MEDICATION ADMINISTRATION
NEW POLICY
Approved 6/24/25
1. PURPOSE AND PHILOSOPHY
To authorize school personnel, in accordance with Utah statute UCA 53G-9-5 et seq. to administer medication to students.
2, POLICY
The South Sanpete School District Board of Education recognizes that medication should be administered by the student or the student’s parent/guardian. However, the Board of Education recognizes that the health of a student may require administration of medication during the course of a school day. Subject to the conditions of this policy, authorized school personnel may provide help with the administration of medication to students (ages 3-22) during periods when the student is under the control or supervision of the school and school personnel.
As long as authorized personnel act in a prudent and responsible manner, school or district staff who provide assistance in substantial compliance with a licensed health care provider’s written order, are not liable civilly or criminally in accordance with U.C.A. § 53G-9-502 for any adverse reaction suffered by the student as a result of taking the medication or discontinuing the administration of the medication under this policy.
DEFINITIONS
Administration the provision of prescribed medication to a student according to the orders of a healthcare provider, and as permitted by Utah law.
Asthma medication means prescription or nonprescription, inhaled asthma medication.
Controlled substance refers to the category of drugs listed in U.C.A. §58-37-4. These are drugs or chemicals whose manufacture, possession, or use is regulated by a government, such as illicitly used drugs or prescription medications that are designated by law.
Delegation is defined as the ability of the nurse to transfer the responsibility of a nursing task to an unlicensed person while the nurse continues to be accountable for the outcomes (American Nurses Association [ANA] 2012). The school nurse will be responsible for the training of such persons.
Diabetes medication means prescription or nonprescription medication used to treat diabetes, including related medical devices, supplies, and equipment used to treat diabetes.
Epinephrine auto-injector means a disposable drug delivery system with a spring-activated concealed needle that is designed for emergency administration of epinephrine to provide rapid, convenient first-aid for a person suffering a potentially fatal anaphylactic reaction.
Medication means a medicine or substance recognized by a licensed provider to have curative or remedial properties. The medication must be administered under the direction of a licensed health care provider and may be a prescribed or over-the-counter product intended for internal or external use.
Medication error occurs when a medication is not administered as prescribed. This includes when the medication prescribed is not given to the correct student, at the correct time, in the dosage prescribed, by the correct route; or when the wrong medication is administered.
Near-Miss is an unplanned event that did not result in injury, illness, or damage – but had the potential to do so. Only a fortunate break in the chain of events prevented an injury, fatality or damage; in other words, a miss that was nonetheless very close. In this policy, the term near-miss is referring to medication-based events.
Non-Prescription refers to medication that is available over-the-counter and generally used without a prescription from a medical provider.
Notification written or verbal notification
PRN Medication is given as needed. This is based on orders or written directions on bottle of medication.
Standing order is a district-wide written order by a physician indicating the terms that medication can be administered by school personnel. These orders will be kept on file for South Sanpete to administer medication and renewed annually.
Unlicensed Assistive Personnel (UAP) are unlicensed staff trained to function in a supportive role by providing patient/student care activities as delegated by the RN.
3, DESIGNATION OF VOLUNTEER EMPLOYEES WHO MAY ADMINISTER MEDICATION
3.1 Prior to the he start of school, annually, the district nurse with the principal will designate a minimum of two Unlicensed Assistive Personnel (UAP) to administer medication at each school. District nurse will be notified of all medication administration needs by school personnel. Documentation and verification of UAP trainings will be kept on file by the district nurse.
3.2 According to R156-31b-701a (3-e), the registered nurse is the person to determine whether the unlicensed assistive personnel can safely provide the requisite care, and if not, the nurse cannot delegate the task. The school nurse retains accountability for appropriate delegation.
3.3 It is the responsibility of the school nurse to inform the school administrator if, in their opinion, the unlicensed assistive personnel is not competent to carry out the task of administering medication. The school nurse may not provide oversight or coordination of this task when the school nurse believes that the unlicensed assistive personnel is not competent to carry out this task.
3.4 the responsibility to administer prescription and nonprescription medication to all students with a written health care provider’s medication order. When a medication is refused or not given, the parent/guardian and district nurse must be notified.
3.5 UAP has the responsibility to administer prescription and nonprescription medication to all students with a written health care provider's medication order. When a medication is refused or not given, the parent/guardian and district nurse must be notified.
