DUNHAM ON TRENT CE PRIMARY SCHOOL
MEDICINES IN SCHOOL POLICY
As medicines are dangerous substances when wrongly administered, the school has to be very careful on safety grounds over such requests.
A number of points should be born in mind:
1. Whenever practicable a parent/carer should come to school to administer the medicine.
2. There is no legal duty, which requires teachers to administer medication; this is a voluntary role and will be called upon in exceptional circumstances. Where exceptional circumstances exist, a contract will be agreed between the school and the parent or carer and records kept appropriately. Where necessary, school staff will receive training on specific medical conditions.
3. The First Aider and head teacher will administer medicines, by arrangement.
There are some cases of long term complaints, i.e. Asthma where it is vital that medication is available all day. In such cases all requests will be accepted as long as the following guidelines are accepted.
Other requests i.e. completing a course of antibiotics will be considered on an individual basis. Medicines will only be given in school if they have been prescribed to be administered 4 times a day. The school will only administer medicines prescribed by a medical practitioner.
1. An indemnity form must be signed in the school office by the parent/carer and details of the dose to be administered.
2. The medicine should be brought to school by the parent/carer, NOT the child, and should be delivered personally to the school office. It is the responsibility of parents to collect the medicine from the office at the end of the day.
3. Although staff will endeavour to check the expiry date of medicines/inhalers/epi-pens etc, this remains the parents’ responsibility
4. Medicines brought by a child or without the indemnity form will not be administered.
No requests will be considered where:
1. the timing and nature of the administration are of vital importance;
2. serious consequences could arise from it being forgotten;
3. some technical or medical knowledge or expertise is required.
We understand that there may be times when it is necessary for a child to have medicine during the day and it is impossible to make alternative arrangements. In such cases all requests will be dealt with sympathetically. What we are seeking to avoid is children bringing medicine and pills to school e.g. throat sweets, unknown to teachers, and keeping them in coat pockets in the cloakroom where they may prove dangerous to other children.
All staff were trained in the use of epi-pens summer 2010.
Epi-pens must be stored safely in the child’s classroom, labelled clearly with the child’s name.
Policy on the Handling of Sharps in School
Injuries from Sharps
When you work with needles, glass and other sharp items you are at risk of sharps injury. If you also work with blood or human tissues, such injuries can lead to life threatening infections such as hepatitis B, hepatitis C and HIV. If you also work with micro-organisms, an injury could result in a significant exposure with the risk of a related infection.
In order to minimise the likelihood of accidents arising as a result of poor working practices and to take the correct action in the event of any accident that may occur, ALL individuals using sharps should be aware of, and use, the following which must be regarded as standard working practices when handling glass, needles and other sharps.
These usually occur as a result of poor handling techniques or incorrect disposal with the latter often affecting someone other than the original user. Where an individual receives a needlestick injury from something they haven't been working with, it can be particularly worrying if it is not possible to trace the source of the item and allay fears of infection with HIV, hepB etc. The most common point at which a needlestick injury arises is after use at the point of disposal because of unnecessary additional handling by users - a used needle should be placed directly in a sharps bin at the point of use.
• Use a needle or sharp item only if it is necessary to do so and then use it only for the purpose it was designed. Always consider less hazardous alternatives wherever possible.
• Once the seal on the sheath of a needle has been broken, carry out any subsequent handling with extreme care and keep handling to a minimum.
• If it is necessary to carry needles or syringes, place them on a tray or in a sealed container.
Never re-sheath needles following use unless a safe system for doing this has been adopted - never hold the sheath with your fingers as if the needle misses the sheath it will puncture a finger.
• Do not detach the needle from the syringe unless absolutely necessary and a safe system for doing this has been adopted.
• Do not put used needles and syringes on the bench or mixed with other items, only put them in something like a tray and make sure they are clearly visible.
• Do not re-use needles so it is always known what a particular needle has been used for.
• Place used needles and syringes, or any other types of sharps, directly into a sharps bin for disposal. Do not detach the needle prior to disposal.
• Have a sharps bin available at the point of use to enable immediate disposal - it is your responsibility to dispose of the sharps you have used, do not leave them for someone else to clear up.
• Dispose of used sharps only in a sharps bin or container which conforms to British Standard 7320:1990 and is UN type-approved for transport - cardboard-type Cin-Bins do not meet this specification and must not be used.
• Use a sharps bins only until the contents reach the fill line marked on the side of the bin - do not overfill, used sharps protruding from bins are very dangerous for those who have to handle them. Never place sharps or sharps bins in plastic bags for disposal - sharps bins are clearly identifiable whereas handlers of bags would not expect them to contain sharps. Putting a sharps bin in a bag is particularly hazardous as it is not readily visible if the lid has come off resulting in sharps being loose in the bag.
