ACBD-AP: Medication Administration

West Fargo Public Schools have established a program for providing medication to learners during the instructional day or when under the direct supervision of the district (e.g., school field trips/activities) when the following requirements have been satisfied.

Medication should be administered at home whenever possible. Medications will only be administered at school when necessary for the health and safety of the learner. The district reserves the right to refuse a request or pay for services to administer medication or medical treatments, except when required under state or federal laws.

A parent or legal guardian is responsible for notifying the school of any health concerns and completing the following applicable forms when requiring specialized treatments, procedures, or dietary accommodations along with the Medication Administration Authorization form ACBD-E2.

ELIGIBILITY FOR PARTICIPATION

A Learner who qualifies for this service under their Individualized Education Plan (IEP) or 504 Plan. The district shall cover the costs of these services and provide means for medication administration as outlined in their IEP/504 plan according to state laws.
A Learner not covered by the Individuals with Disabilities Education Act (IDEA) but who require medication administration when under the direct supervision of the district and every effort has been made to administer the medication outside of the instructional day.

SCHOOL MEDICATION PROVIDERS QUALIFICATIONS:

To meet the expectations of the North Dakota Century Code (NDCC) 15.1-19-23, a district training program has been established for authorizing school personnel not employed as licensed healthcare providers to administer medications to learners when a school nurse is unavailable. Completed training is signed off by a district nurse once completed and the staff member signs form ACBD-E1 agreeing to the responsibilities of administering medication with the support of their building principal and under the guidance of the school nurse.

School personnel may only administer parenteral medications if they have been delegated by a nurse and are registered with the North Dakota Board of Nursing. This includes all injectable medications except in an emergency, school personnel could administer a Glucagon injection and Diastat rectal gel according to Nurse Practices Act exemption found in NDCC 43-12.1-04(1). The administration by school personnel of Epinephrine for Anaphylaxis is authorized as provided by NDCC 23-01-05.2.

AUTHORIZATION/RESPONSIBILITY

The school administrator is responsible for assigning staff within the school setting, providing an area to administer medications with minimal distraction or interruptions, and ensuring staff are trained to safely and effectively administer medication by receiving necessary education, training, and competency validation from the school nurse.

The school nurse is responsible for training assigned staff, verifying competency at the time of training, and for reviewing the medication order(s) to ensure safe and appropriate medication administration at school. The school nurse reserves the right to refuse to administer any medication they feel cannot safely be administered at school. Only the school nurse may take a verbal order from a licensed prescriber. The school nurse will assess and provide teaching as needed prior to medication administration by assigned staff or learners authorized to self-administering medication to ensure competency. The school nurse licensure and practice are governed under the North Dakota Nurse Practices Act and is not liable for relying on or acting upon any incorrect or incomplete information provided by the licensing provider or parent/guardian.

The parent/guardian is responsible for reviewing this medication policy and providing written consent to administer medication(s) or health care services to their learner. The consent authorizes the school medication providers to contact the licensed prescriber as needed to obtain or clarify information and to share health information with school staff who need to know to provide proper care to the learner at school. A parent/guardian cannot delegate or change an order given by a licensed prescriber and are encouraged to partner with the school in the medication administration plan as prescribed by the licensed prescriber.

The Licensed prescriber is responsible for directing school medication providers on administration of prescription medications. A new written authorization is required anytime a new medication is started, medication dose or directions change, discontinuation of a medication, and at the beginning of each school year. School medication providers are not responsible for determining the qualifications of healthcare providers whose signatures appear on prescriptions and medical documentation submitted to the district by a parent/guardian. The district assumes that by signing such documentation, the healthcare provider is attesting to the validity of their qualifications and credentials. The district will comply with healthcare providers' orders but assumes no liability for their content.

FORMS/DOCUMENTATION

ACBD-E2 Medication Administration Authorization Form is completed by a parent/guardian and/or prescribing provider when applicable to authorize school medication providers to administer Food and Drug Administration (FDA) approved over the counter and/or prescription medications in accordance with state laws. The learners’ signature is required when they are authorized to self-administer and/or carry their medication(s).

