La. Admin. Code tit. 28 § CLVII-305

Current through Register Vol. 50, No. 11, November 20, 2024

Section CLVII-305 - Administration of Medication

A. Administration of Medication

1. Each local educational governing authority shall establish guidelines based upon the joint policy of BESE and the Louisiana State Board of Nursing for the administration of medications which shall include but not be limited to the following provisions.

B. Written Orders, Appropriate Containers, Labels and Information

1. Medication shall not be administered to any student without an order from a Louisiana, or adjacent state, licensed physician, dentist, or other authorized healthcare prescriber and it shall include the following information:

a. the student's name;

b. the name and signature of the physician, dentist, or other authorized healthcare prescriber;

c. the physician/dentist/other authorized healthcare prescriber's business address, office phone number, and emergency phone numbers;

d. the frequency and time of the medication;

e. the route and dosage of the medication; and

f. a written statement of the desired effects and the child specific potential of adverse effects.

2. Medication shall be provided to the school by the parent or guardian in the container that meets acceptable pharmaceutical standards and shall include the following information:

a. name of pharmacy;

b. address and telephone number of pharmacy;

c. prescription number;

d. date dispensed;

e. name of student;

f. clear directions for use, including the route, frequency, and other as indicated;

g. drug name and strength;

h. last name and initial of pharmacist;

i. cautionary auxiliary labels, if applicable; and

j. physician's, dentist's, or other authorized healthcare prescriber's name.

3. Labels of prepackaged medications, when dispensed, shall contain the following information in addition to the regular pharmacy label:

a. drug name;

b. dosage form;

c. strength;

d. quantity;

e. name of manufacturer and/or distributor; and

f. manufacturer's lot or batch number.

C. Administration of Medication-General Provisions

1. During the period when the medication is administered, the person administering the medication shall be relieved of all other duties. This requirement does not include the observation period required in Paragraph C.5.

2. Except in the case of a trained unlicensed diabetes care assistant administering diabetes medications or in life threatening situations, trained unlicensed school employees may not administer injectable medications.

3. All medications shall be stored in a secured locked area or locked drawer with limited access except by authorized personnel.

4. Except in Paragraph C.2, only oral medications, inhalants, topical ointments for diaper rash, and emergency medications shall be administered at school by unlicensed personnel.

5. Each student shall be observed by a school employee for a period of 45 minutes following the administration of medication. This observation may occur during instruction time.

6. School medication orders shall be limited to medication which cannot be administered before or after school hours.

D. Principal

1. The principal shall designate at least two employees to receive training and administer medications in each school.

E. Teacher

1. The classroom teacher who is not otherwise previously contractually required shall not be assigned to administer medications to students.

2. A teacher may request in writing to volunteer to administer medications to his/her own students.

3. The administration of medications shall not be a condition of employment of teachers employed subsequent to July 1, 1994.

4. A regular education teacher who is assigned an exceptional student shall not be required to administer medications.

F. School Nurse

1. The school nurse, in collaboration with the principal, shall supervise the implementation of the school policies for the administration of medications in schools to insure the safety, health, and welfare of the students.

2. The school nurse shall be responsible for the training of non-medical personnel who have been designated by each principal to administer medications in each school. The training shall be at least six hours and include but not be limited to the following provisions:

a. proper procedures for administration of medications including controlled substances;

b. storage and disposal of medications;

c. appropriate and correct record keeping;

d. appropriate actions when unusual circumstances or medication reactions occur; and

e. appropriate use of resources.

3. No employee other than a registered nurse, licensed medical physician, an appropriate licensed health professional, or hired and trained unlicensed nursing personnel or unlicensed assistive personnel as defined by the Louisiana State Board of Nursing shall be required to perform an outside tracheotomy suctioning procedure on any child in an education setting. However, nothing shall prohibit an employee who volunteers to perform such procedure and who complies with the training and demonstration requirement from being allowed to perform such procedure on a child in an educational setting.

G. Parent/Guardian

1. The parent/guardian who wishes medication administered to his/her student shall provide the following:

a. a letter of request and authorization that contains the following information:

i. name of the student;

ii. clear instructions;

iii. prescription number, if any;

iv. current date;

v. name, degree, frequency, and route of medication;

vi. name of physician, dentist, or other authorized healthcare prescriber;

vii. printed name and signature of parent or guardian;

viii. emergency phone number of parent or guardian; and

ix. statement granting or withholding release of medical information;

b. written orders for all medications to be given at school, including annual renewals at the beginning of the school year;

c. a prescription for all medications to be administered at school, including medications that might ordinarily be available over the counter;

d. a list of all medications that the student is currently receiving at home and school, if that listing is not a violation of confidentiality or contrary to the request of the parent/guardian or student;

e. a list of names and telephone numbers of persons to be notified in case of medication emergency in addition to the parent or guardian and licensed prescriber;

f. arrangements for the safe delivery of the medication to and from school in the original labeled container as dispensed by the pharmacist; the medication shall be delivered by a responsible adult;

g. unit dose packaging shall be used whenever possible.

