Signature Camper Medication Administration Made Easy

Signature camper medication administration

hello I'm Anita Lopez the video you are watching was designed as a companion piece to the training manual guidelines for medication administration instructional programs for training a licensed personnel to give medications in out-of-home childcare schools and camp settings the goal of this video is to supplement the manual with demonstrations and important information although this video is detailed it does not replace the printed manual using both together will give you the most comprehensive information available this video is divided into chapters for your convenience this format will allow you to access and review important information chapter one is the introduction and overview chapter two provides information on the forms of medications chapter 3 includes information on the care and storage of medications and the required documentation chapter 4 presents the five rights also included are separate chapters on severe allergy and asthma inhaled medications a school staff childcare or other care provider part of your job may involve administering medications to children in your care when working with children it is important to follow accepted guidelines when administering the medications let's look at a few scenarios that show where things can go wrong when administering medications you will see mistakes that have the potential to lead to serious consequences although these scenarios may seem extreme and may be a little outrageous keep in mind they can and do happen hi I'm here for my medicine hi are you doing today dad okay get your all set up here I'm sure water let's take your time good have a nice day Tracy Tracy I'm Stacy Tracy is my sister hi my mom gave you some medicine to give to my brother for his cough and she said I should take it - are you sure uh-huh okay sweetie one second I'll get it for you this baby is so fussy from his new tooth I have an order for Tylenol that I got six months ago I guess I'll just give him a little more since he's probably grown my hey let me see no it is a little bit red we've got some medicine in a cabinet that we used a few months ago when you had pinkeye let me get some and I'll put it in your eye okay okay hi mrs. foster came by and dropped off this medicine for her son but it's a prescription for her she said be okay to give him half the dose okay okay hi mrs. Campbell mrs. Turner said you wanted to see me hi Haley it's time to take your medicine but I'm not supposed to take any more besides I hate the way it tastes are you sure yeah I'm all better now so I don't need to take it anymore okay well as long as you're sure there are many lessons to be learned from these scenarios everyone who administers medications to children at school or in group care settings should be carefully trained to follow both state law regulations and schooler program policies and procedures the child's health and safety is first and foremost and that is why we've developed this video for you some children may require medication while in your care rules and guidelines must be followed for the protection of everyone many schools and most childcare programs do not have a full-time nurse present in each building so a variety of people are learning to safely administer medications to children these people include principals teachers directors paraprofessionals school secretaries and others but they may administer medications only after receiving training from a health care professional in addition I state law with the exception of the family childcare provider the school nurse or childcare nurse consultant must also delegate to those administering medications nurse delegation includes the training demonstration of correct technique and ongoing support and supervision of staff performing the delegated tasks of medication administration both prescription and over-the-counter medications require written permission from the child's parent or guardian in addition there must be written authorization from the healthcare provider who prescribes the medication the authorization for both prescription and over-the-counter medications must include the child's name current date name of the medication and reason for the medication it must have the dosage route time to be given and start and end date finally the authorization should state any special instructions to include possible side-effects of or reactions to the medication these requirements apply to all medications both prescription and over-the-counter in this video you will observe the correct ways to administer store and document several types of medications most commonly given in your setting everyone who helps children with medications at school at childcare facilities at camp or in a family childcare environment need to be carefully trained to follow both state law and school or program policies and procedures for the Colorado Department of Public Health and Environment the maternal and child health Bureau the Colorado Department of Education and koala Starr early learning I'm Anita Lopez thank you for watching as you are well aware there are several forms of medications and each form has its own method of administration let's look at several forms of medications commonly given at school or in childcare settings by people who are not health professionals we'll start by talking about oral medications that are taken by mouth these include tablets capsules syrups and elixirs and suspensions there are three common types of tablets that children take regular tablets chewable tablets and scored tablets regular tablets are simply swallowed whole taken with liquid chewable tablets as their name implies are meant to be chewed up before they're swallowed only tablets clearly marked as chewable should be chewed before they are swallowed score tablets are designed so they can be cut up into smaller doses with a special cutting tool the parents or pharmacists should cut the tablets before they are brought to school or childcare before administering any medications wash your hands even though your hands are clean you should not touch the medication instead pour the capsules or tablets into a medicine cup the lid of the bottle or a small paper cup a clean paper towel will also do after the child washes his or her hands the child should take the medication some children don't have the developmental skills to take their own medication if you have to put medication directly into a child's mouth wear disposable gloves you may have to check the child's mouth to make sure he or she swallowed the medication all tablets and other medication taken