St. Andrew's CE Primary School - Medical Policy

 

Administration of Medication

Introduction

Children with medical needs have the same rights of admission to our school as other children. There are an increasing number of children attending mainstream schools with medical conditions. Schools, acting in loco parentis, have a duty to take reasonable care of children which includes the possibility of having to administer medicines and/or prescribed drugs. This may be required by pupils for regular medication or those requiring occasional dispensing of medicines. The school will make every effort to safeguard the health and safety of those pupils who may be more at risk than their peers due to existing medical conditions. Our policy has been drawn up with reference to DfE publication ‘Supporting pupils at school with medical conditions’ (April 2014) and Administration of Medicines in Schools and Early Years Settings HS-S-32.

 

Legal requirements

THERE IS NO LEGAL DUTY THAT REQUIRES ANY MEMBER OF SCHOOL STAFF TO ADMINISTER MEDICINES.

 

Management and Organisation

When medicines are to be administered in school it is essential that safe procedures are established which are acceptable to appropriate school staff involved. It is essential that clear written instructions are supplied by parents when requesting that medication be administered to their child.

 

Prescribed medicines

Medicines should only be taken to school when essential; that is where it would be detrimental to a child’s health if the medicine were not administered during the school day.  Only medication prescribed by a doctor or dentist can be administered at school by designated and appropriately trained staff members.

Medicines can only be accepted in the original container as dispensed by a pharmacist and with the prescriber’s instructions for administration clearly displayed. Most medicines are prescribed in dose frequencies which enable it to be taken outside school hours therefore only prescriptions of four daily doses can be administered at school, or if the timing of the prescribed dose requires it to be administered during school hours. In this case a doctor’s written confirmation of this requirement must accompany the medication.

Only the prescribed/recommended dose will be administered.  This cannot be changed unless written instructions are received from a medical professional. The form should be signed by the parent or guardian and retained in the school office for reference by staff involved.

 

Exceptions

Prescribed medicine will not be given:

  1. Where the timing of the dose is vital and where mistakes could lead to serious consequences.
  2. Where medical or technical expertise is required.
  3. Where intimate contact would be necessary.

 

Administration of Medicines Management and Organisation

Non-prescription medicines

We are unable to administer any medication that have not been prescribed by a doctor or dentist. This includes paracetamol, aspirin or medicines containing ibuprofen, or any over the counter medications or remedies.

 

Healthcare Plans

In cases where the child’s medical needs may be greater than those of his/her peers, the Headteacher may request that an Individual Healthcare Plan (IHCP) be prepared. In such cases, consultations on the Plan will be done with school staff and the parents/guardians, and health professionals will be involved where necessary. This will also clarify the extent of responsibility taken by the school.

IHCPs will be shared with the child’s class teacher. A copy of the completed IHCP will be stored in the Medical Room and also with the child’s designated member of staff.

The Headteacher will be responsible for managing the administration of medicines and drugs with the agreement of named members of staff. Staff should be able to act safely and promptly in an emergency situation, as well as with the routine administration of medicines.

Members of staff will be asked to volunteer to be involved in the administration of medication. Only those members of staff who have current First Aid qualifications will be expected to act in an emergency. Other members of staff who are willing to dispense medicines to pupils i.e. Teaching Assistants, Class Teacher, Office staff, should be advised of the correct procedure for each pupil.

It is the responsibility of the Headteacher to ensure that new members of staff receive appropriate training.

Parents and staff should be kept informed of the school’s arrangements for the administration of medicines and drugs and will be informed of any changes in these procedures.

A record should be kept of all the medicines and drugs administered by the members of staff responsible. All medication administered must be recorded and witnessed by members of staff.

 

Advice on medication

Children recovering from a short-term illness/infection who are clearly unwell should not be in school and the Headteacher can request that parents or carers keep the pupil at home if necessary.

In the case of chronic illness or disability, i.e. asthma, diabetes, syndromes such as ADHD etc. pupils may need to take prescribed drugs or medicines on a regular basis during school hours in order to lead a normal life within a mainstream school setting. Only those members of staff already named should administer the medication and a record kept.

Staff will not under any circumstances administer drugs by injection and parents would be expected to attend to the pupil in school hours in such cases.

 

School Trips

It is the part of the Inclusion Policy of the school that all pupils should be encouraged to take part in school trips wherever safety permits. It may be that the school would need to take additional safety measures for outdoor visits and staff supervising outings must be aware of any medical needs of such pupils and of the relevant emergency procedures. An additional adult (or the particular parent) may need to accompany visits where a difficult situation might arise.

