Education and Training for Medication Administration

Education and training on medication administration needs to be conducted by the LSN/RN on an ongoing basis to keep students safe and to ensure ongoing competency of staff members.

Content and Competencies

Coordination of training of other school staff about medication administration is an essential part of the job descriptions of RN/LSN. The RN/LSN determines what training is needed, for whom, the content, and available and appropriate training resources (e.g., medication training course through a local college). Education and training can range in format from formal classroom lectures to one-on- one discussions, and in content be related to student, disease or procedure, specific, competency-based; technical; and/or theoretical.

After training, medication administration procedures should be demonstrated by the person being taught and that person’s competencies need to be documented in writing. The RN/LSN shall communicate completion of staff medication competencies enabling the LPN to assist and monitor medication tasks and activities.

Topics to include in initial training, periodic training, or refresher training about medication administration include district policies, directions and time of administration for all medications, verification procedures for setting up medications for administration, proper documentation, data privacy, individualized student health information, emergency protocols, equipment, the six rights of medication administration, and infection control procedures (e.g., hand-washing). Demonstrations of medication administration are an excellent method of testing competencies.

It is especially important that staff members be sensitive to changing community and school populations and their diverse characteristics. All education and training should have a component that addresses the diverse needs of the communities and cultures of the school community.

Education and Training Needs

Training needs to be done before medication administration is performed. It is important that four topics are covered in the staff training. Documentation and evaluation of training must follow.

The supervisor (RN/LSN if available) informs the trainee of:

1. School policies and availability of resources.
2. Available written criteria that indicate when to contact a supervising LSN/ RN, monitoring LPN, or call 911.
3. Student-specific information.
4. Procedures for safe medication administration including the Six Rights of Medication Administration.

The first, second, and fourth are best done before students begin their school year (e.g., during work- shop week) and the third before staff work with specific students.

Although there are a variety of curriculum resources available, Minnesota has no required materials at this time. A training program should have the following:

1. A general medication overview that includes the purposes of medications and the various medication administration routes.
2. Information on medication handling and administration techniques that includes cleanliness, care, storage, the six rights of medication administration, preparing medications, administration procedures, guidance for field trips, proper medical abbreviations, student plans, and emergency information.
3. Need for licensed provider and/or parent/guardian authorizations and record keeping that includes legal requirements, policy and procedure review, record keeping, errors reporting, student refusal and school forms.
4. Rights and responsibilities that include delegation, assignment, and reporting, data privacy, and Minnesota statutes, rules, and guidelines.

Resources

The National Association of School Nurses (NASN) had developed School Nursing Evidence-based Clinical Practice Guideline: Medication Administration in Schools as a decision-making tool to guide professional school nurses in implementing evidenced-based practices and a Toolkit for Medication Administration in Schools which provides sample policies, forms, templates, training and competency checklists and protocols.

Managing Chronic Health Conditions provides some specific training resources for common chronic conditions which require medication administration in schools.

Free Resources:

• Medication Training –Wisconsin Department of Public Instruction - Videos, Procedures & Competency Checklists
• Medication Training Videos for Non-Licensed Personnel – Maine Department of Education - Videos

Cost Associated:

• Considerations for Medication Administration in the School Setting – School Health Associates
• Medication Administration for School Personnel – Minnesota State Community and Technical College - Online Course & In-person Skills Demonstration

Education and Training for Nurses (RN, LSN, LPN)

Both the Minnesota Board of Nursing (RN/LPN) and Professional Educator Licensing and Standards Board (LSN) require continuing education units for licensure renewal. These continuing education units are necessary to stay up to date on nursing practice, medical conditions, medication use, and student health needs. All nurses should have an evaluation of their skills and knowledge-based competencies by a nurse supervisor or peer colleague. Refresher courses, online training, skills-based texts, and school nursing texts can be used to fill any gaps in skills or competencies, such as information about new medications, pediatric care, and school nursing procedures such as medication error prevention and reporting, and documentation. Nurses should have a good understanding of nursing delegation as it applies to their RN or LPN license.

Education and Training for Unlicensed Assistive Personnel (UAP) and/or non-nurses.

School staff who serve as UAPs working with medications need to be knowledgeable about medication administration procedure during the regular school day and during extended day experiences (e.g., field trips and sporting events) as appropriate and school policy. The training content should include:

1. Hands-on student care that is specifically related to the assigned medication administration.
2. School policy and procedures, such as safety measures, general emergency procedures, and how and when to contact the RN/LSN, medical provider, parent/guardian, or school administrator.
3. All applicable federal, state, and local regulations.

In Minnesota, there are at present no specific training requirements for UAPs who are assigned mediation administration. If the UAP is administering medications through the nursing delegation of a RN/LSN there are associated rights and responsibilities that the UAP is accountable for. Training for UAPs who administer medication should include:

• The Six Rights of Medication Administration
• School policy/procedures for safe medication administration, medication handling and storage, types of medications including controlled substances, documentation, and others as appropriate.
• How to understand and follow student specific emergency care plans.
• How to recognize common emergencies.
• Follow all data privacy rules and recognize the right of the student to privacy during medication administration.
• Recognize the student’s skills and abilities as developmentally appropriate.
• Demonstrate safe medication administration procedures.
• Understand the relationship between the nurse and UAP and when to contact the nurse.
• Recognize the limits and conditions by which a UAP may administer medications.
• Reporting and documentation of medication errors, omissions, or student refusals.

The RN/LSN and/or the school should maintain documentation of training and competency in skills for everyone administering medications. Training should occur initially at time of hire or if there is a change in assignment which includes medication administration. Then refresher training should occur annually, when new procedures are implemented, upon request of the UAP, and as needed to understand or prevent medication errors.