Medication Administration Techniques
- Always wash hands well before and after giving medications
- Follow the label directions carefully including any precaution stickers
- Record all medications immediately on the Student Medication Log. Date and initial each entry with the time given. The Student Medication Log and the Authorization for Medication/Treatment Form are to be kept together in a medication binder
- Oral liquid medications are frequently prescribed by the “teaspoon” as a dosage. A calibrated medicine cup is preferable for making this measurement. Measure medication with calibrated cup and dispose of cup immediately after use. Always measure carefully on a flat surface
- Oral medications are always given with the child sitting up
- Measure the medication or remove the correct number of pills from the bottle
- Check student’s name again against name on bottle
- Hand it to or assist the child in putting it in the mouth
- Make sure the medicine is swallowed. Check student’s mouth
- Always follow with water unless otherwise directed
- If a tablet must be broken in half, the parent should do this before bringing the medication to school
- Tablets should be crushed only if approved by the healthcare provider on the Authorization for Medication/Treatment Form
- If the child vomits after the medication or refuses the medication, call and notify the parent.
- Document an explanation of the situation, and that the parent was notified, on the back of the Student Medication Log
- If an error of any kind is made, always notify parent, principal and fill out a Medication Error Report.
- It may be necessary to notify the healthcare provider as well (see procedure for Medication Errors)
- Instillation of eye drops is a sterile technique necessary to prevent the introduction of bacteria into the eye.
- Wash you hands
- Make sure you are putting the medication in the correct eye
- Have the student lie down and extend the neck back over a pillow
- Have the student close his/her eyes
- Do not put in medication if the child is crying
- Rest your hand on the child’s forehead. Gently pull the lower lid down and administer inside the lower lid close to the nose. Do not administer the medication directly on the eyeball
- Apply drops or ointment without touching the container tip to the eye, skin or anything else
- If you contaminate the end of the tube by touching it, squeeze out a small amount of medicine on a gauze pad or cotton tipped applicator and start over
- Have the student remain lying down for a few minutes after the instillation of the eye drops
- Wash your hands when finished
- Double check to make sure the medicine is being put in the correct ear
- Lay the child on the opposite side of the prescribed ear
- Pull up and back on the ear and put in the correct number of drops
- Leave the child on his/her side for a few minutes
- Wipe off any medicine that runs out
- Apply to a clean skin surface
- Always use cotton tipped applicators or tongue depressors to apply salves and ointments. Never use your fingers
- Make sure to cover the site with gauze or adhesive bandage if the healthcare provider’s order indicates to keep the area covered
- Position the student lying down with the neck extended back over a pillow
- Instill drops in prescribed nostril
- Keep the student in this position for a few minutes
- Observe student closely for choking or vomiting
Inhaled Medications – Metered Dose Inhaler (MDI)
- Inhaled medications should be dealt with on an individual basis. Contact the parent or school nurse if you have questions.
- A metered dose inhaler (MDI) is a device used to deliver medication directly to the lungs. In order for a student to carry an inhaler, he/she must have a written notation on the Authorization for Medication/Treatment Form that the student has been trained in its usage. The student’s parent and healthcare provider must sign the form. In order to ensure effective administration of the medicine, the following steps should be performed by the student:
- Remove the cap and hold the inhaler upright
- Shake the inhaler
- Tilt the head back slightly and breath out
- Position the inhaler in one of the following ways:
- Open mouth and position mouth 1 to 2 inches away
- Use a spacer (aerochamber).
- Put in mouth
- Press down on inhaler to release medication and start to breathe in slowly
- Breathe in slowly (3 to 5 seconds)
- Hold breath for 10 seconds to allow medicine to reach deep into lungs
- Repeat puffs as directed on the Authorization for Medication/Treatment Form Wait 1 minute between puffs to permit the second puff to penetrate the lungs better
Inhaled Medications – Nebulizer
- Inhaled medications should be handled on an individual basis. Contact the parent or school health personnel (on-site or on-call) if you have questions.
- A nebulizer is a small air compressor machine that is used to deliver medication directly to the lungs. In order for a student to use a Nebulizer at school, he/she must have a completed Authorization for Medication/Treatment form. If the student has been trained to self-administer their nebulizer there needs to be written notation on the Authorization for Medication/Treatment form that the student has been trained in its usage. The student’s parent and healthcare provider must sign the form and provide the necessary medication and supplies.
- In order to ensure effective administration of the medicine, the following steps should be performed by school health personnel, trained school staff or the student:
- Place the air compressor on a sturdy surface that will support its weight. Plug the cord from the compressor into a properly grounded (three prong) electrical outlet.
- Wash your hands with soap and warm water, and dry completely with a clean towel.
- Carefully measure the medicine exactly as you have been instructed. Use a separate, clean measuring device (eyedropper or syringe) for each medicine.
- Remove the top part of the nebulizer cup.
- Place your medicine in the bottom of the nebulizer cup.
- Attach the top portion of the nebulizer cup and connect the mouthpiece or facemask to the cup.
- Connect the tubing to both the aerosol compressor and nebulizer cup.
- Turn on the compressor with the on/off switch. Once you turn on the compressor, you should see a light mist coming from the back of the tube opposite the mouthpiece.
- Have the student sit up straight on a comfortable chair.
- If you are using a mask, position it comfortably and securely on the student’s face.
- If you are using a mouthpiece, have the student place it between his/her teeth and seal with their lips around it.
- Have student take slow, deep breaths through his/her mouth. If possible, have student hold each breath for two to three seconds before breathing out. This allows the medication to settle into the airways.
- Continue the treatment until the medication is gone (about seven to ten minutes).
Care of Nebulizer
- Disconnect the nebulizer cup from tubing.
- Soak the nebulizer cup with three parts tap water and one part white vinegar for 30 minutes.
- Rinse off the nebulizer cup with water, and allow to air dry
- Store in a zip lock bag.