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Safe Medication in School

May 30, 2024

Editor’s Note: Jenny is the mother of two children with special healthcare needs and a Patient & Family Advisor at her local children’s hospital. In addition to her lived experience, Jenny calls upon her professional experience as a social worker to help her write blogs from her home in Wisconsin. –Cara L. Coleman, JD, MPH, Associate Editor, Pediatrics

Family Connections with Pediatrics

When my son was nine months old we found out that he has a peanut allergy. I will never forget sitting in the emergency department at our local children’s hospital, holding my restless, swollen child, panicking as I thought about what the future might hold. Will I ever let this kid out of my sight again? How will he go to playdates and birthday parties without me? And who will protect him from all of the peanut butter sandwiches in the school lunchroom?

As my baby gets ready to head off to kindergarten next year, I am thankful for a school nurse who can help administer his EpiPen in the event of an emergency. Some students with acute health conditions, such as asthma and epilepsy, require medication during the school day on a more regular basis. Students with chronic health conditions, such as diabetes and ADHD, may require medication at school every day. For all of these students, the ability to access medication at school provides an opportunity to learn, play, socialize, and grow in a safe and healthy environment.

This month’s Pediatrics addresses this topic in “Safe Administration of Medication in School: Policy Statement” (10.1542/peds.2024-066839). In this policy statement, the American Academy of Pediatrics offers guidance and best practices, based on the principles of safety, equity, and collaboration, to anybody who might give medication to students during the school day.

Who can administer medication in school?

School health care teams include many people, from the student and their family, to school administrators and staff, to community pharmacists. The most common provider of school health care is a nurse. Their role includes:

  • Giving medication
  • Monitoring for adverse side effects
  • Training and supervising other staff
  • Reviewing medication logs
  • Documenting medication errors
  • Coordinating between home, school, and community

Not all schools have access to a school nurse. In this situation, the principal may assign responsibilities to other staff members like teachers, assistants, or coaches. As students get older they can also administer their own medication with the support and supervision of one of these adults.

What are some of the best practices shared in the policy statement?

  • Communication—Teams should check in regularly on prescriptions, dosing, plans for giving the medication, and adjustments needed.
  • Documentation—As much as possible, school health forms and medication notes should be standardized and reviewed frequently to avoid errors and best care for students.
  • Consent—Accurate information should be shared with both the student and their family about the nature of the condition and the choices they have for taking medication at school.

What can you do with this article?

  1. Share this policy statement with your school health care team. Highlight the table on p. 15 called “The ‘Rights’ of Medication Administration Protect Student Safety.”
  2. Request that your school administration create an Individual Health Plan and/or an Emergency Action Plan for your child. Make sure you and your child are a part of that process.
  3. Ask your child’s teacher about the protocol for medications if the class has a field trip or other off-campus activity. Ask who is responsible for transporting and administering the medication.
  4. As your child gets older, help them take responsibility for their own medication needs. Educate, equip, and empower them to safely and regularly take their medication at school.
  5. Talk to your primary care clinic about integrating the school’s medication plans with your child’s regular health records. This will help maintain clear communication and consistency.
  6. Advocate for local and state laws that support policies, practices, staffing, and technology to ensure safe medication in all schools, especially those that do not have access to a school nurse.
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