 

Administration of Medicines

Staff may need to consider what reasonable adjustments they might make to enable children with medical needs to participate fully and safely on visits. This may include carrying out a risk assessment for such children. The school visit co-ordinator will be responsible for tabulating medical information for each child and one member of staff will be nominated as having responsibility for the administration of all medication. Roles and responsibilities of parents/carers as outlined below will apply.

It may be necessary to take medication for pupils on a school trip, eg. Epipens/ Jext Pens, Inhalers or Epilepsy emergency medication. It may also be necessary to take copies of any relevant care plans in case of emergency. Emergency medication must be taken on all trips, even where a trained member of staff is not present. In this case medication should be given to the paramedics to administer when necessary.

 

Asthma medication

Children who have a diagnosis of asthma, or a prescription for a reliever inhaler should have TWO inhalers at school, in the original box with the prescription displayed.  The inhalers and spacer devices should also be labelled/ marked with the child’s name.

Inhalers will be stored in the Medical Room class drawers, unless children are required to carry an inhaler outside as per their IHCP.  In this case one inhaler and spacer will be stored in a safe, accessible place in the classroom - clearly labelled, and out of direct sunlight. All staff working in the classroom must be made aware where the inhaler is stored and when/ how the inhaler should be administered.

Depending on the needs of the individual, inhalers should be taken to all physical and/ or outdoor activities.

It is the responsibility of parents to regularly check the condition of inhalers and ensure that they are working and have not been completely discharged.

 

Antibiotics

Pupils who are prescribed antibiotics can often recover very quickly and may well be fit enough to return to school, but it may also be essential that the full course of medication should be completed. In this case, the Headteacher is willing for named staff to administer the antibiotics supplied by the parent or carer.

A Medical Consent Form must be completed giving full instructions for administration of the medicine.

It is the responsibility of the parent to ensure that the medication is collected each day and is not out of date.

 

Diabetes medication

The school will monitor pupils with Diabetes in accordance with their IHCP. Blood sugar results will be recorded daily and noted accordingly. Pupils with diabetes must not be left unattended if feeling unwell, or sent to the office unaccompanied. Sharps boxes should always be used for the disposal of needles. Sharp boxes can be obtained by parents / carers from the child’s GP or Paediatrician and returned to the parents/carers when full for replacement.

 

Maintenance Drugs

A child may be on daily medication for a medical condition that requires a dose during the school day. As with all other medicines a form should be completed giving clear instructions to staff at the school. A record of all doses administered will be kept.

 

Topical Medications

In cases of eczema or skin conditions it will be expected that the child will be able to use the cream/lotion on their own.

 

Allergies/Anaphylaxis

Medication for the treatment of allergies will be kept in easily identifiable containers in the school office or individual classrooms. Each container should be clearly labelled with the child’s name and class and all staff who regularly work with the child should be trained in the use of EpiPen administration.

 

Emergency Procedures

In the case of emergency, the school will call an ambulance and contact the parents. When conditions require immediate emergency treatment, trained staff may volunteer to administer medication or emergency procedures such as resuscitation.

Staff should never take children to hospital in their own car.  It is safer to call an ambulance, as if the child’s condition worsens during the journey this could put them at further risk, and staffs’ insurance policies will not cover this type of usage.

A member of staff must accompany a child taken to hospital by ambulance and should stay until the parent/carer arrives.

In all cases, administration of medication and/or treatment to a pupil will be at the discretion of the Headteacher and Governors of the school. However, ultimate responsibility remains with the parents/carers.

 

Hygiene and Infection Control

All staff should be familiar with normal precautions for avoiding infection and follow basic hygiene procedures. Staff should have access to protective disposable gloves (stored in the Medical Room) and should take care when dealing with blood or other bodily fluids and disposing of dressings or equipment.

 

Storage of Medication

All medicines should be delivered to the school office by the parent or carer. In no circumstances should medicines be left in a child’s possession. When medication is received, it should be recorded in the Medication In/ Out log in the Medical Room.

Teachers and teaching assistants should not take receipt of any medicines. All medicines should be stored in accordance with product instructions (paying particular attention to temperature). Medicines will be stored in the Medical Room class drawers, locked cabinet, or fridge.  Medication should not be kept in classrooms, with the exception of adrenaline pens and inhalers/spacers.

All medicines must be stored in the supplied container and be clearly labelled with:

  • the name of the child;
  • the name and dose of the medicine and
  • the frequency of administration.