by mouth should be followed by a four to six ounce glass of water to prevent an upset stomach water is the best choice since juice or milk might interact with some medications be sure to follow label instructions to determine whether medication should be taken with food sometimes children gag and have trouble taking tablets if that happens the written prescription may call for you to crush them using a pill crusher or a mortar and pestle some tablets contain sustained-release medication and should not be crushed so don't crush tablets unless the prescription specifically calls for it pour all of the crushed medication into a small amount of soft food or into a liquid and give it to the child be sure to wash the pill crusher or mortar and pestle afterwards so no residual medication is left for the next child in contrast to tablets capsules are coded so they dissolve over a period of time in the stomach or the intestines but not in the mouth most often the prescription calls for capsules to be swallowed whole just like tablets but there are capsules designed to be broken apart and sprinkled onto a small amount of soft food like applesauce one of these is called a sprinkle if a capsule should be sprinkled the directions on the prescription will specifically say so the next categories of oral medications will consider syrups elixirs and suspensions are liquids and are most accurately measured into a calibrated medicine spoon or syringe never use silverware it's just not accurate small amounts of liquid can be measured with a calibrated medicine dropper that is included with the medication if you use a medicine cup always pour from the side of the bottle opposite the label so the label stays readable and read it at eye level for accuracy and clean any medication off the outside of the bottle after pouring whatever the measuring container you use be sure the child takes all of the medication syrups and elixirs are clear liquids but suspensions are not clear they contain medication that doesn't dissolve completely in the liquid they usually need to be refrigerated and because the medication can separate they always need to be shaken at least 15 seconds before being measured and given to a child let's turn now from oral medications to topical medications these include eye drops and I augment ear drops and ointments and creams that are applied to the skin to use eye drops begin by washing your hands and putting on gloves have a few tissues available some eye drops need to be refrigerated you may want to warm them by rolling them in your hands before you begin check the label to see if the drops need to be shaken have the student tilt her head back and close her eyes then use a tissue to wipe from the inside corner of the eye to the outside use a clean tissue for each eye tell the student to look up as you gently open the eye to expose the lower lid bring the medication toward the eye outside of the students field of vision be sure not to touch the eye or anything else with the tip of the bottle you don't want to scratch the cornea or contaminate the medication in the bottle gently pull down the lower eyelid to make a pouch under the eye hold the medication no more than an inch above the eye and drop it into the pouch not directly onto the pupil have the child close her eye and put gentle pressure on the inside corner of the eye for about 20 seconds wipe away any excess medication or tearing with a clean tissue if the eye becomes itch year or red after medication has begun contact the school nurse or childcare health consultant and the parent I augment SAR applied along the inside of the lower eyelid be sure not to touch the eye or anything else with the tip of the tube after the ointment is applied hold the eyelid open for a few seconds have the child's roll the eye around or blink a few times to distribute the medication and keep the eye closed for 20 to 30 seconds if you're asked to administer ear drops wash hands and put on gloves if possible have the child lie down on a cot with the affected ear facing up if the child is sitting in a chair tilt your head sideways until the ear is parallel with the ground if necessary clean the outer ear with a cotton ball if you see anything unusual contact the school nurse and parent for a child younger than 3 hold the earlobe and pull down and back for a child older than 3 hold the upper part of the ear and pull up and back without letting the bottle touch the ear drop the medication on the side of the ear canal have the child stay still for about a minute then repeat with the other ear if that is prescribed the doctor's orders may also call for cotton ball that is slightly dampened with water to be loosely placed in the ear canal the cotton ball needs to be damp so it doesn't absorb the medication another kind of topical medication includes oils and creams that are applied to the skin as with other medications begin by washing your hands and putting on gloves wearing gloves or using an applicator will keep you from being exposed to infectious diseases will ensure that you don't absorb the medication through your skin and will help protect the child from germs note the condition of the affected area if it looks unusual contact the school nurse or the child's parent apply the ointment or cream and if the instructions call for it cover the area with gauze don't remove your gloves until after the gauze is in place then remove and dispose of them safely correct handling of all medications is of vital importance before you give any medication to a child wash your hands and if the child will touch the medication he or she should wash their hands also everyone who helps children with medications must know how to store them safely prescription medications must always be kept in the original labelled container from the pharmacy over-the-counter medications should also be kept in the original labeled bottle or box not emptied out into a plastic bag or other container except for self administered medications that students have permission to carry with them medications should always be stored in a clean locked cabinet or secured area controlled drugs such as Ritalin must be safely secured and require special attention in school and program policies some medications need to be refrigerated the refrigerator should be in a secured area out of reach of children and should be checked periodically to ensure that it doesn't freeze the medications the temperature inside should be between 36 and 46 degrees Fahrenheit ideally food and medications should not be kept in the same refrigerator however if only one refrigerator is available they can be stored together as long as the