W. Va. Code R. § 126-25A-12

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 126-25A-12 - Emergency Medication

12.1. The West Virginia Registered Nurses Board and W. Va. Code allows for the delegation of specific prescribed emergency medication. There are emergency medications that can only be administered by licensed nurses, such as, but not limited to, intranasal midazolam and intravenous clotting factor. The following emergency medications have been approved for school RNs to determine the ability to delegate, train, and continuously supervise school personnel to administer when a diagnosis and order are in place and the school RN or LPN is not available to provide such care:

12.1.a. glucagon;

12.1.b. epinephrine;

12.1.c. albuterol or other emergency asthma medication;

12.1.d. opioid antagonist; and

12.1.e. certain seizure medication can only be delegated to unlicensed school personnel if ordered by the student's physician and the certified school RN provides the final determination to allow delegation.

12.2. A public, private, parochial, or denominational school located within this state may possess and maintain at the school a supply of epinephrine auto-injectors for use in emergency medical care or treatment for an anaphylactic reaction. Each county board may also develop an optional stock epinephrine policy during secondary activity/extracurricular events outside the school day. A prior diagnosis for a student or school employee requiring the use of epinephrine auto-injectors is not necessary to permit the school to stock epinephrine auto-injectors.

12.3. Epinephrine auto-injectors shall be maintained by the school in a secured, unlocked location, which is only accessible by certified school RNs, health care providers, and authorized nonmedical personnel, and not by students.

12.4. An allopathic physician licensed to practice pursuant to the provisions of W. Va. Code § 30-3-1 or an osteopathic physician licensed to practice pursuant to the provisions of W. Va. Code § 30-14-1 may prescribe within the course of the physician's professional practice standing orders and protocols for use when necessary by a school that wishes to maintain epinephrine auto-injector pursuant to the provisions of this section.

12.5. Certified school RNs are authorized to administer an epinephrine auto-injector to a student or school employee during regular school hours or at a school function when the certified school RN medically believes the individual is experiencing an anaphylactic reaction. A certified school RN may also use the school supply of epinephrine auto-injectors that meet the requirements of a prescription on file with the school for a student or school personnel.

12.6. Designated qualified school personnel and, at the county board's discretion, school transportation employees, may administer epinephrine when they reasonably believe, based upon their training, that an individual is experiencing an anaphylactic reaction. These employees must have been trained in the administration of an epinephrine auto-injector by the certified school RN and have been designated and authorized to administer the epinephrine auto-injector to a student or school employee during regular school-related events.

12.6.a. Designated qualified school personnel may also use the school supply of epinephrine auto-injectors for a student or school employee authorized to self-administer that meet the requirements of a prescription on file with the school. Transportation employees, including school bus operators, are not eligible to receive the additional pay provided in W. Va. Code § 18-5-22(e).

12.7. The parent/guardian of a student administered a school-maintained epinephrine auto-injection shall be provided with a comprehensive notification immediately. The comprehensive notification should include the date and the approximate time the incident occurred, symptoms observed, who administered the injection, the rationale for administering the injection, the response to the epinephrine administration, the dose of epinephrine administered, the current location of the student, and any other necessary elements to make the student's parent/guardian fully aware of the circumstances surrounding the administration of the injection and the student's subsequent health status.

12.8. A certified school RN or designated qualified school person who administers an epinephrine auto-injection to a student or a school personnel provided in this policy and in W. Va. Code § 18-5-22(c) is immune from liability for any civil action arising out of any act or omission resulting from the administration of the epinephrine auto-injection unless the act or omission was the result of the certified school RN or trained and authorized nonmedical school personnel's gross negligence or willful misconduct.

12.9. The county board shall provide training on anaphylaxis and allergy awareness for food service workers and others in the school system.

12.10. W. Va. Code § 18-5-22(d) allows county boards the option to adopt stock opioid antagonist policies under a standing order by a licensed prescriber with specific protocols for administration by certified school RNs and other licensed RNs and LPNs working in the school. County boards must follow the protocols/standards for dosage set forth by the West Virginia Department of Health and Human Resources. The certified school RN shall train the designated school personnel for administration of an opioid antagonist, deem competent, and authorize them to administer an opioid antagonist. The opioid antagonist may be given to a student, school personnel, or any person on school property during regular school hours. Administration of the opioid antagonist may be given when the authorized personnel believes, based upon their training, that the individual is experiencing an adverse opioid event.

12.11. All licensed prescribers who prescribe an opioid antagonist to a school or county shall provide educational materials and training to the certified school RN, other licensed nurses, and school employees working in the opiate-related overdose prevention and treatment programs, as well as materials on administering the prescribed opioid antagonist.

12.12. Any certified school RN, other licensed nurses, and designated and trained school personnel who administers an opioid antagonist as provided in this policy and W. Va. Code § 18-5-22(d) is immune from liability for any civil action arising out of any act or omission resulting from the administration of the opioid antagonist unless the act or omission resulted from the school RN or trained and authorized nonmedical school personnel's gross negligence or willful misconduct.

12.13. Prior notice to the parent/guardian of a student of the administration of the opioid antagonist is not required. Immediately following the administration of the opioid antagonist, the school shall provide notice to the parent/guardian of a student who received the opioid antagonist. Any certified school RN, other licensed nurse, and designated school personnel working in the school who administers an opioid antagonist to a person believed to be suffering from an opioid-related overdose is required to seek additional medical treatment at a medical facility for that person immediately following the administration of the opioid antagonist to avoid further complications resulting from a suspected opioid-related overdose. The notice shall include who administered the opioid antagonist, the rationale for administering the antagonist, the approximate time of the administration of the opioid antagonist, and any other necessary elements to make the student's parent/guardian fully aware of the circumstances surrounding the administration of the antagonist.

12.14. All public schools must report each incident resulting in administering epinephrine injections and administering opioid antagonist in their county. Public schools must report other medication administration errors (e.g., wrong dose, incorrect medication administered, other medication administration errors). The medication administration errors will be reported to the West Virginia Poison Center by calling 1-800-222-1222 after emergency medical services have transported the student or staff member to acute care. The notification should include the name of the student, the student's age and gender, date and the approximate time the incident occurred, symptoms observed, who administered the injection, the name of the school the student attends, a contact telephone number, the rationale for administering the injection, the response to the epinephrine administration or opioid antagonist, the dose of epinephrine or opioid antagonist administered, and any other necessary elements to provide a complete report for the individual situation. The West Virginia Poison Center will provide the data upon request to the public schools, county boards, and annually to the State Superintendent of Schools. The State Superintendent of Schools shall prepare an annual report to present to the West Virginia Legislature's Joint Committee on Government and Finance as set forth in W. Va. Code §4-3, by December 31 of each year.

W. Va. Code R. § 126-25A-12