3.6 Authorization for administration of medication by school personnel may be withdrawn by the district nurse at any time after actual notification to the parent/guardian should problems or difficulties occur, such as::
3.6.1 Student refusing medication repeatedly; or
3.6.2 Improperly labeled prescription or non-prescription medication
3.6.3 Incomplete parent authorizations forms
4. Training Of Designated UAP By School Nurse
4.1 Training for all UAP's for each school should occur prior to the first day of school
4.2 The district nurse will:
4.2.1 Arrange an annual training with the district nurse for the UAP assigned to administer medication at each school This training will include:
4.2.1.1 Medication administration per provider's order
4.2.1.2 Emergency medications procedure and administration
4.3 Designated staff will sign that they received medication administration training
5. Proper Identification and Safekeeping of Medication
5.1 Individual medication must be delivered to the school by the student's parent/guardian (NOT A Student), or by a responsible adult.
5.1.1 The prescription and non-prescription (over the counter medication) medication should be in the original container that has been properly labeled. The label contains the name of the student, doctor, pharmacy, medication, the dosage, time of day to be given, method of administration, and the date of the prescription
5.1.2 A one week‘s supply or more is recommended.
5.2 A district nurse will ensure a secure location for the safekeeping of medications at each school
5.2.1. Medication(s) to be administered by UAP must be stored in a locked cabinet with the exception of:
5.2.1.1. Medications needing refrigeration.
5.2.1.2. Emergency medications (glucagon, epinephrine, asthma rescue inhalers)
5.3. Unused medication(s) should be picked up within two weeks of the last day of school or it will be disposed of by the district nurse and recorded on the appropriate form.
5.3.1. Unused medications not picked up within the two-week period may be donated or discarded as seen appropriate by the district nurse.
5.3.2. When disposing of any controlled substance, two people must be present to record the medication, amount of medication discarded, date, and how discarded. Both witnesses must sign the appropriate form.
5.3.3. Medications remaining at the school after this time shall be destroyed according to the direction of the school nurse.
6. CONTROLLED SUBSTANCES
6.1. Controlled substances may never be carried on person by students on campus even with a prescription as outlined in the Safe Schools policy and in accordance with Utah Code 58-37-8. Violation of such will result in both school disciplinary action and the involvement of local law enforcement.
6.2. All prescribed controlled substances must follow the parameters outlined in section 5 of this policy in addition to the following procedures:
6.2.1. Two school personnel must witness in person and by signature on the appropriate form the receipt of all controlled substance prescriptions. The form for controlled substances must include the following:
6.2.1.1. All information as outlined in section 5.1
6.2.1.2. Time and date of receipt
6.2.1.3. Total count of medication received
6.2.1.4. Signature and printed names of parent/guardian and both school witnesses.
6.2.2. At least one of the school witnesses must be a UAP trained in medication administration or the district nurse.
6.2.3. Controlled substances must be stored in a locked location. This area should not be accessible to anyone except district nurses and UAP trained in medication administration.
6.2.4. When disposing of any controlled substance, the school will follow section 5.3.2-3 for disposal.
7. ADMINISTRATION OF MEDICATION AT SCHOOL
7.1. Individualized prescription and/or non-prescription medication may be administered to a student only if the parent provides the following:
7.1.1. The student’s parents or legal guardian has provided a completed, current, signed and dated form providing for the administration of medication to the student during regular school hours. This request must be updated on an annual basis, or whenever a change is made in the administration of medication.
7.1.2. A licensed health care provider has also provided a signed and dated form describing the administration route, dosage, and time schedules for medication administration and the side effects that may be seen in the school setting from medication.
7.2. The side effects of a medication shall determine if the drug is appropriate to delegate its administration to unlicensed school personnel.
7.2.1. Any medication with known, frequent side effects that can be life threatening shall not be delegated.
7.2.2. Medications that require the student’s heart rate, blood pressure, or oxygen saturation to be obtained before, during, or after administration of the drug shall not be administered by UAP.
7.3. UAPs may administer the medication if the medication is an oral medication, inhalant medication, eye or ear drop medication, gastrostomy, topical medication, epinephrine auto-injector, glucagon, seizure rescue medication or insulin.
7.3.1. Medications requiring other routes such as IV, rectal, intramuscular injections or subcutaneous injections cannot be administered by UAP (excluding emergency rescue medications such as epinephrine auto-injectors, seizure rescue medication, glucagon, and insulin).
7.4. If prescription and/or non-prescription medications are specified in a student’s IEP or 504 accommodation plan, a healthcare plan will still be required.
7.4.1. Students not on an IEP or 504 who need medication administered at school need a health plan provided by the district nurse.
7.4.2. District nurse will be notified of and attend all IEP and 504 meetings when medical accommodations, concerns or diagnoses are present or of concern.
7.5. Any adverse reactions, near-miss events or medication errors will be reported promptly to the parent/guardian and district nurse. If the parent is unavailable, the student’s doctor will be called for further direction. This adverse reaction or error must be documented on the error reporting form.