• Clearly label sharps bins for disposal prior to them leaving the area in which they are generated. Label in accordance with the requirements set out in the University Clinical Waste Code of Practice. If there is an incident at any point in the waste disposal chain it must be possible to trace the item back to where it was produced in order that any infection risk associated with the contents can be assessed.
DUNHAM ON TRENT CE PRIMARY SCHOOL MEDICINE POLICY
(LA guidelines Summer 2012)
The aim of this policy is to effectively support individual children with medical needs and to enable pupils to achieve regular attendance. This has been revised within Acts of Parliament and follows all legal requirements.
Parents should not send a child to school if they are unwell. Dunham on Trent CE Primary School is not an extension of Accident & Emergency. If your child sustains an injury it is your duty of care to ensure you take your child to their local A + E or GP. We can only deal with first aid issues that occur on site.
Where a child has a long term medical need a written health care plan will be drawn up with the parents and health professionals.
Parents must inform the school about any particular needs before a child is admitted or when a child first develops a medical need. A care plan will be drawn up.
The National Curriculum Inclusion Statement 2000 emphasises the importance of providing effective learning opportunities for all pupils and offers three key principles for inclusion:
Setting suitable learning Challenges Responding to pupils’ diverse needs. Overcoming potential barriers to learning and Access to Teaching styles and Learning objectives.
Parents and Carers
If the school staff agree to administer medication on a short term or occasional basis, the parent(s) are required to complete a Consent Form Verbal instructions will not be accepted.
If it is known that pupils are self-administering medication in school on a regular basis, a completed Consent Form is still required from the parent(s).
For administration of emergency medication, a Care Plan must be completed by the parent(s) in conjunction with the school nurse and school staff. Minor changes to the Care Plan can be made if signed and dated by the parent(s). If, however, changes are major, a new Care Plan must be completed. Care Plans should be reviewed annually.
The parent(s) need to ensure there is sufficient medication and that the medication is in date. The parent(s) and carer(s) must replace the supply of medication at the request of relevant school/health professional. Medication should be provided in an original container with the following, clearly shown on the label:
• Child’s name, date of birth;
• Name and strength of medication;
• Expiry dates whenever possible;
• Dispensing date/pharmacists details.
Some teaching unions advise school staff not to administer medication to pupils, the unions also accept that sometimes it is done; if so they advise that the teacher has access to information, training and that appropriate insurance is in place. In practice, head teachers may agree that medication will be administered or allow supervision of self-administration to avoid children losing teaching time by missing school. Each request should be considered on individual merit and school staff have the right to refuse to be involved. It is important that school staff who agree to administer medication understand the basic principles and legal liabilities involved and have confidence in dealing with any emergency situations that may arise. Regular training relating to emergency medication and relevant medical conditions should be undertaken.
HEALTH CARE PLANS
The Health care Plan should be completed by Parent(s), designated school staff who have volunteered and school nurse. It should include the following information (see appendix 1)
When training is delivered to school staff, the school must ensure that a training record is completed for inclusion in the Health and Safety records. This will be primarily appropriate for the use of Epipens (for allergies), although other conditions/procedures may also be included from time to time. This is for both insurance and Audit purposes.
When items need to be available for emergency use, e.g. asthma pumps and Epipens, they may be kept in a designated area, or with the pupil, as appropriate. It is not necessary for a locked cupboard to be used, but such items should be easily available for the use of pupils and/or staff. When prescription items are held by the school for administration by school staff they should be stored either in the staff room fridge or in a lockable cabinet, with restricted access to keys.
CLASS 1 and 2 DRUGS
When Class 1 and 2 drugs (primarily “Ritalin” prescribed for Attention Deficit Syndrome) are kept on school premises, a written stock record is also required in order to comply with the Misuse of Drugs Act legislation. This should detail the quantities kept and administered, taken and returned on any educational visit, and returned to the parent/carer, e.g. at the end of term.
Parent(s) should be encouraged to ask the GP to prescribe an antibiotic which can be given outside of school hours wherever possible. Most antibiotic medication will not need to be administered during school hours. Twice daily doses should be given in the morning before school and in the evening. Three times a day doses can normally be given in the morning before school, immediately after school (provided this is possible) and at bedtime. If there are any doubts or queries about this please contact your school nurse.
It should normally only be necessary to give antibiotics in school if the dose needs to be given four times a day, in which case a dose is needed at lunchtime.