The Medical Consent Form must be signed on receipt of medicines. All inhalers will be stored in the school office (unless IHCP states one is required in the classroom).

All emergency medicines, such as asthma inhalers/spacers and adrenaline pens, should be readily available to children and staff and kept in an agreed place in the classroom and/or in the office. Children may carry their own inhalers, when appropriate.

Parents should be asked for two Epi-pens, which will be stored in the Medical Room. The teacher must ensure that the Epi-pen is collected when doing outdoor PE and for other external lessons.

 

Disposal of Medication

Staff should not dispose of medicines.

Parents are responsible for ensuring that date-expired medicines are returned to the pharmacy for safe disposal. They should collect medicines at the end of the agreed administration time period. Parents are responsible for ensuring that date expired medicines are returned to a Pharmacy for safe disposal.

 

Summary of Procedure to Dispense Medication

  • Medical Consent Form must be completed by the parent / carer for any medication required to be administered at school.
  • Medicine must be in original packaging with the prescription label displayed, showing the name of child, and dose to be administered.
  • Recommended / prescribed dose will not be exceeded without written permission from a medical professional.
  • All medication given must be recorded and witnessed in the Medication log form (Appendix 2) Inhalers only need to be recorded.
  • It will be the parent / carers responsibility to collect medication at the end of each school day where necessary.
  • All medication must be collected by parents/ carers at the end of each school year, and returned on the first day of the Autumn term
  • Medication will be taken out of school on trips or visits and be the responsibility of a member of staff at all times.

 

Roles and Responsibilities

Parent/Carer

  • Should give sufficient information about their child’s medical needs if treatment or special care is required and complete an IHCP if medication is to be stored at school to be administered for their child on a long term basis.
  • Must deliver all medicines to the school office in person.
  • Must complete and sign the Medical Consent form when they give medication to the office staff.
  • Must keep staff informed of changes to prescribed medicines.
  • Must ensure all medication is in date, in its original packaging, labelled with a clearly displayed prescription, and in a fully functional condition.
  • Must collect medication at the end of each school year (or more regularly as required) in order to check and clean children’s medication and medical devices (e.g. spacers, nebulisers, etc.) before returning them the first day of the following term.

 

Headteacher

  • To ensure that the school’s policy on the administration of medicines is implemented.
  • To ensure there are members of staff within the school willing to volunteer to administer medication to specific pupils if required.
  • To ensure that staff receive support and appropriate training where necessary.
  • To share information, as appropriate, about a child’s medical needs.
  • To ensure that parents are aware of the schools policy on the administration of medicines.
  • To ensure that medicines are stored correctly.

 

Staff

  • On receipt of medicines, the child’s name, prescribed dose, expiry date and written instructions provided by the prescriber should be checked.
  • Ensure that the parent/career completes a Medical Consent form for the administration of medicines following the prescriber’s instruction.
  • Ensure that the Medication In/ Out log is completed when medication is received/ taken away by parents/ carers or staff members.
  • Ensure that a second member of staff is present when medicines are administered.
  • Complete the ‘administration of medicines’ record sheet each time medication is given.
  • Ensure that medicines are returned to parents for safe disposal.

 

Refusal of Medicine

If a child refuses to take medicines, staff should not force them to do so, but should note this in the records and inform parents immediately or as soon as is reasonably possible.

 

First Aid Children with Long-term Medical Needs

It is important that the school has sufficient information about the medical condition of any child with long term medical needs. A health care plan will be written for children with long term medical needs, involving the parents and relevant health professionals.

 

Confidentiality

The head and staff should always treat medical information confidentially. The head should agree with the child/parent who else should have access to records and other information about a child.

 

Staff training

Training opportunities are identified for staff with responsibilities for administrating medicines.  

 

Monitoring

This policy should be reviewed REGULARLY in accordance with national guidance.

*Parents, as defined in section 576 of the Education Act 1996, include any person who is not a parent of a child but has parental responsibility for or care of a child. In this context, the phrase ‘care of the child’ includes any person who is involved in the full-time care of a child on a settled basis, such as a foster parent, but excludes baby sitters, child minders, nannies and school staff.

 

First Aid

First Aiders are responsible for supporting health and welfare issues within the School and in particular:

  • To be responsible for attending to and monitoring student or visitor illness/injury and to refer pupils to their own doctor or hospital as appropriate;
  • To maintain the school medical equipment/first aid boxes;
  • To assist in the monitoring of first aid equipment and boxes;
  • To assist in the development and health promotion activities at the school;
  • Ensure adequate numbers of staff are trained in first aid procedures (to cover trips, sickness, etc.);
  • To ensure the necessary records are maintained relating to accidents associated with the work of the school.