A separate written statement or computerized medication list can be accepted and attached to the medication authorization form including the learners name, name of medication(s), dose, route, time, frequency, indication, special instructions, side effects, prescribing provider name, current date, and pharmacy if applicable.
The licensed prescriber's signature may be required at the school nurse’s discretion (e.g., controlled substances, self-administer/carry, frequent use of over-the-counter meds).
The school medication provider will complete the check-in process on page 2 for any new medication(s) hand delivered by an adult including medication quantity, expiration date, and verify orders are signed.
Any medication found in school without approval will be held and given back to a responsible adult.

ACBD-E3 Medication Administration Record is completed by the school medication provider for each medication received to record their time and initials after medication administration and when medication refills are received or picked up by an adult and when medication is properly disposed of according to state laws.

The school medication provider shall document in an electronic office note if the learners file has been transferred or form ACBD-E3 is inaccessible after medication pick up or disposal.

ACBD-E4 Medication Incident Report is completed by the school medication provider anytime a medication incident occurs. A parent/guardian and the principle will be notified as soon as possible along with the licensed prescriber at the school nurse's discretion.

These forms are filed into the WFPS District Student Health Folder and shall become part of the learner’s confidential cumulative education record protected under the Family Educational Rights and Privacy Act (FERPA).

MEDICATION PROCEDURE

The school medication provider shall provide medication(s) in good faith consistent with training received, minimizing interruption or distraction, using two identifiers (e.g., learner’s name & photo), and adhering to the 6 rights of safe medication administration prior to administering the medication(s):

Right person
Right medication
Right dose
Right time
Right route
Right documentation

OVER THE COUNTER MEDICATION (OTC)

The medication must be supplied in the original manufacturer’s package that includes storage, ingredients, directions for use, and expiration date. It must be labeled with learner name, date of birth, and quantity if possible.
A written order from a licensed prescriber is needed for OTC medications if the dose or directions are outside of the manufacturer’s recommendation, for any OTC medication taken daily for more than 10 days, and for some OTC medication containing aspirin due to the risk of Reyes Syndrome.
Requests to administer non-standard, off-label, experimental, or nutrition supplements may be evaluated case by case by the school nurse and administrator to determine safety.
When safe doses cannot be determined they will not be permitted at school.

PRESCRIPTION MEDICATION

The medication must be supplied in a pharmacy labeled container including the name and phone number of the pharmacy, learners name, medication name, directions for use, licensed prescriber name, quantity, expiration date, and any storage instructions.
Medication orders must match the pharmacy label. Dose changes require a new order and label.
No more than a one-month supply of any prescription medication will be accepted at one time.
Controlled substances will be counted and documented by the school medication provider and adult delivering the medication. The school nurse may recount them as needed to make sure there is no drug diversion.
Medication may be administered 30 minutes before or after their scheduled dosing time.

SELF ADMINISTER/CARRY

Generally used in life-threatening situations requiring immediate access. (e.g., asthma, anaphylaxis).
A learner may self-administer and/or carry medications if they have an order from a licensed prescriber, have been instructed in the correct and responsible way to administer the medication, and have been assessed by the school nurse as having the appropriate self-management skills.
The parent/guardian is required to review the medication policy, directions for use, and administration procedure with their child to check for understanding. They must be able to self-administer and/or carry their medication(s) safely, responsibility, and monitor themselves for side effects.
The school nurse will review the self-administer order and medication storage plan and may assess the learner’s understanding and administration skills to ensure they can safely and responsibly self-manage their medication(s).
School staff reserve the right to examine any medication containers at any time and may revoke privileges to self-administer and/or carry any medication(s) not being used or maintained properly by the learner.
Learners are prohibited from carrying controlled substances or medication with special storage requirements. (e.g., temperature, security).