medications are in a separate leak-proof container for some programs a locked box for the refrigerated medications may be required the parent or guardian is responsible for providing the needed medications to the school or childcare program notify the parents when the medication supply is low or medications are about to expire all medications in out home settings all medications no longer being used or expired should ideally be returned to the child's parents for disposal if this cannot be done staff from the school or childcare program should properly dispose of the medications according to the Colorado Department of Public Health and Environment and the Environmental Protection Agency it is no longer recommended that even small quantities of medications be flushed down the drain you should follow the recommendations from the EPA or your local health department for proper disposal of medications these recommendations are outlined in the medication administration training manual a staff person or RN and a witness should document a disposal of medications on the medication log a disposal log or both record-keeping is essential when medication is given at school or childcare this chapter will discuss the record-keeping requirements for medication administration every student who is taking medication must have a medication log for each medication administered this log is a legal document and helps ensure children receive the right medication by the right route at the right time in the right dose it can prevent an accidental double dose of the medication as well completed logs and authorizations must be kept by the school or childcare program according to school record policies and/or childcare licensing rules and regulations the log must contain the student's name prescribed medication dosage route and time it should be given it should also contain the names and initials of staff trained to administer the medication including these names makes it possible at a later date to track who gave medications it's also a good idea to clip a picture of the child to the medication log that way you can check that you're giving medication to the right child each time you give medication to a child fill in the actual time and initial the log write an ink not pencil remember the log is a legal document controlled drugs such as Ritalin should be counted when received and whenever given this count should be documented in addition to requiring a medication log school or program policies and procedures should spell out what's required if there is an error involving medication any error must be documented in a medication incident report and must be reported immediately to the school nurse or childcare health consultant the building administrator and parents if you forget to give a dose of medication report it if you give it to the wrong child report it if you give the wrong medication or the wrong dose report it if you give it at the wrong time or by the wrong route report it accidents do happen and honesty is in your own best interest and in the interest and safety of the children in your care as most people know children are not always enthusiastic about taking their medication sometimes they will refuse a medication or not show up at all to take the medication if this happens notify the school nurse or the parent and make a note of what happened in the medication log if the child vomit also recorded in the log and contact the school nurse or childcare health consultant and parent do not repeat the dose other situations that should be noted on the medication log include documenting if the parent does not bring in the ordered medication if the medication drops on the floor or goes down the drain and cannot be given refer to your school or program policy for administering and documenting medications that are needed and given on field trips plan ahead four times the child will be away from the school or program and be sure to have a person that has been trained and delegated the task of medication administration along on the trip another policy that each school or childcare program must have in place involves confidentiality whatever you learn about a child's medication or health condition cannot be discussed with anyone unless the parents give their permission if parents or guardians want people at school or in childcare to know why their child needs medication they'll say so otherwise anything you learn about a child's health status or medications must not be shared a breach of confidentiality with a child who has a chronic illness for example can result in serious upset for the child in the family it can also lead to lawsuits and liability for the school and the person who violated the family's confidentiality when administering medication it is a good idea to remember the five rights to make sure the right child has the right dose of the right medication given by the right route at the right time this will help reduce the chance of making a mistake remember before giving any medication wash your hands if the child will be touching the medication his or her hands must be washed too hey hi what's your name Maria Maria what's your last name Gonzales Maria Gonzales RIA Gonzales okay the first right is the right child even if you think you know the child you're giving medication to double check by asking his or her name checking the name on the medication label against the permission form if you are not familiar with the child or the child is nonverbal check the child's identity with another staff member or verify the child's identity by having the child's picture stapled to the medication log says you have an antibiotic 12:00 o'clock second make sure you're administering the right medication compare the physicians written instructions to the medication log and the pharmacy label this doesn't look like the same pills that I usually take at home if for some reason the child questions the medication believe him or her and triple-check the physicians instructions the medication log and the label on the medication I don't know why would be different but I better do some checking on this make sure this is the right medication for you okay okay contact your school nurse or child care health consultant so calls can be made to the doctor's office or pharmacy to confirm the medication in this situation the family child care provider should contact the parents before administering the medication okay Maria I checked with our school nurse and she checked and she indeed said this was your medication okay okay Thanks third is the right dosage always give the right amount of medication specified by the orders from the person