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Policy ASSISTING STUDENTS WITH MEDICATIONS Code JLCD Issued 4/14 Purpose: To establish structure for assisting students with medications in a school setting. When possible, medications should be given by parents/legal guardians before or after school hours. Any prescription medication to be given at school or school related activities must be accompanied by written orders from a health care practitioner who is recognized by South Carolina’s Department of Labor, Licensing and Regulation as authorized to prescribe medications. Limited over-the-counter medications may be administered by the school’s RN or LPN with parental consent without a medical order. The school district and its employees reserve the right to refuse to honor medication requests that are not consistent with professional standards (e.g., manufacturer’s guidelines, Physician’s Desk Reference) and/or are deemed unsafe for the school setting. Requests from physicians, parents/legal guardians for administration of herbal/alternative medicinal products or medications prescribed “off-label” or for an investigational use will be evaluated on a case-by-case basis by the school district’s nursing staff, school administrators, the prescribing health care practitioner and medical consultant, if there is one. When a school has a nurse assigned full time, unlicensed school personnel may be trained by the nurse to assist with routine medications. The full time nurse is responsible for the administration of medications when he/she is present in the health office. If the nurse is absent, or the school does not have a full time nurse assigned, or the nurse is not present in the health office because of other duties or assignments, the principal or her/his designee is responsible for assisting with and controlling access to routine medications. Unlicensed school personnel may be trained by the school nurse to provide emergency medication, supplied by the parent or legal guardian, for students with an identified chronic health condition in accordance with the student’s Individualized Healthcare Plan and orders from the student’s physician or other legal prescriber. Schools will stock epinephrine auto-injectors to be administered to a student or other individual on school premises whom the school nurse or other designated school personnel believes in good faith is experiencing anaphylaxis in accordance with the district’s standing protocol. Medications must be brought to the school by a responsible adult and delivered to the school nurse or, in the absence of the nurse, to the school employee designated by the principal. The responsible adult delivering medication to the school may be required to count and sign in medication with the nurse or designated employee. No student shall carry medicine in school or on school related events except for students given permission to do so by the Individualized Healthcare Plan to guard against a life threatening condition. Permission shall be granted only after careful review by the school district in consultation with the registered professional school nurse and the student's parent/legal guardian, physician or legal prescriber. These rights will be revoked if there is sufficient evidence that unsupervised self-monitoring or self-medicating would seriously jeopardize the safety of the student or others. Charleston County School District (see next page) PAGE 2 - JLCD - ASSISTING STUDENTS WITH MEDICATIONS Medications that have expired or are not currently being used by a student will not be stored at the school. Medications will not be stored at the school during summer breaks. Parents/Legal guardians will be notified and given an opportunity to pick up their child’s medications. Medications that are not picked up will be disposed of in a manner that respects security as well as environmental concerns. See administrative regulations for additional implementation information. See the following links for more information. National Association of School Nurses (2011). Position Statement: Medication Administration in the School Setting. http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatements South Carolina Board of Nursing Advisory Questions 50, 51, 52 http://www.llr.state.sc.us/POL/Nursing/index.asp?file=AdvisoryOp/advisoryop.htm Safe Access to Vital Epinephrine (SAVE) Act http://www.scstatehouse.gov/sess120_2013-2014/bills/3725.htm Joint Advisory Opinion by the South Carolina Boards of Medical Examiners, Nursing and Pharmacy Regarding Over the counter Medications in Schools http://www.llr.state.sc.us/POL/Nursing/index.asp?file=laws.htm Adopted 8/25/86; Revised 7/28/97, 12/1/99, 1/23/06, 4/28/14 Legal references: A. S.C. Code of Laws, 1976, as amended: 1. Section 40-33-70 - Amends law relating to on-site supervision of a nurse. 2. Sections 59-63-80 and 90 - Policy for individual healthcare plan for certain students. 3. Section 15-78-60 - Immunity from liability for districts and employees. Charleston County School District SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations Table of Contents General Information …………………………………..……………………..…2 Doctors Orders and Parental Permission….