NORTHFIELD BOARD OF EDUCATION FILE CODE: 5141.21
Northfield, New Jersey X Monitored
Policy X Other Reasons
The Northfield Board of Education shall not be responsible for the diagnosis and treatment of student illness. The administration of medication to a student during school hours will be permitted only when failure to take such medicine would jeopardize the health of the student, or the student would not be able to attend school if the medicine were not made available to him/her during school hours.
For purposes of this policy, “medication” shall include all medicines prescribed by a physician for the particular student, including emergency medication in the event of bee stings, etc., and all non-prescription “over the counter” medication.
Before any medication may be administered to or by any student during school hours, the board shall require the written request of the parent/guardian which shall give permission for such administration and relieve the board and its employees of liability for administration of medication. In addition, the board requires the written order of the prescribing physician which shall include:
A. The purpose of the medication;
B. The dosage;
C. The time at which or the special circumstances under which medication shall be administered;
D. The length of time for which medication is prescribed;
E. The possible side effects of the medication.
Both documents shall be kept on file in the office of the school nurse. A copy of both shall be kept in the office of the school principal.
The district school physician shall develop procedures for the administration of medication which provide that:
A. All medications, whether prescribed or “over the counter”, shall be administered by the school physician, school nurse or substitute school nurse, the parent/guardian or the student himself/herself where the parent/guardian so permits and with the school nurse present;
B. Medications shall be securely stored and kept in the original labeled container;
C. The school nurse shall maintain a record of the name of the student to whom medication may be administered, the prescribing physician, the dosage and timing of medication and a notation of each instance of administration;
D. All medications shall be brought to school by the parent/guardian or adult student and shall be picked up at the end of the school year or the end of the period of medication, whichever is earlier;
E. A student may self-administer medication without supervision of the school nurse for asthma or other life-threatening illnesses. “Life-threatening illness” has been defined as an illness or condition that requires an immediate response to specific symptoms or sequelae that if left untreated may lead to potential loss of life such as, but not limited to, the use of an inhaler to treat an asthma attack or the use of an adrenalin injection to treat a potential anaphylactic reaction.
Each school in the district shall have and maintain at least one nebulizer in the office of the school nurse
or at a similar accessible location. The Superintendent of Schools shall prepare and the board shall adopt regulations on the administration of asthma medication through the use of a nebulizer by the school nurse or his/her designee(s). Regulations shall be in accord with New Jersey statute and administrative code and shall include, but not be limited to the following:
A. Requirement that each school nurse shall be authorized to administer asthma medication through use of a nebulizer;
B. Requirement that each school nurse receive training in airway management and in the use of nebulizers and inhalers consistent with nationally recognized standards;
C. Requirement that each student authorized to use asthma medication or a nebulizer have an asthma treatment plan prepared by the student’s physician that identifies, at a minimum, asthma triggers and an individualized health care plan for meeting the medical needs of the student while attending school or a school-sponsored event.
Student Self-Administration of Medication
The board shall permit self-administration of medication for asthma or other potentially life-threatening illnesses by students who have the capability for self-administration of medication, both on school premises during regular school hours and off-site or after regular school hours when a student is participating in field trips or extracurricular activities. Parents/guardians of the student must meet the following conditions:
A. Provide the board with written authorization for the student’s self-administration of medication;
B. Provide written certification from the student’s physician that the student has asthma or another potentially life-threatening illness and is capable of and has been instructed in the proper method of self-administration of medication;
C. Sign a statement acknowledging that the district shall incur no liability as a result of any injury arising from the self-administration of medication by the student and that the parents/guardians shall indemnify and hold harmless the district and its employees or agents against any claims arising out of the self-administration of medication by the student.
The board shall:
A. Inform the student and his/her parents/guardians that permission is effective for the school year for which it is granted and must be renewed for each subsequent school year upon fulfillment of requirements listed above;
B. Inform parents/guardians in writing that the district and its employees or agents shall incur no liability as a result of any injury arising from the self-administration of medication.
C. Maintain the right to revoke a student’s permission to self-medicate if he/she has failed to comply with all conditions of this policy and/or has violated in any way the tenets of the agreement to self-medicate. The Superintendent of Schools shall confer with the school physician and school nurse prior to recommending termination of a student’s permission to self-medicate and shall also consult with the student, the student’s parents/guardians and the student’s physician.
Emergency Administration of Epinephrine
The board shall permit the school nurse or school physician to administer epinephrine via epi-pen or other pre-filled auto-injector mechanism in emergency situations. In their absence, a designee or designees who are employees of the board may do so.