STOCK MEDICATION

The district provides a select number of stock medications available for use as needed during the instructional day with parental authorization obtained either annually through registration or verbally during the school year. A parent/guardian should notify the school nurse if these medications were given before school but should not be given before school to suppress symptoms of illness (e.g., fever, vomiting). These medications are administered following the manufacturer’s direction for use. A parent/guardian shall be notified at the discretion of the school medication provider when stock medication is administered.

Acetaminophen (Tylenol) 325mg tablets - 1 tablet grades 1-5 and 1-2 tablets grades 6-12.
Oral pain relief (Benzocaine) and artificial tears (Refresh) eye drops grades K-12.
Ibuprofen 200-400mg (Motrin/Advil) and antacid (Tums) 500-1000mg tablets for grades 6-12
Epi-pen injectors and Benadryl 12.5mg 1-4 tablets as needed for emergency use only.

EMERGENCY MEDICATION

In accordance with state laws in an emergency or natural disaster trained school staff, willing to assume responsibility, and deemed competent may be authorized to administer lifesaving emergency medications (e.g., albuterol, diazepam, epinephrine, and glucagon). The district keeps records of school staff trained annually to recognize signs/symptoms of emergencies and administer these lifesaving medications. The school nurse shall follow standard emergency procedures along with any individualized emergency care plans and provide ongoing training to unlicensed school staff as needed. The school nurse, parent/guardian, and 911 shall be contacted when an emergency medication is administered during the instructional day. Parental consent will be assumed in an emergency.

Under NDCC 15.1-19-16 a learner diagnosed with asthma or anaphylaxis may possess and self-administer emergency medication(s) for the treatment of such conditions provided written authorization on form ABCD-E2 is completed and the learner has been instructed in the self-administration of the emergency medication or treatment of asthma or anaphylaxis. Neither a private school or a school district nor any employee of the private school or district is liable for civil damages incurred by a learner who self-administers emergency medication.

FIELD TRIPS

Medications required off-campus must be arranged with the school nurse prior to the school activity. Any medication to be administered to a learner will be kept in the possession of an assigned adult on the field trip or activity with instruction on how to administer the medication and document upon return to the school. A single dose of medication will be sealed in an envelope labeled with the learner's name, medication name, and directions for administration. Learners who self-administer and/or carry medication will be responsible for bringing their medication(s) and following the self-administer/carry procedure.

MEDICATION STORAGE & DISPOSAL

Non-emergency medications and controlled substances will be stored away from heat, light, and moisture in a locked, clean cabinet or drawer inaccessible to learners. The office door will be locked at the end of the day providing added security.

Emergency stock medication will be stored securely with a plan for quick access (e.g., AED box, emergency bag).

Medication that requires refrigeration will be labeled and stored in a secured place inside the nurse’s fridge.

A parent/guardian will receive a written notice with a reasonable deadline and instructions on how to pick up their learner’s medication at the end of the school year, when medication is discontinued or expired, and if they transfer to a different school. Failure to pick up medication(s) by the deadline or to make alternate arrangements with the school medication provider will result in proper disposal of the medications by the school nurse following state regulations.                       

ADDITIONAL PROHIBITIONS

Learners who violate administrative policy FFA-AP: Student Alcohol and Other Use or Abuse by engaging in a prohibited activity with prescription or over the counter medications may be subject to disciplinary action and may be prohibited from taking medication on school property.

Marijuana is federally illegal and is not allowed in schools.

LIABILITY DISCLAIMER

It is not the district's intent to expand or modify its potential liability exposure through developing this medication program. The district's voluntary creation of this program shall not be construed to create or assume any potential liability under any local, state, or federal law or regulation. State law provides liability protection for an individual or district that establishes a program for providing medication to learners and is not civilly or criminally liable for any act or omission of that individual when acting in good faith while providing medication to a learner, except when the conduct amounts to gross negligence.

Adopted: 08/09/93

Reviewed:

Revised: 04/24/95, 08/13/07

01/09/12, 04/01/15

02/27/18, 01/29/20

04/22/25