 

First Aid Boxes

First aid boxes are located in the following places:

  • Lower corridor and stairs
  • Upper corridor  
  • Medical Room

 

 

Accident

Accidents will be recorded in the Accident Books. Parents will be phoned if the accident is serious. If the child has bumped their head parents will always be informed with a sticker, a text and a letter home. If there is cause for concern we will also call the parent. Teachers will try to speak to parents at the end of the day if their child has had an accident. If the child has any significant marks from bumps, staff must inform the parents.

Children will be regularly reminded of the importance of safety conscious behaviour.

 

 

Emergency Medical Treatment

If anyone attending an incident believes that they may have been affected by bodily fluids e.g. vomit, sputum, blood in the face/mouth/open wound then medical advice should be sought immediately.

If the accident does not require immediate hospital treatment, the child’s parents/carers will be phoned and asked to take them to casualty or the local health centre/ pharmacist as the parent deems appropriate.

 

Defibrillators

As recommended in the DfE documentation “Automated external defibrillators (AEDs) – A guide for schools” we have purchased and AED, which is located in the school entrance, in the lobby outside the office.

Stickers and signs have been put up to notify anyone in the building of the presence of the AED.

Should someone show symptoms that could indicate a cardiac arrest we will attach them to the AED which will automatically scan them and will only administer a shock if the patient’s heart is in a shockable rhythm.  If cardiac arrest is diagnosed by the AED, CPR will maximise the opportunities for defibrillation to be administered effectively. The AED will continue to analyse the patient’s heart rhythm after each shock and will provide ongoing instructions about continuing CPR.

 

Infectious Illness

The school office MUST be informed whenever a child is off due to illness, and infectious diseases MUST always be reported to the school office, especially:

  • measles
  • suspected and/ or confirmed cases of chicken pox,
  • diarrhoea and/ or vomiting,
  • slapped cheek (Parvovirus B19),
  • shingles (members of staff)
  • German measles
  • Mumps
  • Scarlet fever

 

Due to some children and members of staff being vulnerable to infection, it may sometimes be necessary to anonymously inform parents and / or staff when a confirmed infectious illness is reported.

 

To read the full guidance on infection control in schools please refer to this document:

https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities

 

Hygiene

Children will be taught the basic rules of hygiene, e.g. always to wash hands after using toilet and before eating, not to leave food around for any length of time, not to put anything into their mouths when on the playground or on an outing, e.g. acorns, berries, stones, leaves, worms, etc. Students will also be encouraged to use hand sanitisers / wash hands prior to lunch.

 

Medical Care

 

General

Our policy has been drawn up with reference to DfE ‘Supporting pupils with Medical Needs in School’ Statutory Guidance, December 2015’.

If a child is unwell at school, we will make every effort to contact the parents/guardians. It is therefore very important that we have up-to-date home/work telephone numbers or other contact numbers, and it is the parents’/ carers’ responsibility to ensure office staff have all contact details required during the school day.

Until we have contacted the child’s parents we will take any action required in the interests of the child.

Many of the school staff are trained ‘emergency first aiders’ and in the event of an accident, appropriate first aid will be given. In the case of more serious accidents, we will contact parents as soon as possible. 

 

Accidents

In the event of an accident injuring one or more people, the first priority is to ensure, within the limits of personnel and facilities, the safety of other pupils and adults in the vicinity. In attending to the injured person(s), help may be called from colleagues holding a first aid certificate.

If the accident is of a more serious nature the office staff should be informed. A decision will then be taken by a senior member of staff whether or not an ambulance should be called. Parents should be contacted as soon as possible.

The member of staff who was first on the scene must complete an accident report form (from the office) and submit it to the Head teacher for signature.

 

Care and Management of Specific Conditions/ Illnesses

Asthma

The following has been written in accordance with the DoH March 2015 Guidance on the use of emergency salbutamol inhalers in schools https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/416468/emergency_inhalers_in_schools.pdf

For children with a diagnosis of asthma, or with a prescription of Ventolin as a reliever medication, the following should be in place:

  • An inhaler and spacer device provided by parents, which is kept in the Medical Room at school. Inhalers need to be in their original box with the prescription clearly displayed, and both the inhaler device and spacer labelled with the child’s name
  • An IHCP (updated a annually, AND when medication/ asthma care plan is changed)
  • A signed consent form from parents giving consent for us to administer their child’s own medication, and the school’s emergency Salbutamol inhaler if required.
  • Child’s details recorded on the school’s Asthma Register.

