Each school principal shall authorize two or more staff members to administer prescribed or over-the-counter (OTC) oral or topical medication, eye drops, ear drops, and nasal sprays (“medication”). Oral medications are administered by mouth either by swallowing or inhaling and may include administration by mask if the mask covers the mouth or mouth and nose. The designated staff members will receive Registered Nurse (RN) delegation and training prior to the opening of school each year.

Medication may only be administered to students on a scheduled basis upon written authorization from a parent or guardian with a written request by a licensed health professional prescribing within the scope of their prescriptive authority, which includes an explanation that there exists a valid health reason that makes the administration of such medication advisable during school hours or when the student is under the supervision of school officials. If the medication is to be administered more than fifteen consecutive days, the written request must be accompanied by written instructions from a licensed health professional in addition to the medication order. Requests shall be valid for not more than the current school year, but may include summer school if applicable. All medication must be properly labeled and contained in the original pharmacy container.

The person administering the medication or their designee shall:

1. Collect the medication directly from the parent or guardian (students should transport medication to school only when they are developmentally able to do so safely) and collect an authorization form properly signed by the parent or guardian and the prescribing licensed health professional (which will include instructions from the prescribing licensed health professional);
2. Store the medication in a locked, substantially constructed cabinet. Medication for rescue in life threatening situations must be secure and readily available;
3. Maintain a daily record which indicates that the prescribed medication was administered, including by whom it was administered and the time it was administered; and
4. Provide for the delegation, training and supervision of the staff accepting the delegation or medication administration.

A copy of this procedure and related policy shall be available online and can be provided to the parent or guardian upon request.

Prescribed and over-the-counter (OTC) oral, topical medications, eye drops or ear drops may be administered by a registered nurse, a licensed practical nurse or an authorized staff member.

Nasal sprays containing legend (prescription) drugs or controlled substances may be administered only by a licensed nurse or, if a school nurse is not present on school premises, an authorized school employee; or a parent/ guardian-designated adult with training as required by RCW 28A.210.260.

Emergency Injectable Medication

No prescribed medication shall be administered by injection by staff except when a student is susceptible to a predetermined, life-endangering situation. The parent or guardian shall submit a written statement which grants a staff member the authority to act according to the specific written orders and supporting directions provided by a licensed health professional prescribing within his or her prescriptive authority (e.g., medication administered to counteract a reaction to an insect sting – auto injector for anaphylaxis ). Such medication shall be administered by staff trained by the supervising registered nurse to administer such an injection in accordance with the Individual Health and Emergency plan for that student.

Administration of emergency injectable medication by staff will be documented in the student’s health record.

Written orders for emergency medication to address allergic reactions, signed and dated, from the licensed health professional prescribing within his or her prescriptive authority shall:

1. State that the student suffers from an allergy which may result in an anaphylactic reaction;
2. Identify the drug, the mode of administration, and the dose. This decision must be made by the licensed health professional prescribing within his or her prescriptive authority;
3. Indicate when the injection shall be administered based on anticipated symptoms or time lapse from exposure to the allergen; and
4. Recommend follow-up after administration. This may include administration of additional medications. With a known exposure to an allergen, or signs and symptoms of an anaphylactic reaction, non-licensed school staff shall be instructed by the school nurse to administer epinephrine autoinjector, call 911 and have the student transported for additional emergency care.

Self-Administered Medications

If a licensed health professional and a student’s parent or guardian request that a student be permitted to carry his/ or her own medication and/ or be permitted to self- administer the medication, the principal may grant permission after consulting with the school nurse. The process for requesting and providing instructions shall be the same as established for other medications. The principal and nurse shall take into account the age, maturity and capability of the student; the nature of the medication; the circumstances under which the student will or may have to self-administer the medication and other issues relevant in the specific case before authorizing a student to carry and/or self-administer medication at school. The prescriber is required to assure that the student is trained to self administer and/ or is capable of safely self carrying medication. Except in the case of multi-dose devices like asthma inhalers), students shall only carry one day’s supply of medication at a time. Violations of any conditions placed on the student permitted to carry and/or self-administer his or her own medication may result in termination of that permission, as well as the imposition of discipline when appropriate.

Parent/Guardian-Designated Adult Care of Students with Epilepsy

Parents/ guardians of students with epilepsy may designate an adult to provide care for their student consistent with the student’s individual health care plan. At parent/ guardian request, school district employees may volunteer to be a parent/ guardian-designated adult under this policy, but they will not be required to participate.

Parent/guardian-designated adults (PDA) who are school employees will file a voluntary, written, current and unexpired letter of intent stating their willingness to be a parent/guardian-designated adult. Parent/guardian-designated adults who are school employees are required to receive training in caring for students with epilepsy from the school nurse. Parent/guardian-designated adults who are school employees will receive additional training from a parent/guardian-selected health care professional or expert in epileptic care to provide the care (including medication administration) requested by the parent/guardian.

Parent/guardian-designated adults who are not school employees are required to show evidence of comparable training, and meet school district requirements for volunteers. Parent/ guardian-designated adults will receive additional training from a parent/guardian-selected health care professional or expert in epileptic care to provide the care requested by the parent.

The school nurse is not responsible for the supervision of procedures authorized by the parents/ guardians and carried out by the parent/guardian-designated adult.

Sunscreen

Pursuant to a 2017 change to state law, the definition of medication does not include over-the-counter topical sunscreen products regulated by the US Food and Drug Administration. Over-the-counter topical sunscreen products may be possessed and used by students, parents, and school staff without a written prescription or note from a licensed health care provider, if the following conditions are met: a) the product is regulated by the US Food and Drug Administration as an over-the-counter sunscreen product and b) if possessed by a student, the product is provided to the student by their parent or guardian.

Policy Cross References

• 3416 – Medication at School
• 3419 – Self-Administration of Asthma and Anaphylaxis Medications
• 3420 – Anaphylaxis Prevention and Response

Legal References

• RCW 28A.210.260 Administration of Medication—Conditions.
• RCW 28A.210.270 Administration of Medication—Immunity from Liability.
• Attorney General Memorandum (2/9/89)—Administration of Medication.
• RCW 18.71.
• RCW 18.79.

Revisions

• August 28, 2017
• April 22, 2015
• June 2013

Approved

• December 16, 2011