………………………….…......4 Controlled Substances ……………………………………………………..….4 Sample/ Off-Label/Herbal/Alternative & Investigational Medicine…………5 Self- Medication………………………………………………………….…….. 6 Accepting and Storage of Medications ………………………………………7 Stocked Over-The-Counter Medication ……………………………………... 8 Emergency Medications- Student Specific………………………...………... 8 Emergency Medications- Stocked Epinephrine Auto Injector………………9 Disposal of Medications………………………………...……………..……….9 Documentation Of Medications...…………………………………..………...10 Medications on Field Trips………………………..…………………………...10 Medication Errors……………………………………………………………….11 References & Other Applicable Documents……………………………..…..12 CCSD Managing Medications in School 1/2015 Administrative Regulations Page 1 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations General Information It is the responsibility of the school district, through its nursing services department, to establish secure and safe procedures for managing medications that are consistent with applicable laws, regulations, and standards. School nurses, with support from school and district level administration, should communicate to parents, students and staff the required medication practices for the school setting. 1. The administration of medications includes the acts of: a. preparing and giving drugs in accordance with the orders of a licensed, authorized advanced practice registered nurse (i.e., nurse practitioner, certified nurse-midwife, clinical nurse specialist), or a physician, dentist, or other authorized licensed provider as to drug, dosage, route and frequency; b. observing, recording, and reporting desired effects, untoward reactions, and side effects of drug therapy; c. intervening when emergency care is required as a result of drug therapy; d. appropriately instructing the student regarding the medication; e. recognizing accepted prescribing limits and f. reporting deviations to the prescribing advanced practice registered nurse, physician, dentist, or other authorized licensed provider. 2. Assisting with medications includes the acts of: a. reminding a student of the time to take a medication; b. opening the container that is properly labeled; and/or c. assisting the individual to place the medication in the mouth or properly apply the medication. 3. The RN assigned to the school or the RN supervising the clinical practice of the LPN assigned to the school in collaboration with the LPN may select, train, determine the competency of, and evaluate unlicensed school personnel (meaning school personnel who are not licensed nurses) for assisting students with routine medications in situations where the RN or LPN on staff at the school is absent or not available. 4. The Unlicensed school personnel may also be trained by the nurse to assist students with emergency medications for a specific student based on the Individualized Health Care Plan and the MD orders. CCSD Managing Medications in School 1/2015 Administrative Regulations Page 2 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations 5. Training provided by RNs for unlicensed school personnel who will assist with medications in the school setting will include written and verbal instruction, competency assessment, evaluation and monitoring. 6. Medication guidelines that apply during regular school sessions also apply during after hours, summer sessions and field trips. 7. The first dose of a medication that a student has not previously taken should be given by the parent/guardian at home so that the student can be monitored closely for hypersensitivity and side effects. 8. Intravenous (IV) medications may only be administered by a RN in a school setting. The student should have an established port or access route. 9. Injectable medications given via subcutaneous, intradermal, and/or intramuscular routes, insulin (in any form), medications instilled in the eye or ear, and medications inserted into the rectum or vagina must be administered by a RN or LPN (See Emergency Medication section for exceptions). 10. Generally, medications should be given within 30 minutes before or after the prescribed time. The safe allowable time variances for medications differ. If there is a question regarding whether a medication was given within a safe time interval, the manufacturer’s guidelines should be consulted. 11. Sustained-release tablets/capsules must never be crushed or opened unless expressly ordered by the authorized prescriber. This could result in the student receiving a bolus dosage of the medication rather than a smaller dosage over time. 12. All personnel administering or assisting students with medications must ensure that the right student receives the right medication at the right time in the right dosage via the right route for the right reason. 13. Medications must be used only for the specific student and reason for which the medication was ordered. Never borrow a medication from one student for another. 14. Medications must be poured by the person who will administer or assist with the medication at the time that it will be given. 