Parent(s) must complete the Consent Form and confirm that the child is not known to be allergic to the antibiotic. The antibiotic should be brought into school in the morning and taken home again after school each day by the parent. Whenever possible the first dose of the course, and ideally the second dose, should be administered by the parent(s).
All antibiotics must be clearly labelled with the child’s name, the name of the medication, the dose and the date of dispensing. In school the antibiotics should be stored in a secure cupboard or where necessary in a refrigerator. Many of the liquid antibiotics need to be stored in a refrigerator – if so; this will be stated on the label.
Some antibiotics must be taken at a specific time in relation to food. Again this will be written on the label, and the instructions on the label must be carefully followed. Tablets or capsules must be given with a glass of water. The dose of a liquid antibiotic must be carefully measured in an appropriate medicine spoon, medicine pot or oral medicines syringe provided by the parent.
The appropriate records must be made. If the child does not receive a dose, for whatever reason, the parent must be informed that day.
For pupils who regularly need analgesia (e.g. for migraine), an individual supply of their analgesic should be kept in school. It is recommended that school does not keep stock supplies of analgesics e.g. paracetamol (in the form of soluble), for potential administration to any pupil. Parental consent must be in place. CHILDREN SHOULD NEVER BE GIVEN ASPIRIN OR ANY MEDICINES CONTAINING ASPIRIN.
OVER THE COUNTER MEDICINE (EG HAYFEVER REMEDIES)
These should be accepted only in exceptional circumstances, and be treated in the same way as prescribed medication. Parent(s) must clearly label the container with child’s name, dose and time of administration and complete a Consent Form.
DISPOSAL OF MEDICINE
Parents are responsible for ensuring that date expired medicines are returned to a pharmacy for safe disposal. They should collect medicines held by the school at the end of each term.
On occasion it may be necessary for a school/centre to administer an “over the counter” medicine in the event of a pupil suffering from a minor ailment , such as a cold, sore throat while away on an Educational Visit . In this instance the parental consent form ( EV4 ) will provide an “if needed” authority, which should be confirmed by phone call from the Group Leader to the parent/carer when this is needed, and a written record is kept with the visit documentation. This action has been agreed by the Council’s Insurance and Legal Sections.
When a child refuses medicine the parent should be informed the same day and be recorded accordingly. Staff cannot force a child to take any medicine.
Children are encouraged to take responsibility for their own medicine from an early age. A good example of this is children keeping their own asthma reliever.
It has also been agreed by the Council’s Insurance and Legal Sections that, in the event of a pupil suffering from travel sickness (by coach or public transport) the following procedure may apply:
DAY VISITS (e.g. to a museum or exhibition)
The pupil should be given the appropriate medication before leaving home, and when a written parental consent is received he/she may be given a further dose before leaving the venue for the return journey (in a clearly marked sealed envelope with childs details, contents, and time of medication). Medication is to be kept in the charge of a named member of staff, and the parental consent is signed by that staff member before inclusion in the visit documentation.
GUIDELINES FOR THE ADMINISTRATION OF EPIPEN BY SCHOOL STAFF
An Epipen is a preloaded pen device, which contains a single measured dose of adrenaline (also known as epinephrine) for administration in cases of severe allergic reaction. An Epipen is safe, and even if given inadvertently it will not do any harm. It is not possible to give too large a dose from one dose used correctly in accordance with the Care Plan. An Epipen can only be administered by school staff that have
Volunteered and have been designated as appropriate by the head teacher and who has been assessed as competent by the school nurse/doctor. Training of designated staff will be provided by the school doctor/nurse and a record of training undertaken will be kept by the head teacher. Training will be updated at least once a year.
1. There should be an individual Care Plan and Consent Form, in place for each child. These should be readily available. They will be completed before the training session in conjunction with parent(s), school staff and doctor/nurse.
2. Ensure that the Epipen is in date. The Epipen should be stored at room temperature and protected from heat and light. It should be kept in the original named box.
3. The Epipen should be readily accessible for use in an emergency and where children are of an appropriate age; the Epipen can be carried on their person.
4. Expiry dates and discoloration of contents should be checked by the school nurse termly. If necessary she may ask the school doctor to carry out this responsibility. The Epipen should be replaced by the parent(s) at the request of the school nurse/school staff.
5. The use of the Epipen must be recorded on the child’s Care Plan, with time, date and full signature of the person who administered the Epipen.
6. Once the Epipen is administered, a 999 call must be made immediately. If two people are present, the 999 call should be made at the same time of administering the Epipen. The used Epipen must be given to the ambulance personnel. It is the parent’s responsibility to renew the Epipen before the child returns to school.
