Supporting Pupils with Medication Needs

1
Supporting Pupils with Medication Needs
Courtesy of Cathleen Maguire WELB
2
(No Transcript)
3
Background

• Joint Department of Education, Department of
  Health, Social Services and Public Safety
  publication
• In conjunction with the ELBs, CCMS, a range of
  education and health professionals and the
  Teachers Unions
• Guidance sent by Department Education to all
  schools on 14 April 2008 with a covering letter
  and addendum regarding some updated medical
  terminology

4
Working party established through the Regional
Strategy Group (ELBs)

• Function to organise dissemination of
  medication needs guidance to all schools total
  of 1308 schools, in all sectors in Northern
  Ireland
• Composition of working party an officer from
  each Board, a DE rep. and principals of
  mainstream and special schools
• Funding of 248k earmarked by DE for training
• WELB holds budget for all Boards

5
Medication Needs Guidance Training Working Group

• Chair
• Cathleen Maguire WELB
• Members
• Paula Jordan Principal, Sperrinview School
• David Ryan BELB (Secretary)
• Roberta Connolly NEELB
• Mary Shalley SELB
• Noreen McElroy Principal, Erne School
• Peter Dornan BELB
• Karen Atchison Principal, Cooley Primary School
• John Shivers SEELB
• Alison Thompson Special Education Branch, DE

6
Current situation re tendering

• Tenders were invited from more than four
  companies for submission to WELB by 7 May 2008
• Three were finally submitted and the successful
  company is The Beeches Management Centre who work
  in association with Educare on an East/West basis
  in Northern Ireland
• Each major stage was brought to the RSG for
  approval
• Training for Principals of all schools will be
  completed during the first term of 2008/09
  subject to the conditions of the tender

7
Foreword to Guidance

• There is no legal duty that requires school
  staff to administer medication this is a
  voluntary role and this guidance does not intend
  to alter in any way the right of staff not to
  volunteer.

8
Important to note

• Administration of medication remains the
  responsibility of parents
• Only essential medication should be taken to
  school, with the Principals permission
• Parents should be encouraged to request medicines
  that can be administered outside of school hours
• Schools should be aware of the risks of
  administering common painkillers and should do so
  only under medical guidance

9
Roles and Responsibilities

• 1.3.1 It is important that responsibility for
  pupils health and safety is clearly defined and
  that each person involved with pupils who need
  medication is aware of what is expected of them.
  A partnership approach with close cooperation
  among schools, parents, health professionals and
  other agencies is important in providing a
  supportive environment for pupils with these
  needs to enable them to participate fully in
  school activities.

10
Roles and responsibilities

• Parental responsibility
• ensure their childs fitness to attend school
• make the school aware of the need for medication
• agree the schools role with the principal
• provide medical evidence, written instructions
  and make a written agreement
• provide medication details

11
Roles and responsibilities

• Parental responsibility
• provide sufficient, correctly labelled medication
• ensure changes are notified
• dispose of unused medication
• give written permission for their child to carry
  his / her own medication

12
Roles and responsibilities

• Employer responsibilities
• ensure that the school has a policy
• ensure that the insurance arrangements provide
  staff with full cover
• make staff aware of their legal responsibilities
• make sure that correct procedures are in place
• keep accurate records
• ensure that staff have appropriate training

13
Roles and responsibilities

• Board of Governors responsibilities
• safeguard and promote the welfare of pupils on
  school premises or in the lawful control of a
  member of school staff
• ensure their school has policies
• ratify said policies
• follow health and safety policies produced by the
  ELBs and CCMS
• take account of the views of the principal, staff
  and parents when developing the policy

14
Roles and responsibilities

• Principals responsibilities
• operation of the policy including the
  development of procedures
• make parents aware of the policy and dealing
  sympathetically with requests
• make all staff aware of the policy and procedures
• delegate the co ordination role
• ensure that relevant staff are informed about the
  childs condition and how to meet the childs
  needs and receive training including any
  emergency procedures

15
Roles and responsibilities

• Principals responsibilities
• safe storage of medicines
• arrange cover where needed
• ensure that accurate records are kept
• ensure that supply teachers and other visitors
  are informed of medication needs
• ensure that work experience placements are
  suitable and that pupils are encouraged to share
  information with employers
• ask the employer to provide written confirmation
  of insurance cover for staff

16
Roles and responsibilities

• The voluntary nature of this role must be
  re-emphasised but where teachers or other staff
  volunteer their responsibilities are to
• understand the pupils condition and when and
  where s/he may need extra attention
• be aware of the possibility of emergencies and
  how to manage them
• take part in appropriate training
• be aware of possible side effects and how to
  manage them
• supervise those who self-administer as required

17
Roles and responsibilities

• Role of the School Health Service
• the school nurse is the primary point of contact
• co ordinates the compilation of the Medication
  Plans calling on the input/ expertise of others
  as required
• practices may differ slightly from one Health and
  Social Care Trust to another