15. The frequency of medications given on an “as needed” basis for specific symptoms should be monitored. If, in the opinion of the nurse, a student is CCSD Managing Medications in School 1/2015 Administrative Regulations Page 3 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations requiring medication too frequently, the nurse should notify the parent and/or refer the student to their healthcare provider. Doctors Orders and Parental Permission 1. The following require (1) a written order from a health care practitioner who is recognized by South Carolina’s Department of Labor, Licensing, and Regulation as authorized to prescribe medications and (2) written permission from the student’s parent/guardian: a. prescribed medications, b. herbal/alternative medicinal products, c. experimental medications, d. medications being used off-label (including over-the-counter medications to be given in dosages or for reasons that are not consistent with the medication label or package insert), and e. over-the-counter medication other than the CCSD stocked medications which are administered by the school RN or LPN based on clinical policies and signed parental consent. 2. Medication permission forms and medication orders must be updated at the beginning of each new school year, when changes are made to the student’s medication regimen and are part of the student’s school health record. 3. The “CCSD Medication/Procedure Doctor’s Orders Form” when signed by a prescribing health care practitioner may serve as a health care practitioner’s written order. Parent or guardian signature serves as authorization to be given at school. See form in Nursing Services section of the CCSD website at: http://www.ccsdschools.com. 4. The health care practitioner’s written order must be consistent with the pharmacy label. If not, the licensed nurse must clarify the order with the health care practitioner and/or the pharmacist before administering. 5. For short term medications (less than 2 weeks); the correctly labeled prescription bottle may act as a written order from a health care practitioner. The school nurse may require a written order or verification from the health care practitioner for the medication. CCSD Managing Medications in School 1/2015 Administrative Regulations Page 4 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations Controlled Substances 1. A prescribed controlled substance maintained at school for an individual student’s use should be limited to no more than a 31-day supply. 2. Controlled substances should be accounted for at least on a weekly basis by two school employees and recorded. One employee performs the count while the other acts as a witness and recorder. One of the employees should be the school nurse. Both employees are responsible for the accuracy of the medication count. 3. When returning controlled medications to a student’s parent/guardian, the amount should be verified, recorded and witnessed. 4. Controlled substances count discrepancies must be investigated and corrected immediately. If unexplained discrepancies exist, it must be reported to CCSD Nursing Services administration to determine if SC DHEC Bureau of Drug Control should be notified. If diversion or theft of controlled substances by a licensed nurse is suspected, in addition to taking actions as stated above, the employer must notify the Board of Nursing not more than 15 business days from discovery of the alleged misconduct. Sample, Herbal, Off-Label, and Investigational Medications 1. “Sample” medications provided for a student by his/her health care practitioner may be accepted for administration if the health care practitioner provides written guidance for administering the medication and the medication is brought to the school in the original container provided by the pharmaceutical manufacturer. 2. Herbal, “off-label” and investigational medications will be evaluated on a case by case basis. 3. The following should be on file before administering “off-label” medications in a school setting: a. a written order from a health care practitioner who is recognized by South Carolina’s Department of Labor, Licensing, and Regulation as authorized to prescribe medications, b. identification of the condition for which the product is being used, c. a written request from the parent/guardian that gives permission for administration by the school, d. verification that the medication and requested dosage are safe for the student (reports from the manufacturer or a reliable pharmacy or college CCSD Managing Medications in School 1/2015 Administrative Regulations Page 5 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations of pharmacy, current medical journals, information from a pediatric medical or mental health facility, or information in a drug reference manual), and e. documentation from credible sources regarding therapeutic and untoward effects and interactions. 