I dunno...

2. Classroom teachers, office staff (they cover for me), principal, cafeteria workers & specials teachers all know who the kids are.

3. I haven't been good about keeping track this year.

[AdobeRN]

1. Placed in a gallon zip lock baggie - labeled with Name, grade & expiration date. Baggie is then placed in my cabinet - I have a shelf just for Epi pens - in alpha order. I have one student that has a severe nut allergy - parent provided extra set of Epipens to be kept in his classroom.

2. I keep a quick reference list for myself - taped on inside of my med cabinet. We use E-school for all school business- there is an area to put in medical alerts for students. I will make a note "Epipen in clinic" so the teacher or anyone who has access to that student record can see it. I notify teachers via email as the epipens, inhalers or whatever rescue med comes in to me so they are aware.

3. See #1. When I do my monthly check list of checking AED, I will scan thru the meds to see what will expire soon and then email parent. While it is preferred to keep a students own supply of Epipens with me -it is not really necessary, district supplies each campus with stock Epipens - so if a students Epipen expires and I never hear back from parent I don't worry about it.

[dd_txrn, ASN, BSN]

1. Student's can carry their own, if we have signed documentation from the doctor. If I keep them, they are in my cabinet.

2. I put a flag in Skyward, it is in my sub-book. I send out an email to all teachers when I find out there is an allergy.

3. I check at the beginning of the year when they drop it off, but don't keep a log.

Side note: I did find out at our last nurse's meeting that we have the go-ahead to keep stock epi-pens starting next year.

[JenTheSchoolRN, BSN, RN]

1. Students can self carry (again I work with older students). But this year, I did away with students "needing" to have one in school if prescribed. Instead I use stock Epi. I just need the order. SO MUCH EASIER. Extra epi-pen gets sent it/put on student if they self carry for field trips. I double check with students and use this as teaching especially for severe allergy students as a reaction may be more likely to happen out of school and they need to have their epi-pen and know how to use it on themselves if needed. (I have them use the practice testers on themselves).

2. We have flags in our computer system teachers can see (and teachers can only see relevant students to them). However, we have no cafeteria and any teacher/staff could be covering any class, so they are technically all need to know. I know MA rules are a butt, so I created a Google Doc (we use the Google platform at work) that I restrict access to and allow not to be printed for teachers, so no paper lists ever go to anyone. I review it with them before field trips. It has worked very well.

3. I don't have a list, but I do check Epi-pens for expiration 3-4 times a year. But since we moved to me using stock Epi, this is less of a concern because I will grab that med if I use at school and I order that and know its expiration date. I also double check expiration dates when I pack Epi for field trips.

1. Students can self carry (again I work with older students). But this year, I did away with students "needing" to have one in school if prescribed. Instead I use stock Epi. I just need the order. SO MUCH EASIER. Extra epi-pen gets sent it/put on student if they self carry for field trips. I double check with students and use this as teaching especially for severe allergy students as a reaction may be more likely to happen out of school and they need to have their epi-pen and know how to use it on themselves if needed. (I have them use the practice testers on themselves).

2. We have flags in our computer system teachers can see (and teachers can only see relevant students to them). However, we have no cafeteria and any teacher/staff could be covering any class, so they are technically all need to know. I know MA rules are a butt, so I created a Google Doc (we use the Google platform at work) that I restrict access to and allow not to be printed for teachers, so no paper lists ever go to anyone. I review it with them before field trips. It has worked very well.

3. I don't have a list, but I do check Epi-pens for expiration 3-4 times a year. But since we moved to me using stock Epi, this is less of a concern because I will grab that med if I use at school and I order that and know its expiration date. I also double check expiration dates when I pack Epi for field trips.

We use Google here too- Do you share the the doc and not allow any editing? What setting prevents them from being able to share or print? Great idea!

[JenTheSchoolRN, BSN, RN]

We use Google here too- Do you share the the doc and not allow any editing? What setting prevents them from being able to share or print? Great idea!

Yep, I shut off editing access - it is read only to anyone but me and other nurse in my building.

I can't completely police the no printing, but it is reinforced by those above me, so that helps. And they can access it on their phones if needed as well, which also helps.