N.H. Admin. Code § He-C 4002.21

Current through Register No. 50, December 12, 2024

Section He-C 4002.21 - Administration and Storage of Medication

(a) Programs shall administer any medication, treatment, or other remedy to any child, as provided by the child's parents and in accordance with this section.

(b) For the purposes of this section, "administer" means an act whereby a single dose of a medication is instilled into the body of, applied to the body of, or otherwise given to a child for immediate consumption or use.

(c) Only authorized staff, a registered nurse (RN), licensed practical nurse (LPN), or licensed practitioner shall administer prescription and over-the-counter medications to children, in accordance with the child's medication order.

(d) Authorized staff shall administer only those medications for which there is a medication order provided by a licensed practitioner, and written permission from the parent.

(e) Programs shall not accept any prescription medications that do not include a prescription label or medication order from a licensed professional.

(f) Each medication order shall legibly display:

(1) The child's name;

(2) The medication name, strength, the prescribed dose and method of administration;

(3) The frequency of administration;

(4) The indications for usage of all medications to be used pro re nata (PRN); and

(5) The dated signature of the licensed practitioner for orders other than the prescription label.

(g) Medication orders for PRN medication shall include:

(1) The indications and any special precautions or limitations regarding administration of the medication;

(2) The maximum dosage allowed in a 24-hour period;

(3) The dated signature of the parent for topical substances or over-the-counter medication; and

(4) For other than the prescription label, the dated signature of the licensed health care practitioner for prescription medication.

(h) In the event of a medication error in the administration of medication, the family child care provider, center director, site director, or designee shall notify the child's parents immediately.

(i) In the event of a medication error in the documentation of the administration of medication, the family child care provider, center director, or designee shall notify the child's parents by the end of the day in which the error occurred.

(j) Prior to administering prescription and over-the-counter medication to any child, child care staff shall complete and document training on medication administration, as required by He-C 4002.33(b)(4), delivered by the department, a physician, RN, or LPN practicing under the direction of an APRN, RN, or physician, or online training approved by the department.

(k) Authorized staff shall complete training in medication safety and administration every 3 years.

(l) Documentation of training in medication safety and administration shall be maintained on file at the child care program and be available for review by the department.

(m) For each child receiving medication, child care staff shall maintain medication information on file and available for review by the department, including medication orders, parental authorization to administer medication, and information regarding a child's allergies, if applicable.

(n) Child care staff shall maintain a written record for each dose of medication administered to each child, which shall:

(1) Be maintained on file in the program, available for review by the department;

(2) Be completed by the authorized staff who administered the medication immediately after the medication is administered; and

(3) For each administered medication, include at a minimum:

a. The name of the child;

b. The date and time the medication was taken;

c. A notation of any medication error or the reason why any medication was not taken as ordered or approved;

d. The dated signature of the authorized staff who administered the medication to the child; and

e. For administration of a PRN, documentation shall also include the reason for administration.

(o) All medication shall be:

(1) Inaccessible to children;

(2) Stored at the temperature and conditions recommended by the manufacturer or as directed on the prescription label;

(3) Stored in a secondary container separate from food if in a refrigerator; and

(4) Labeled with the child's name to ensure correct identification of each child's medication.

(p) Medications such as insulin, inhalers, and epi-pens shall be readily accessible to child care staff caring for children requiring such medications, to assure timely administration when needed and in accordance with parental instructions in He-C 4002.20(g)(2)a.

(q) Medications described in (p) above shall be permitted to be in the possession of a school-age child as long as the following are on file at the program:

(1) Written authorization from the prescribing health care practitioner; and

(2) Written permission from the child's parents.

(r) The only exception to (q) above shall be when a school-age child is with children younger than 6 years of age, insulin, inhalers, and epi-pens shall not be in the school-age child's possession, but shall be readily accessible to staff.

(s) All medications belonging to staff shall be stored separate from children's medications in a locked area, or otherwise inaccessible to children.

(t) All prescription or over-the-counter medication and topical substances shall be kept in the original containers or pharmacy packaging and properly closed after each use.

(u) Any contaminated, expired, or discontinued medication, whether prescription or over-the-counter, and topical substances shall be returned to the child's parents or, if belonging to the program, disposed of properly by authorized staff.

(v) Child care staff shall administer over-the-counter medications in accordance with the manufacturer's instructions or written instructions from the child's health care practitioner.

N.H. Admin. Code § He-C 4002.21

Amended by Volume XXXVI Number 49, Filed December 8, 2016, Proposed by #12046, Effective 11/19/2016, Expires 5/18/2017.

Ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17;

Amended by Volume XXXVII Number 50, Filed December 14, 2017, Proposed by #12415, Effective 11/6/2017, Expires 11/6/2027.

Amended by Volume XLII Number 19, Filed May 12, 2022, Proposed by #13373, Effective 4/22/2022, Expires 4/22/2032 (formerly He-C 4002.18)