4. The following should be on file before administering investigational medications in a school setting: a. a written order from a health care practitioner who is recognized by South Carolina’s Department of Labor, Licensing, and Regulation as authorized to prescribe medications, b. identification of the condition for which the product is being used, c. a written request from the parent/guardian that gives permission for administration by the school, and d. a copy of the detailed consent form signed by the parent or guardian which describes the study (including the benefits and risks), the signs and symptoms of adverse reactions to be reported, and contact information for the investigators. Self Medication 1. Certain students with life-threatening health care conditions may selfadminister and or self-monitor within the school day or school based-activities. 2. The following conditions must be met in order for the student to be permitted to self-monitor and/or self-medicate: a. determination by the school that the student’s self-monitoring and/or selfmedicating will not seriously jeopardize the safety of the student or others; b. written statement from the student’s healthcare provider who prescribed the medication or monitoring device verifying that the student has a life threatening medical condition and that the student has been instructed and demonstrated competency in self-monitoring and/or selfadministration of his/her medication; c. written authorization from the student’s parent/legal guardian; d. written Individual Health Care Plan (IHP) developed with input from and approval from student’s health care provider, parent, student ,school nurse and other designated school personnel; e. authorization from the parent for the school to share the student’ sIHP with school staff who have a legitimate need for knowledge of the information; f. maintenance of the medication in a container appropriately labeled by the pharmacist who filled the prescription; and CCSD Managing Medications in School 1/2015 Administrative Regulations Page 6 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations g. a signed statement from the parent/legal guardian acknowledging that the school district and its employees and agents are not liable for an injury arising from a student’s self-monitoring and self-administering medications and that the parent or guardian will indemnify and hold harmless the district and its employees and agents against a claim arising from a student’ self-monitoring or self-administration of medications. 3. The permission for self-monitoring or self-medicating is effective for the school year in which it is granted and must be renewed each school year. Accepting and Storage of Medications 1. Medications are to be brought to the school by a responsible adult and delivered to the school nurse or, in the absence of the nurse, to a school employee. Controlled substances must be counted with the responsible adult delivering the medication and the school employee receiving the medication. A record should be maintained to record the medication count and signatures of individuals who count. 2. Parents/guardians must provide medications to the school in original containers with all labeling from the pharmacy and/or manufacturer intact and readable and must include only medication that is on the label. 3. All medications must be stored in a clean, securely locked, substantially constructed container that guards against theft. The medication storage container should be located in a room that can be locked when the room is not in use (e.g., the school nurse’s office). 4. Parents are expected to pick up expired, discontinued, and/or excess medications within 5 days of notification by the school nurse. 5. Expired, discontinued, and/or excess medications will not be sent home with students. This standard does not preclude a student from transporting to and from school, medication that the student has been authorized to self-administer. 6. Access to medications should be limited to only a few school personnel designated and authorized by the school’s principal. Keys should be kept in a secure location. 7. A plan should be in place to allow access to emergency medications at all times. CCSD Managing Medications in School 1/2015 Administrative Regulations Page 7 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations 8. Medication storage arrangements should allow for the need to transport medications during school emergencies (e.g., fire, lock down situations). 9. Proper temperature and storage conditions for each medication must be maintained. Medications that require refrigeration must be segregated from food items in a securely locked container. 10. Controlled substances must be inventoried and any discrepancies reconciled prior to disposal. Stocked Over-The- Counter Medication 1. Stocked medications are medications purchased by the school system or another person or entity in bulk and stored at the school for administration to students or staff. These medications can only be administered by a licensed nurse who is employed by the school district. 2. Stocked medications must be maintained in the manufacturer’s original container with labeling intact. Medication dosages for emergency stock medications must be consistent with the recommendations of the manufacturer. 