 

A child with symptoms of asthma should never be left unattended.

Symptoms of asthma can cause panic, so in the event of an asthma attack staff should:

  • stay calm and reassure the child;
  • encourage the child to sit up and lean forward slightly;
  • use the child’s own inhaler – if not available , use the school’s emergency generic inhaler kept in the Medical Room;
  • remain with the child while the inhaler and spacer are brought to them;
  • immediately help the child to take two separate puffs of salbutamol via the spacer;
  • if there is no immediate improvement, continue to give two puffs at a time every two minutes, up to a maximum of 10 puffs;
  • stay calm and reassure the child. Stay with the child until they feel better. The child can return to school activities when they feel better.
  • If the child does not feel better or you are worried at ANY TIME before you have reached 10 puffs, CALL 999 FOR AN AMBULANCE.
  • If an ambulance does not arrive in 10 minutes, give up to another 10 puffs in the same way

If the child is well enough to go to the office for their inhaler, they should be accompanied to the medical room.

If the child’s IHCP says they should have their inhaler with them at all times, and the symptoms are severe (ie the child has obvious difficulty breathing; cannot stop coughing, or “catch their breath”; is going blue etc) the responsible member of staff with the child should administer the inhaler without walking the child to the medical room.

If an inhaler has to be administered outside due to severe asthma symptoms, the Medical Welfare Officer should attend as soon as possible for assistance.

If symptoms improve after the inhaler is administered, the child should be taken to the medical room to be observed, and further doses of medication should be administered as/ if required, and as per the child’s IHCP. 

Call 999 and request an ambulance immediately if the child:

  • appears exhausted
  • has a blue/ white tinge around their lips
  • is going blue
  • has collapsed

 

Emergency asthma inhaler/ spacer device

 

The emergency salbutamol inhaler should only be used by children, for whom written parental consent for use of the emergency inhaler has been given, and who have either been diagnosed with asthma and prescribed an inhaler, or who have been prescribed an inhaler as reliever medication. The inhaler can be used if the pupil’s prescribed inhaler is not available (for example, because it is broken, or empty).

 

Arrangements for the supply, storage, care, and disposal of the inhaler and spacers in line with the schools policy on supporting pupils with medical condition:

 

  • having a register of children in the school that have been diagnosed with asthma or prescribed a reliever inhaler, a copy of which should kept with the emergency inhaler
  • having written parental consent for use of the emergency inhaler included as part of a child’s individual healthcare plan
  • ensuring that the emergency inhaler is only used by children with asthma with written parental consent for its use
  • appropriate support and training for staff in the use of the emergency inhaler in line with the schools wider policy on supporting pupils with medical conditions
  • keeping a record of use of the emergency inhaler as required by Supporting pupils and informing parents or carers that their child has used the emergency inhaler

 

 

Epilepsy

Staff need to be aware of any children with a history of epilepsy or seizures. Children with severe medical conditions will have an IHCP in place. These are kept in the Medical Room.

If a child has a seizure during school hours, contact the Medical Welfare Officer immediately for assistance.

During a seizure:

  • DO note the time the seizure starts and ends. This may not seem like a priority at the time, but is very important (see when to call 999)
  • Do NOT attempt to restrict the child’s movements, but
  • DO remove or cover objects near the child that could pose a risk to the child, and ensure the child’s head is safe. As soon as the child is relaxed or `floppy’ enough, try and roll them into the recovery position.
  • Allow the child to relax or sleep somewhere quiet after the seizure – but do NOT leave them unaccompanied.

 

Please note that although it can be distressing to witness, if a child has a diagnosis of epilepsy, a seizure will probably not require the child to be sent home. However, call 999 and request an ambulance if:

  • It is the child’s first seizure

(ie staff are not aware/ been informed that the child has previously had a seizure)

  • The seizure lasts more than 5 minutes
  • The child is unresponsive 10 minutes after the seizure
  • The child has a second, or multiple seizure

The school nurse will provide training for staff if we have a child who has epilepsy and the children’s epilepsy nurse will provide specialist training for those with responsibility for a child who has a prescription of Midazolam.

 

Diarrhoea &/or Vomiting

As per the Public Health England 2016 Guidance, all children who vomit and/ or have diarrhoea must be kept away from school for 48 hours from the last episode of diarrhoea or vomiting.

 

Head lice

Any outbreak of head lice should be reported to school. Letters will be issued to all the children in that class encouraging the parents to check their child’s head and treat any lice.