2. All aerosol medications shall be delivered to the school in premeasured dosage.

3. No more than a 35 school day supply of medication shall be kept at school.

4. Except in the case of emergency medication, the initial dose of a medication shall be administered by the student's parent/guardian outside the school jurisdiction with sufficient time for observation for adverse reactions.

5. The parent/guardian shall also work with those personnel designated to administer medication as follows:

a. cooperate in counting the medication with the designation school personnel who receives it and sign a drug receipt form;

b. cooperate with school staff to provide for safe, appropriate administration of medications to students, such as positioning, and suggestions for liquids or foods to be given with the medication;

c. assist in the development of the emergency plan for each student;

d. comply with written and verbal communication regarding school policies;

e. grant permission for school nurse/physician consultation; and

f. remove or give permission to destroy unused, contaminated, discontinued, or out-of-date medications according to the school guidelines.

H. Student Confidentiality

1. All student information shall be kept confidential.

I.

1. Notwithstanding any provision of law or any rule, regulation, or policy to the contrary, the governing authority of each public elementary and secondary school shall permit the self-administration of medications by a student with asthma or diabetes or the use of auto-injectable epinephrine by a student at risk of anaphylaxis, provided that the student's parent or legal guardian provides the school in which the student is enrolled with the following documentation:

a. written authorization for the student to carry and self-administer such prescribed medications;

b. written certification from a licensed medical physician or other authorized prescriber that the student:

i. has asthma, diabetes, or is at risk of having anaphylaxis;

ii. has received instruction in the proper method of self administration of the student's prescribed medications to treat asthma, diabetes, or anaphylaxis;

c. written treatment plan from the student's licensed medical physician or authorized prescriber for managing asthma, diabetes, or anaphylactic episodes. The treatment plan must be signed by the student, the student's parent or other legal guardian, and the student's licensed medical physician or other authorized prescriber and shall also contain the following information:

i. the name, purpose, and prescribed dosage of the medications to be self-administered;

ii. the time or times the medications are to be regularly administered and under what additional special circumstances the medications are to be administered;

iii. the length of time for which the medications are prescribed;

d. any other documentation required by the governing authority of the public elementary or secondary school.

2. The documentation required by Paragraph 1 of this Subsection shall be kept on file in the office of the school nurse or other designated school official.

3. The governing authority of the public elementary and secondary school shall inform the parent or other legal guardian of the student in writing that the school and its employees shall incur no liability as a result of any injury sustained by the student from the self-administration of medication used to treat asthma, diabetes, or anaphylaxis. The parent or legal guardian of the student shall sign a statement acknowledging that the school shall incur no liability and that the parent or other legal guardian shall indemnify and hold harmless the school and its employees against any claims that may arise relating to the self-administration of medications used to treat asthma or anaphylaxis.

4. For the purposes of the Subsection:

Auto-Injectable Epinephrine - a medical device for the immediate self-administration of epinephrine by a person at risk for anaphylaxis.

Glucagon - is a hormone that raises the level of glucose in the blood. Glucagon, given by injection is used to treat severe hypoglycemia.

Inhaler - a medical device that delivers a metered dose of medication to alleviate the symptoms of asthma.

Insulin Pen - a pen- like device used to put insulin into the body.

Insulin Pump - a computerized device that is programmed to deliver small, steady, doses of insulin.

5. A student who has been granted permission to self-administer medication pursuant to this Subsection shall be allowed to carry and store with the school nurse or other designated school official an inhaler, auto-injectable epinephrine, or insulin at all times.

6. Permission for the self-administration of asthma or diabetes medications or use of auto-injectable epinephrine by a student shall be effective only for the school year in which permission is granted. Permission for self-administration of asthma or diabetes medications or the use of auto-injectable epinephrine by a student shall be granted each subsequent school year, provided all of the requirements of this Subsection are fulfilled.

7. Upon obtaining permission to self-administer asthma or diabetes medication or to use auto-injectable epinephrine pursuant to this Subsection, a student shall be permitted to possess and self-administer such prescribed medication at any time while on school property or while attending a school sponsored activity.

8. A student who uses any medication permitted pursuant to this Subsection in a manner other than prescribed shall be subject to disciplinary action; however, such disciplinary action shall not limit or restrict such student's immediate access to such prescribed medication.

La. Admin. Code tit. 28, § CLVII-305

Promulgated by the Board of Elementary and Secondary Education and the Board of Nursing, LR 39:1030 (April 2013), amended LR 39:2193 (August 2013), Promulgated by the Board of Elementary and Secondary Education and the Board of Nursing, LR 39:1030 (April 2013), amended LR 39:2193 (August 2013), LR 501148 (8/1/2024).

AUTHORITY NOTE: Promulgated in accordance with R.S. 17:436.1 and R.S. 17:436.1(J).