with prescriptive Authority and the pharmacy label make certain to use a medication spoon medication syringe or the medication cup that came with the medication so that the medication will be measured accurately forth is the right time check the medication log for the time when the medication should be given check to see if the medicine has already been given for the current day and plan so the medication will be given up to 30 minutes before or 30 minutes after the scheduled time in some cases you may need to contact the parents to find out when the medication was last given at home the fifth right is the right route this is the method by which the medication is to be taken whether oral inhaled or topical again the authorization medication log and pharmacy label will tell you the correct route for the medication if you have any questions or if anything is not clear contact your school nurse child care health consultant or parents always review these five rights before you give the medication as you are preparing to give the medication and finally when you complete the task including the documentation the five rights give you a systematic way to check what you are doing and reduce your chances of making a mistake earlier in this video you saw several scenarios that could have resulted in harm to the children and care now that you have seen this video we will discuss some ways that those situations could have been handled so that children were safe and the staff administering the medications were following the guidelines for safe medication administration in the school and childcare setting hi I'm here for my medicine okay tell me your name this is Jenkins you know my name I know I just want to be sure I'm Stacy Stacy Walker okay Stacy I see your picture here everything checks out you take your antibiotic at 11:00 okay hi my mom gave you some medicine to give to my brother for his cough and she said I should take it too well I'm sure your mom wants to make sure you don't take the wrong medicine or the wrong amount I'll need to contact our school nurse so she can call your mom okay good this baby is so fussy from his new tooth I have an order for Tylenol but it's not current and his dosage will have changed we should call mom shouldn't we and have her call our health care provider and get a new order before I give you anything okay my eye hurt let me see Oh it looks really weird you might have pinkeye again I've got some medicine in the cabinet that we used a few months ago but we can't use it let me call your mom and see she can get us a new prescription okay hi hi mrs. foster came by and dropped off this medicine boys son but it's a prescription for her so we can't give it to her son I'll call her and let her know we can only administer medication prescribed for her child okay let her know she will need to come by and pick up her prescription as soon as possible hello okay thank you hi mrs. Campbell mrs. Turner said you wanted to see me hi Hayley it's time to take your medicine but I'm not supposed to take any more besides I hate the way it tastes and no medicine can taste bad but the prescription says you have to take the pills for two more days I'm all better now so I don't need to take it anymore well we'll call your mom and check but I notice that this is an antibiotic so it's important to take all the medicine okay we have talked about a variety of settings including schools childcare before and after-school programs and camps where medications may need to be given administering medications to children in these settings is a serious responsibility today you have learned requirements for administering medications including delegation authorizations care and storage documentation and the five rights in this section of the video you have seen the proper techniques for the safe administration of oral and topical medications it is our hope that viewing this video has provided you with some strategies to ensure that the children in your care remain healthy and safe the final two chapters of this video will cover information about children with severe allergies who may need emergency medication and children who have asthma and may need inhaled medication anaphylaxis is a rapid severe allergic reaction anaphylaxis occurs when the body over reacts to an allergen to which the person has been previously exposed a child may have a severe allergy to medications insects stings and bites food or even latex children that have been diagnosed with allergies requiring immediate intervention should have an individualized health care plan that directs their care provider on the correct steps to take in case of an exposure if you witness signs and symptoms of a severe allergic reaction in a child with no care plan call 9-1-1 current state law allows children to self carry their own emergency epinephrine in an auto-injector with the approval of the child's parent health care provider and the school nurse even though these children will be responsible for carrying their own epinephrine it is important for staff to know that these children have a life-threatening allergy these children will most likely need assistance in administering this life-saving medication further it is strongly suggested that the family provide an extra epinephrine auto-injector in case the epinephrine carried by the child is not readily available children with allergies may have mild symptoms which may include a runny nose a few hives that look like red raised bumps and itching and a histamines are useful in the treatment of minor symptoms the most common antihistamine used for these symptoms is benadryl antihistamines are taken orally and may be in the form of a tablet liquid or quick dissolve strip other times the symptoms are severe and quick an emergency action must be taken some of the symptoms include hives red raised bumps spreading over the body wheezing and difficulty swallowing or breathing swelling of the lips face tongue throat hands or feet nausea and vomiting signs of shock and even loss of consciousness if these symptoms are present epinephrine must be administered immediately an individualized care plan must be in place to direct staff on the immediate care required for children having an allergic reaction the care plan is your authorization from the health care provider and the parent to put the plan into action and deliver the medications needed the epinephrine may be in the form of an EpiPen a prefilled auto injector if an EpiPen is used 900 called after an EpiPen injection the child should lie down and stay down until help arrives to administer the injection firmly grasp the EpiPen do not place your thumb on the end