3. Limited over-the- counter (OTC) medications as indicated on the School Nurse Health Information Form (Emergency Card) will be provided by the Charleston County School District for administration by the school RN or LPN. Written permission from a student’s parent/guardian is required for the indicated overthe-counter (OTC) medication. A completed School Health Information form (Emergency Card) when signed by a student’s parent/guardian, may serve as written permission to administer the over the counter medications that the parent/guardian indicated. See form in Nursing Services section of the CCSD website at: http://www.ccsdschools.com. Over-the-counter medications will only be given as recommended by the manufacturer on the label and/or package insert. Emergency Medication- Student Specific 1. Under certain circumstances, a licensed nurse may train an unlicensed person to give prescribed medications via intramuscular injection or rectal route if the medication is required for a medical emergency that a specific student may CCSD Managing Medications in School 1/2015 Administrative Regulations Page 8 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations experience based on the doctor’s orders and the student’s Individualized Healthcare Plan.(e.g., epinephrine for anaphylaxis, glucagon for hypoglycemia, and diazepam rectal gel for status epilepticus). 2. A medical emergency is defined as a sudden, urgent, unforeseen occurrence requiring immediate action in order to prevent disability or death. Read SC Board of Nursing Advisory Questions 50 and 52 (Internet links provided in the References section of this document). Emergency Medication- Stocked Epinephrine Auto Injectors 1. Under the SAVE Act, CCSD Nursing Services will ensure that all CCSD nurses are trained in the administration of epinephrine based on the CCSD Nursing Services Clinical Policy and MD orders. 2. Epinephrine auto-injectors will be obtained by the Nursing Services Department for each school’s nurse to maintain at the school. 3. The school nurse assigned to the school will monitor expiration date of autoinjector to ensure timely replacement upon expiration. 4. The SAVE Act applies to any student or other individual on school premises whom in good faith the nurse believes is experiencing anaphylaxis. Disposal of Medications 1. Medications should not be disposed of in sinks or toilets, but rather in the regular trash after mixing with an inerting agent and triple-bagging. An inerting agent is a substance that will render the medication mixture useless to individuals who may seek to divert the drugs. The inerting agent must be a material that dissolves (e.g., laundry detergent/washing powder). 2. Disposing of medication requires the presence of two school employees – one employee destroys the medication while the other is present as a witness and assists with documentation. The school nurse should be one of the employees involved with disposing of medications that are expired, discontinued, or left at the end of the school year. CCSD Managing Medications in School 1/2015 Administrative Regulations Page 9 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations Documentation of Medications 1. The school nurse must establish an individual medication record form for each medication that will be given at school. School nurses will use electronic documentation, but will also keep a written documentation form for documenting during computer down times and for unlicensed assistive personnel. 2. Each medication dose given to a student must be documented by the person assisting the student with the medication on forms that have been approved. Nurses will document electronically. If initials are entered on the medication record, the employee’s full signature and printed name should appear elsewhere on the form. 3. Documentation of medication should include the date, time, route, dosage, and the signature of the person who administered or assisted with the medication. Documentation should occur at the time that a medication is given; never before. 4. Documentation of medications given on an as needed basis should include the reason that the medication was given. The reason must be consistent with the medication order as written on the Medication/Procedure Doctor’s Order form or Clinical Policy. 5. Abbreviations should not be used. Medications on Field Trips (CCSD Field Trip Policy IJOA) 1. School personnel should consult with the school nurse early in the field trip planning process because accommodations must be made for students who will need medications or other nursing services. At a minimum (per policy), the nurse should be advised of field trip plans four weeks prior to the event. 2. Parents/guardians must provide written medical orders and sign permission forms for medications that are not normally given at school for field trips that involve time outside of the normal school day. 3. The registered nurse should assess the needs of students who will attend the field trip to determine if it is necessary for a nurse to accompany the group or whether other school personnel can be designated by school administrators to assist students who will need medications or other health services. 