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Discussion

Standing Prescriptions

I have to start this post with a couple of disclaimers: First, this is my first post...EVER! I've always been a lurker, now I'm hoping to participate more. Second, this is my second day as a school nurse...school starts in two weeks!

I just started as a school nurse at a private school in Las Vegas. I come from a pediatric background both in the hospital and in specialty clinics so the clinical requirements don't bother me...just all of this fun administrative stuff I'm trying to sort through before school starts. Currently there aren't many specific policies in place for medications and action plans...which also allows for a lot of gray areas. (I'm hoping to change this in the near future.) What experience have any of you had with having standing orders/prescriptions written for the school for emergency medications? Right now I'm specifically looking at EpiPens (which we stock at different stations through the school) and having a stock bronchodilator available in case our self-carry asthmatics lose their inhalers or they aren't available. Legally, can I have a physician write a prescription to the school? What other medications/equipment would you recommend that we have on hand that require a prescription?

Any other resources or direction would be GREATLY appreciated as well!!

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    We have a school physician. She is available to to physicals, advise us and she also writes our standing orders. We obtain orders for daily things we use such as Bactine, triple antibiotic ointment, hydrogen peroxide, A&D ointment, Artificial tears, etc. She also writes for Epi-Pens and naloxone. I usually get my epi pens through a grant but prior to finding that option, I just took the standing order to the pharmacy and they billed the school district. We choose not to stock ibuprofen, Tylenol, allergy meds and such. We require students to get an individual order from their family doctor for this. We also do not stock bronchodilators. We copy the orders and have her renew them for each school year.

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    If you already have stock epipens a physician somewhere had to write the prescription. I'd recommend finding that person. There may be an allergy action plan already. If not you can collaborate to write one as well as writing a bronchodilator protocol.

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    We have a physician that will write all of our prescriptions. I'm just wondering about having him write it as a standing prescription. I'm going to get a couple of the free Epi-pens from the manufacturer, but then we'll be paying for the rest from a local pharmacy. We have access to OTC meds with the authorization to give them done by parents during registration...so for most kids I know what I can give. We don't have any official protocols for our Epi-Pens or other emergency meds...which I will be working on.

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