of the pen pull off the gray safety release jab the black tip firmly into the outer thigh so it clicks and hold on the thigh approximately 10 seconds the pen automatically injects epinephrine in an emergency it can even be used through jeans or slacks note that the needle is visible when pulled from the leg return the used EpiPen to its holder using the one handed technique and then give it to the paramedics when they arrive the severe symptoms usually improve quickly after the EpiPen is administered refer to the child's individualized care plan for instructions on administering a second dose of epinephrine if ordered and available remember if you have an administered epinephrine you must call 9-1-1 remember to document the medications given on a medication log EpiPens must be stored at room temperature and never exposed to extreme heat or direct sunlight check the expiration dates for all medications needed for severe allergies and give families ample time to replace the medications as the expiration date draws near if your schooler program takes field trips plan ahead to ensure that the medications and care plan accompany the child with a severe allergy and that a medication trained and delegated person is on the trip asthma is a chronic lung condition characterized by ongoing inflammation of the Airways or bronchial tubes asthma is the most common childhood chronic disease and is a leading cause of missed school days asthma symptoms can range from mild to severe and can vary from episode to episode asthma can be brought on by many triggers such as exercise colds and illness allergies weather changes irritants including pollution and emotional changes it is important to be aware of the triggers for each individual child identified with asthma and whenever possible avoid these triggers it is important that the following asthma symptoms be treated according to the child's individualized health care plan continual coughing shortness of breath rapid in difficult breathing tightness in the chest and wheezing the care plan is your authorization from the child's health care provider and parent to treat the symptoms you are observing current state law allows children to self carry their own inhaled asthma medications with the approval of the child's parent health care provider and the school nurse even though these children will be responsible for administering their own inhaled medication it is important for staff to know that these children have asthma and are carrying their own medication further it is recommended that an extra inhaler be kept at school in case the staff needs to administer the medication to the child while there is no cure for asthma and children do not outgrow asthma this chronic disease is controllable with effective use of asthma medications here are some commonly used medications and treatments for those with asthma bronchodilators are used for quick relief this medication is a short-acting medication and acts quickly to open constricted Airways and relaxing smooth bronchial muscles improvement is usually seen within five to ten minutes inhaled steroids are used to reduce inflammation and may be taken daily to control or prevent persistent asthma symptoms long-acting bronchodilators relax muscles that tighten around Airways and helps the inhaled steroids work more effectively these medications do not provide quick relief the medication most often in school and childcare is the short-acting bronchodilators albuterol this medication is delivered by a metered dose inhaler this device delivers medication in a fine mist to the lungs correct use of inhalers is important and may be a problem for many children they often find it hard to coordinate the quick puffs from the inhaler and breathing the medication deep into their lungs for this reason many children use their inhaler with what is called a spacer or holding chamber to use the inhaler with a spacer remove the cap from the canister and shake it well the new hf a inhalers may require priming if this particular inhaler has not been used for two weeks pump three to four times into the air away from your face priming instructions for various inhalers may differ check packaging instructions or contact your school nurse or child care nurse consultant for specific instructions put the spacer on the mouthpiece of the inhaler have the child stand or sit up straight and breathe out completely with the mouth around the spacer press the canister and instruct the child to breathe in deeply and evenly this should take about three to five seconds if possible hold breath for 10 seconds and then breathe out gently to ensure that all the medication was inhaled have the child take a second breath through the spacer have the child wait at least a minute before taking the second puff if one is ordered if using inhaled steroids the child should rinse mouth with water after use some health care providers prefer that a child use an inhaler without a spacer follow the instructions from the healthcare provider on administration technique a nebulizer is another way to deliver inhaled medications and may be prescribed for some children who have asthma or are recovering from a respiratory illness again the quick relief short-acting bronchodilators albuterol is the medication most commonly used with a nebulizer to use the nebulizer begin with clean hairs okay pour the medication into the cup it may have to be measured and mixed with saline or it may come pre measured and ready to use connect one end of the tubing to the compressor and the other end to the bottom of the nebulizer Cup turn on the compressor and check that mist is coming out of the mouthpiece depending on the type of nebulizer the child may use a mask or a mouthpiece stay with the child ensuring that all the medication is delivered this usually takes about five to 15 minutes after each use rinse the mouth piece and nebulizer cup with tap water and allow them to air dry all inhaled medications given to children must be documented on a medication log children with asthma take inhaled medication on a prescribed schedule to control their symptoms but they may also need to have immediate access to their medications instructions for when to use these medications should be provided in an individualized care plan school or center-based childcare programs should consult the school nurse or childcare health consultant if there are any questions concerning the care of children with asthma for the Colorado Department of Public Health and Environment the maternal and child health Bureau the Colorado Department of Education and koala star early learning I'm Anita Lopez thank you for watching you you