18
Part 1 Contextual issues

• Three categories of medication
• Short term/acute such as for a chest infection
• Long term such as for asthma or ADHD
• Medical emergency out of the blue or an
  aspect of a known medical condition
• Indemnity policy
• Confidentiality and need for sensitivity
• Need for Health and Education collaboration re
  children with Statements

19
Developing policies for supporting pupils with
medication needs

• Sample policy available on Pages 15 17
• Policy needs to be clear to staff, parents and
  pupils
• It must deal with whether the Principal accepts
  responsibility for administration of medication
  and the areas covered such as
• prior written agreement of parents
• action to be taken if a child refuses to take
  medication
• record keeping
• labelling, safe storage and disposal of
  medication
• self administration of medication

20
The Medicines Act 1968

• Classifies medicines General Sales List (GSL),
  Pharmacy (P) and Prescription Only Medicines
  (POM)
• No-one may administer a parenteral POM otherwise
  than to himself, unless he is an appropriate
  practitioner or is acting in accordance with the
  directions of an appropriate practitioner.

21
The Medicines Act 1968

• Certain medicines are exempt from this
  restriction when administered for the purpose of
  saving life in an emergency e.g Anaphylaxis
• Adrenaline is one of the exemptions
• Epipens are safer because of the pre-measured
  dose

22
Controlled Drugs

• Methylphenidate (Ritalin, Equasym, Concerta)
• Controlled by Misuse of Drugs Act which states
  specific requirements for storage, administration
  and recording
• Locked, non-portable container
• Only named staff to have access
• Records kept for audit and safety purposes

23
Circumstances when special arrangements are
required

• Educational trips the guidance does not give
  advice on whether or not children should be
  included in trips but where they are a copy of
  the Medication Plan should be taken on a school
  visit as appropriate
• Sporting activities may require modification or
  precautions such as an inhaler
• School transport training must be supplied to
  staff re. emergency procedures as appropriate and
  staff must be aware of their roles,
  responsibilities and liabilities

24
Part 11 Administration of medication

• Parent must produce medication in original
  labelled container with name of medication,
  pupils name, dosage, date and expiry date.
  Unlabelled containers are unacceptable
• Self administration recommended for those deemed
  old and developmentally mature enough to self
  medicate
• Advice provided on refusal of medication
• Record keeping using Form AM4 advised
• Photocopiable Forms AM1 to AM6 are included
• for use as a full Medication Plan

25
Administration of long term medication

• Completion of a full Medication Plan (MP)
  normally necessary
• Medication Plan must involve health professional,
  parent, principal, class teacher, head of
  year/form teacher, SENCO, adult assistant if in
  place, school staff who agree to administer
  medication, staff trained in emergency
  procedures and pupil, as appropriate
• Need for an MP should only be assessed by a
  health professional

26
Administration of long term medication

• Forms AM2 or AM3 may be used for pupils with
  medical needs who do not require a full
  Medication Plan
• MP should include childs name and contact
  details, medical condition, special requirements,
  medication and side effects, what constitutes an
  emergency, precise steps to be taken in an
  emergency, emergency phone numbers, role of the
  school and details of other health and social
  care professionals involved

27
Medication Plan Forms AM1 AM7

• Full MP will consist of AM1, AM2/3, AM4, AM6.
  Form AM7 is authorisation for administration of
  rectal diazepam
• Form AM5 is the schools record of medication
  administered to all children
• Pages 36 and 37 outline function of forms
• All forms are downloadable as WORD documents at
  www.deni.gov.uk
• Pages 39 to 51 are the forms to be copied

28
Part 111 Emergency Procedures

• Emergencies are usually related to four
  conditions and are reflected in a pupils MP
• Acute asthmatic attack
• Diabetic hypoglycaemic attack
• Anaphylactic reaction
• Prolonged epileptic seizures
• Emergency procedures outlined (Pages 55, 56)
  including an Emergency Call Form for display by
  the office telephone (Page 57)
• The consequences of taking no action are likely
  to be more serious than those of trying to assist
  in an emergency

29
Part 1V most common conditions and practical
advice

• Basic information is provided on the five most
  common medical conditions in schools
• Asthma
• Epilepsy
• Diabetes
• Anaphylaxis
• Attention Deficit Hyperactivity Disorder (ADHD)
• Symptoms of onset are identified, medicine and
  control are outlined and advice is provided re.
  emergency procedures in respect of each
  condition.

30
Part V Contacts

• Useful contacts for support organisations in
  respect of main medical conditions
• Internet resources
• Additional information on anaphylaxis issued by
  DHSSPS available at
• Http//www.dhsspsni.gov.uk/hsc_sqsd_20-08.pdf
• (This information emailed by DE to all schools
  on C2k and sent by hard copy to those not on C2k )