The designees must be properly trained by the school nurse in the administration of the epi-pen or other pre-filled auto-injector mechanism using the standardized training protocol designated by the State Department of Education. Each designee shall receive individual training for each student for whom he/she is designated.
The board shall inform the student’s parents/guardians in writing that if the specified procedures are followed, the district, its employees and agents shall have no liability as a result of any injury arising from the administration of the epi-pen or other pre-filled auto-injector mechanism to the student.
Parents/guardians shall provide the board with the following:
A. Written orders from the physician that the student requires the administration of epinephrine for anaphylaxis and does not have the capability for self-administration of the medication;
B. Written permission for the administration of epinephrine via epi-pen or other pre-filled auto-injector mechanism by the school nurse or designee(s);
C. A signed statement acknowledging their understanding that if the specified procedures are followed, the district shall have no liability as a result of any injury arising from the administration of the epi-pen or other pre-filled auto-injector mechanism by the school nurse or designee(s) to the student and that the district, its employees, and agents shall be indemnified and held harmless against any claims arising out of the administration of the epi-pen or other pre-filled auto-injector mechanism to the student.
Permission for the administration of epinephrine via epi-pen or other pre-filled auto-injector mechanism shall be granted annually and must be renewed each school year upon the fulfillment of the above requirements.
Placement and Availability of Epinephrine, and Transportation to Hospital Emergency Room
Pursuant to P.L. 2007, C. 57, school policy requires:
A. The placement of a student’s prescribed epinephrine in a secure but unlocked location easily accessible by the school nurse and designees to ensure prompt availability in the event of an allergic emergency at school or at a school-sponsored function. The location of the epinephrine shall be indicated on the student’s emergency care plan. Back-up epinephrine shall also be available at the school if needed;
B. The school nurse or designee to be promptly available on site at the school and school-sponsored functions in the event of an allergic reaction; and
C. The transportation of the student to a hospital emergency room by emergency services personnel after the administration of epinephrine, even if the student’s symptoms appear to have resolved.
The board may adopt additional regulations on all aspects of the administration of medication. When implementing school policy and P.L. 2007, C. 57, staff will consult these NJ Department of Education guidance documents:
A. Training Protocols for the Emergency Administration of Epinephrine (9/08)
B. Guidelines for the Management of Life-Threatening Food Allergies in Schools (9/08)
Adopted: No Date
NJSBA Review/Update: November 2009; December 2010
Readopted: October 24, 2011
Administering Medication, Medication in School, Nebulizer
Legal References: N.J.S.A. 18A:11-1 General mandatory powers and duties
N.J.S.A. 18A:40-1 Employment of school physicians, optometrists and nurses; salaries; terms; rules
N.J.S.A. 18A:40-3.2 et seq. Medical and Nursing Personnel
N.J.S.A. 18A:40-4 Examination for physical defects and screening of hearing of students
N.J.S.A. 18A:40-7 Exclusion of students who are ill
N.J.S.A. 18A:40-12.3 Self-administration of medication by student; conditions
N.J.S.A. 18A:40-12.5 Policy for emergency administration of epinephrine to
public school students
N.J.S.A. 18A:40-12.6 Administration of epinephrine; primary responsibility;
N.J.S.A. 18A:40-12.7 Nebulizer
N.J.S.A. 18A:40-12.8 Administration of asthma medication by school nurse through nebulizer; training; student asthma treatment plan
N.J.S.A. 18A:54-20 Powers of board (county vocational schools)
N.J.S.A. 45:11-23 Definitions
N.J.A.C. 6A:16-1.1et seq. Programs to Support Student Development
-1.4(a), -2.1, -2.2, -2.3, -2.4
Bernards Township Education Association v. Bernards Township Board of Education, 1981 S.L.D. (9/29/81), aff’d State Board, 1982 S.L.D. 4/7/82, aff’d App. Div., unpublished opinion (A-4211-81T3, 5/18/83)
Communications Workers of America, Local 1033, On behalf of Karen Norton, Barbara Woolston, Mary Ellen Schoen et al. v. New Jersey State Department of Education, Marie H. Katzenbach School for the Deaf, State Board Docket #52-91
Policy Advisory #1 on N.J.S.A. 18A:40-12.3 et seq. Self-Administration of Medication By a Student, New Jersey State Department of Education, June 5, 1995
Protocol and Implementation Plan for the Emergency Administration of Epinephrine by a Delegate Trained by the School Nurse, New Jersey State Department of Education, October, 1998
Cross References: *5131.6 Drugs, alcohol, tobacco (substance abuse)
*5141.3 Health examinations and immunizations
*6153 Field trips
*Indicates policy is included in the Critical Policy Reference Manual.