4. The registered nurse will consider guidance outlined in the SC Board of Nursing Advisory Questions 50, 51, and 52 when determining whether other school personnel can be trained to assist specific students with health needs. The CCSD Managing Medications in School 1/2015 Administrative Regulations Page 10 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations Internet links for these Advisories are located in the References section of this document. If SC Board of Nursing Advisories allows training of other school personnel, the registered nurse will assure that training takes place and recommend to the school administrator those staff or faculty who successfully complete the competency evaluations. The school administrator should assign staff to assist students with medications on the field trip based on the recommendations of the RN. 5. The school nurse should prepare medications and medication documentation forms for the field trip. 6. Medications must be supplied by the parent/guardian in a pharmacy-labeled or manufacturer-labeled container. South Carolina’s Pharmacy Act does not support repackaging of medications by the school nurse or school district employees. At the time that a prescription is filled, some pharmacists will package one or two doses in a separate container for field trips if requested by the parent. 7. In addition to supplying medications, parents should also supply any special devices required for measuring medication doses (e.g., medication measuring cups or spoons for liquid medications). Spoons used for eating do not provide an accurate measure of medications. 8. All medications must be given to a CCSD staff member by a responsible adult. Controlled medications must be counted, recorded and witnessed by the responsible individual bringing in the medication and the staff member. School staff should only accept the minimum supply needed to cover the doses required for the trip. Any controlled medication being returned after the trip must be counted, recorded and witnessed by the responsible adult and the designated staff member. 9. If a student has been authorized to self-administer her/his medications while on the field trip, the nurse (preferably) or the person assigned to act as a point of contact for the student must verify that the student has an adequate amount of medication and supplies. 10. A plan should be developed to properly store and secure the medications while on the field trip. 11. Plans must also be made for maintaining each student’s confidentiality while on the field trip. CCSD Managing Medications in School 1/2015 Administrative Regulations Page 11 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations Medication Errors 1. Any failure to properly administer medication according to the written order provided by the prescribing health care practitioner is considered a medication error. Some examples of medication errors include: a. a medication was given to the wrong student, b. a wrong medication was given, c. a wrong dose was given, d. a medication was given by the wrong route, e. a medication dose was given at the wrong time, f. an extra medication dose was given, g. the established procedure for giving a medication was not followed (e.g., incorrect site used) h. a medication was not given and the student was present at school 2. Information regarding a medication error must be communicated to the parent/guardian and the student’s health care practitioner at the time of the occurrence. Documentation of medication errors on the student’s medication record should include the student’s condition prior to the occurrence, a statement of the occurrence, the student’s condition following the occurrence, actions taken on behalf of the student following the occurrence. 3. All medication errors should be reported to the Nurse Liaison. A Medication Occurrence Report form for internal school district reporting should be completed. Data regarding medication errors should be analyzed and preventive actions and/or system changes implemented to prevent errors. System enhancements should be implemented to address error trends that may be identified. REFERENCES & OTHER APPLICABLE DOCUMENTS American Academy of Pediatrics Committee on School Health (2009). Position Statement: Guidance for the Administration of Medications in School. Accessed January 29, 2012 on-line at: http://aappolicy.aappublications.org/cgi/reprint/pediatrics;124/4/1244.pdf Code of Federal Regulations Title 40, Chapter 1, Subchapter 1, Part 261.33: Discarded commercial chemical products, off-specification species, container residues, and spill residues thereof. Accessed January 29, 2012 on-line at: http://ecfr.gpoaccess.gov/cgi/t/text/textidx?c=ecfr&tpl=/ecfrbrowse/Title40/40cfr261_main_02.tpl CCSD Managing Medications in School 1/2015 Administrative Regulations Page 12 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations Daniels, R., Grendell, R.N., and Wilkins, F.R. (2010). Nursing Fundamentals: Caring & Clinical Decision Making 2nd Edition. Delmar Cengage Learning (Clifton Park, NY). Environmental Protection Agency. Pharmaceuticals and Personal Care Products (PPCPs) (Last updated October 27, 2010). Accessed January 29, 2012 on-line at: http://www.epa.gov/ppcp/ Johnson, P.E, et al. (May 2003). Medication Use in Schools. Accessed January 29, 2012 on-line at: http://www.fshp.org/associations/7114/files/MED%20book.qxd.pdf National Association of School Nurses (2011). Position Statement: Medication Administration in the School Setting. Accessed January 29, 2012 on-line at: http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStateme nts South Carolina Board of Medical Examiners Policy for Physicians: Out-of-State Physicians’ Orders. Accessed January 29, 2012 on-line at: http://www.llr.state.sc.us/POL/Medical/index.asp?file=MDDOPolicies.HTM South Carolina Board of Nursing Advisory Question 50: “Is it within the role and scope of a licensed nurse practicing in a school setting to select, train, determine competency and evaluate unlicensed school personnel in the provision of treatments and the administration of medications required to meet a specific student’s needs in the event that a medical emergency occurs when a licensed nurse is not readily available?” Accessed January 29, 2012 on-line at: http://www.llr.state.sc.us/POL/Nursing/index.asp?file=AdvisoryOp/advisoryop.htm South Carolina Board of Nursing Advisory Question 51: “Is it within the role and scope of a licensed nurse practicing in a school setting to select, train, determine competency of and evaluate unlicensed school personnel in the provision of select nursing tasks required in order for a student to attend school?” Accessed January 29, 2012 on-line at: http://www.llr.state.sc.us/POL/Nursing/index.asp?file=AdvisoryOp/advisoryop.htm South Carolina Board of Nursing Advisory Question 52: “Is it within the role and scope of a registered nurse (RN) or licensed practical nurse (LPN) practicing in a school setting to select, train, determine the competency of and evaluate unlicensed school personnel for assisting students with medications taken on a routine schedule?” Accessed January 29, 2012 on-line at: http://www.llr.state.sc.us/POL/Nursing/index.asp?file=AdvisoryOp/advisoryop.htm South Carolina Code of Laws Title 40, Chapter 33: Nurse Practice Act. Accessed January 29, 2012 on-line at: http://www.scstatehouse.gov/code/title40.php CCSD Managing Medications in School 1/2015 Administrative Regulations Page 13 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations South Carolina Code of Laws Title 40, Chapter 47: Physicians and Miscellaneous Health Care Professionals. Accessed January 31, 2012 on-line at: http://www.scstatehouse.gov/query.php?search=DOC&searchtext=40%2047&category= CODEOFLAWS&conid=6859804&result_pos=&keyval=732&numrows=10 South Carolina Code of Laws Title 44, Chapter 53, Section 44-53-360, Poisons, Drugs and Other Controlled Substances: Narcotics and Controlled Substances. Accessed January 29, 2012 on-line at: http://www.scstatehouse.gov/code/title44.php South Carolina Code of Laws Title 59, Chapter 63, Section 59-63-80: Development of policies governing individual health care plans for students with special health care needs; definitions; written statements (includes information regarding students selfadministering medications). Accessed January 29, 2012 on-line at: http://www.scstatehouse.gov/code/title59.php South Carolina Code of Laws Title 63, Chapter 5, Section 63-5-340: Minor’s consent to health services. Accessed January 29, 2012 on-line at: http://www.scstatehouse.gov/code/title63.php South Carolina Code of Laws Title 63, Chapter 5, Section 63-5-350: Certain health services may be rendered to minor of any age without consent of parent or guardian. Accessed January 29, 2012 on-line at: http://www.scstatehouse.gov/code/title63.php South Carolina Code of Regulations Chapter 61, Part 1, Section 61-4 Controlled Substances: Handling and Administering Controlled Substances in Hospitals. Accessed January 29, 2012 on-line at: http://www.scstatehouse.gov/coderegs/statmast.php South Carolina Code of Regulations Chapter 61, Part 4, Section 61-79: South Carolina Hazardous Waste Management Regulations. Accessed January 29, 2012 on-line at: http://www.scstatehouse.gov/coderegs/statmast.php South Caroline Code of Regulations Chapter 61, Part 5, Section 61-84-1200, Standards for Licensing Community Residential Care Facilities: Medication Management. Accessed January 29, 2012 on-line at: http://www.scstatehouse.gov/coderegs/statmast.php South Carolina Department of Health and Environmental Control Land and Waste Management. Accessed January 29, 2012 on-line at: http://www.scdhec.gov/environment/lwm/html/hazwaste.htm CCSD Managing Medications in School 1/2015 Administrative Regulations Page 14 of 15 SUBJECT: MANAGING MEDICATIONS IN SCHOOL SETTINGS Administrative Regulations United States Department Of Justice Drug Enforcement Administration (1991). Controlled Substances Security Manual: An Informational Outline of the Controlled Substances Act of 1970. Accessed January 29, 2012 on-line at: http://www.deadiversion.usdoj.gov/pubs/manuals/sec/security.pdf World Health Organization (1999). Guidelines for safe disposal of unwanted pharmaceuticals in and after emergencies. Accessed January 29, 2012 online at: http://www.who.int/water_sanitation_health/medicalwaste/pharmaceuticals/en/index.htm l Date of Approval: January 2015 CCSD Managing Medications in School 1/2015 Administrative Regulations Page 15 of 15