7. If the child leaves the school site e.g. school trips, the Epipen must be readily available.
GUIDELINES FOR MANAGING ASTHMA
People with asthma have airways which narrow as a reaction to various triggers. The narrowing or obstruction of the airways causes difficulty in breathing and can usually be alleviated with medication taken via an inhaler. Inhalers are generally safe, and if a pupil took another pupil’s inhaler, it is unlikely there would be any adverse effects. School staff, who have volunteered to assist children with inhalers, will be offered training from the school nurse.
1. If school staff are assisting children with their inhalers, a Consent Form from parent(s) should be in place. Individual Care Plans need only be in place if children have severe asthma which may result in a medical emergency.
2. Inhalers MUST be readily available when children need them. Pupils should be encouraged to carry their own inhalers. If the pupil is too young or immature to take responsibility for their inhaler, it should be stored in a readily accessible safe place e.g. the classroom.
3. It would be considered helpful if parent(s) could supply a spare inhaler for children who carry their own inhalers. This could be stored safely at school in case the original inhaler is accidentally left at home or the child loses it whilst at school. This inhaler must have an expiry date beyond the end of the school year.
4. All inhalers should be labelled with the child’s name.
5. Some children, particularly the younger ones, may use a spacer device with their inhaler; this also needs to be labelled with their name. The spacer device needs to be sent home at least once a term for cleaning.
6. School staff should take appropriate disciplinary action if the owner or other pupils misuse inhalers.
7. Parent(s) should be responsible for renewing out of date and empty inhalers.
8. Parent(s) should be informed if a child is using the inhaler excessively.
9. Physical activities will benefit pupils with asthma, but they may need to use their inhaler 10 minutes before exertion. The inhaler MUST be available during PE and games. If pupils are unwell they should not be forced to participate.
10. If pupils are going on offsite visits, inhalers MUST still be accessible.
11. It is good practice for school staff to have a clear out of any inhalers at least on an annual basis. Out of date inhalers, and inhalers no longer needed must be returned to parent(s).
12. Asthma can be triggered by substances found in school e.g. animal fur, glues and chemicals. Care should be taken to ensure that any pupil who reacts to these are advised not to have contact with these.
GUIDELINES FOR MANAGING HYPOGLYCAEMIA (HYPO’S OR LOW BLOOD SUGAR) IN PUPILS WHO HAVE DIABETES
Diabetes is a condition where the person’s normal hormonal mechanisms do not control their blood sugar levels. In the majority of children the condition is controlled by insulin injections and diet. It is unlikely that injections will need to be given during school hours, but some older children many need to inject during school hours. All staff will be offered training on diabetes and how to prevent the occurrence of hypoglycaemia. This might be in conjunction with paediatric hospital liaison staff or Primary Care Trust staff.
Staff who have volunteered and have been designated as appropriate by the head teacher will administer treatment for hypoglycaemic episodes.
To prevent “hypo’s”
1. There should be a Care Plan and Consent Form in place. It will be completed at the training sessions in conjunction with staff and parent(s). Staff should be familiar with pupil’s individual symptoms of a “hypo”. This will be recorded in the Care Plan.
2. Pupils must be allowed to eat regularly during the day. This may include eating snacks during class time or prior to exercise. Meals should not be unduly delayed e.g. due to extra curricular activities at lunchtimes or detention sessions. Off site activities e.g. visits, overnight stays, will require additional planning and liaison with parent(s).
To treat “hypo’s”
1. If a meal or snack is missed, or after strenuous activity or sometimes even for no apparent reason, the pupil may experience a “hypo”. Symptoms may include sweating, pale skin, confusion and slurred speech.
2. Treatment for a “hypo” might be different for each child, but will be either dextrose tablets, or sugary drink, chocolate bar or hypostop (dextrose gel), as per Care Plan. Whichever treatment is used, it should be readily available and not locked away. Many children will carry the treatment with them. Expiry dates must be checked each term, either by a member of school staff or the school nurse.
3. It is the parent’s responsibility to ensure appropriate treatment is available. Once the child has recovered a slower acting starchy food such as biscuits and milk should be given. If the child is very drowsy, unconscious or fitting, a 999 call must be made and the child put in the recovery position. Do not attempt oral treatment. Parent(s) should be informed of “hypo’s” where staff have issued treatment in accordance with Care Plan.
If Hypostop has been provided
The Consent Form should be available.
Hypostop is squeezed into the side of the mouth and rubbed into the gums, where it will be absorbed by the bloodstream. The use of Hypostop must be recorded on the child’s Care Plan with time, date and full signature of the person who administered it. It is the parent’s responsibility to renew the Hypostop when it has been used. DO NOT USE HYPOSTOP IF THE CHILD IS UNCONSCIOUS.