7.6. Failure to follow appropriate district policy may result in district discipline and/or criminal charges.
8. SCHOOL-BASED HEALTH CLINIC STANDING ORDERS
8.1. Stock over-the-counter medications and point-of-care testing may be available in schools for students through use of standing orders.
8.1.1. Standing orders must be signed by a qualified medical provider in the state of Utah at least annually and may include orders for over-the-counter medications, CLIA-waived point-of-care lab tests and first aid treatment.
8.2. Use of stock medications and/or lab tests for students is dependent on:
8.2.1. A signed waiver agreement by a parent/guardian at least annually; AND
8.2.2. Verbal authorization at the time of service by a parent/guardian
8.3. Administration of a stock medication or lab test may only be done by a:
8.3.1. Trained UAP with approval by a district nurse; OR
8.3.2. A district nurse.
8.4. Stock medications and lab tests should be stored in a secure location separate from individualized student medication.
8.4.1. Medications must be clearly labeled in their original container with an identifying marker as a as stock medications.
8.5. Training UAPs on the use of stock medications and lab tests must be completed at least annually by a district nurse as outlined in section 4.
8.6. Documentation of the use of stock medications or lab tests must be completed as outlined in section 11.
8.6.1. Signed waivers shall also be stored securely by the district as outlined in section 11.2.
9. EMERGENCY RESCUE MEDICATIONS
9.1. Emergency Rescue Medications are medications provided during a life-threatening emergency. These medications include:
9.1.1. Glucagon
9.1.2. Epinephrine auto-injectors
9.1.3. Seizure rescue medication
9.1.4. Asthma rescue inhalers
9.1.5. Naloxone (Narcan)
9.2. Storage of these medications must be readily accessible to promote efficient administration of the medication.
9.2.1. Emergency rescue medications should be stored in an easily accessible location during normal school hours
9.2.2. Must be stored with prescription identification information and student’s diagnosis in an organized manner.
9.3. Medications can be given immediately in the event of an emergency by any trained volunteer employee.
9.3.1. In the event an emergency medication is given, immediate notification to EMS, the student’s parent/guardian, district nurse, and school administrator must be made.
9.4. Emergency rescue medication trainings for teachers and other staff (such as lunch and recess aids) are of utmost importance and highly encouraged to be scheduled at least every 12 months.
9.4.1. Training for emergency medications are provided by district nurse.
9.4.2. Trainings may occur during CPR/First Aid certification courses, Medication Administration Trainings for UAP, and alternate methods as designated by the school principal.
9.4.3. In accordance with U.C.A. 26B-4-406, a school, school board, or school official may not prohibit or dissuade a teacher or other school employee at a primary or secondary school from completing a training program.
9.5. Any school employee is authorized to activate the Emergency Response System (EMS) in the event they are concerned with the student’s health or safety.
9.5.1. In the event EMS is activated, the district nurse and student’s parent/guardian must be notified immediately.
9.5.2. Upon return from any hospitalization that resulted from an EMS activation, student, parent/guardian, administrator and district nurse will evaluate the need for a health care plan or ongoing services.
10. EMERGENCY SEIZURE MEDICATION
10.1. Emergency seizure medications shall only be administered in accordance with Utah Code, 53G-9-505, Utah Administrative Code, and Utah Nurse Practice Act Rule R156-31b-701a.
10.1.1. If seizures are full-body, tonic-clonic, emergency seizure medication may be administered by a volunteer trained by a District nurse as outlined in the student’s individualized health care plan.
10.1.2. The student must have received a first dose of this medication outside school in a non-medically supervised setting and ceased having a full body, prolonged, or convulsive seizure without other complications.
10.1.3. If an emergency medication is administered to a student, emergency services must be activated, and parent/guardian, the district nurse, and administration must be notified.
11. MAINTENANCE OF MEDICATION ADMINISTRATION RECORDS
11.1. Medication Records:
11.1.1. The district nurse monitors and verifies all records via paper and/or electronic documentation.
11.1.2. A medication log will be maintained for all OTC medication administration, (such as an office visit note in the students powerschool record)
11.1.3. Authorization to administer medication will be provided on the appropriate form whenever possible.
11.1.4. Authorization and medication administration orders from outside providers will be accepted as long as they meet or exceed the information required on district forms.
11.1.5. Documentation of medication administration must be completed by the person who administers the medication at the time of medication administration.
11.1.5.1. Medication Error/ Reaction Reporting: This form should be completed by UAP in the event that a student has an adverse reaction to medication, or if an error or near-miss has been made in the administration of medication given during the school day. Parent/guardian, district nurse, administrator, and superintendent shall be informed immediately.
11.2. All medication documentation is considered a medical legal document. As such, documentation will be:
11.2.1. Secured in a locked space only accessed by UAP who administer medication and district nurse
11.2.2. Reviewed for correctness annually by a district nurse
11.2.3. Stored with all health plan information in the health office four years after leaving the district.
12. STUDENT SELF-ADMINISTRATION OF ASTHMA, DIABETES MEDICATION OR AN EPINEPHRINE AUTO-INJECTOR
12.1. A student in grades preschool to grade 12 shall be permitted to possess and self-administer asthma medication, diabetes medication, or an epinephrine auto-injector if:
12.1.1. The student’s parent or guardian signs a statement authorizing the student to self-administer asthma or diabetes medication or an epinephrine auto-injector; and acknowledging that the student is responsible for, and capable of, self-administering the asthma or diabetes medication, or an epinephrine auto-injector; and
12.1.2. The student’s health care provider signs the appropriate form authorizing student to self-administer, including the name of the medication, indicating it is medically appropriate for the student to self-administer asthma, diabetes medication, or an epinephrine auto-injector and be in possession of the asthma, diabetes medication and supplies, or the epinephrine auto-injector at all times.
12.1.3. Any misuse of asthma, diabetes medication and supplies, or the epinephrine auto- injector by the student may subject the student to disciplinary action under the District’s Safe School Policy and state law.
13. STUDENT SELF-ADMINISTRATION OF OTHER MEDICATION
13.1. This policy does not prohibit a student grade 6 to grade 12 from carrying his/her own temporary prescription medication to school in instances where the student’s maturity level is such that he/she could reasonably be expected to appropriately administer the medication on his/her own. In such instances, the student may carry one day’s dosage of prescription or non-prescription medication, excluding all controlled substances, on their person.
13.2. Students in preschool through grade 5 will not carry or self-administer prescription and/or non-prescription medications except for asthma inhalers, insulin, or epinephrine auto-injectors.
13.3. A student aged 12 years or older may carry and self-administer a single dose of nonprescription (over-the-counter) medication, without a prior parental/guardian written request.
13.3.1. Authorization for the ability to carry and/or self-administer medication may be denied or withdrawn by the school principal after consultation with their assigned district nurse at any time following actual notice to the student’s parent or guardian.
13.3.2. Distribution of any drug or medication from one student to another will be considered Dangerous and Disruptive Conduct and shall be dealt with according to Safe Schools Policy
13.4. Any misuse of such medication by the student may be subject to disciplinary action under the District’s Safe Schools Policy and state law.
14. COMPLIANCE TO POLICY
14.1. A random medication audit will be performed at least annually in each school by the district nurse.
14.1.1. The following areas will be included in the audit:
14.1.1.1. Medication authorization forms in place and signed by parent/guardian and health care provider for the current school year.
14.1.1.2. Prescription and nonprescription medication containers are properly marked for each medication with student name, doctor and pharmacy name, medication name, dosage, time to be given, method of administration, and date of the prescription, and expiration date.
14.1.1.3. Medication is kept in a safe, locked, secure storage cabinet/drawer.
14.1.1.4. Documentation of medication administration is in place.
14.1.2. At the conclusion of each audit, the results will be given to the UAP administering the medication, the school principal, and the district nurse’s supervisor.
14.1.3. Items not in compliance will be rectified with a two (2) week period with notification of compliance made to the district nurse. If parent/guardian is out of compliance with medication policy and does not come within compliance, the school may withdraw authorization for administration of medication under section 3.6 of this policy.
15. MEDICATION SHARING PROHIBITED
15.1. No student is permitted to sell or otherwise give to others any medication, prescription or nonprescription. Violations of this policy are subject to disciplinary action under the school’s drug policies.
16. FIRST AID
16.1. Basic first aid will be provided to students during school hours
REFERENCES
Utah Code Section 26B-4-401 (5) - Asthma medications
Utah Code Section 26B-4-406 - Emergency Injection for Anaphylactic Reaction Act
Utah Code Section 26B-4-408 - Training in use and storage of stock albuterol.
Utah Code Section 53G-9-502 et seq., - Administration of Medication
Utah Code Section 53G-9-504 - Administration of glucagon -- Training of volunteer school personnel -- Authority to use glucagon -- Immunity from liability.
Utah Code Section 53G-9-505 – Trained school employee volunteers -- Administration of seizure rescue medication -- Exemptions from liability.
Utah Code Section 53G-9-506 – Diabetes medication -- Possession -- Self-administration
Utah Code Section 58-37-4 et seq. - Controlled Substances Revised 1/2019
Nurse Practice Act, UCA 58-31b (2023).
Nurse Practice Act Rule, UCA R156-31b (2023).
Nurse Practice Act Rule R156-31b-701a - Delegation of Nursing Tasks in a Non-School Setting
Nurse Practice Act Rule R156-31b-701b - Delegation of Tasks in a School Setting
Guidelines for administration of student medication (April, 2024)
Nurse Practice Act
