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Policy 303: Student Health Services and Medication Management
Revised: September 25, 2001
Revised: March 28, 2007
Revised: November 15, 2011 
Revised: February 17, 2015
 

Policy

 
The School Act, the School Act Regulations, and Ministerial Orders have assigned to the Board certain duties and responsibilities for the health and well-being of students. 
 
The Board recognizes its responsibility for providing health services, social services and other support services in order to protect the health and well-being of students. The Board will establish effective procedures for addressing these issues:
    • Immunization of students
    • Communicable diseases, including HIV/AIDS (Acquired Immune Deficiency Syndrome)
    • School safety in regards to exposure to blood and body fluids
    • Referrals by the school for Public Health Services
    • Administration of medication.
The Board will cooperate actively with parents, public health services, and other social agencies to foster the good health and well-being of students.
 

Administrative Procedures

 
Immunization of Students
Any student seeking admission to a school operated by the North Vancouver School Board must present written evidence from a licensed physician or an authorized health centre (within 30 days of the first day of attendance) of all routine childhood immunizations including, but not limited to, diphtheria, pertussis (whooping cough), tetanus, poliomyelitis, haemophilus influenza B (HIB), measles, mumps and rubella, pneumococcal, hepatitis B, varicella (chickenpox), and meningococcal C.
 
Students may be exempted from the foregoing under the following circumstances:
    • The school is provided with a physician’s written certificate which indicates that immunization would be detrimental to the child’s health, or
    • The parent or guardian provides the school with a written statement that indicates that the parent or guardian has moral convictions or religious beliefs that are in opposition to immunization.
Students who are exempted from this requirement may be excluded from school for the duration of a community outbreak of a communicable disease, at the discretion of the Medical Health Officer.
 
Communicable Diseases, Including Acquired Immune Deficiency Syndrome

Acquired Immune Deficiency Syndrome (AIDS)
For most students who are HIV positive or who have AIDS, the benefits of an unrestricted educational setting outweigh the risks of their acquiring potentially harmful infections in the setting and the apparent non-existent risk of transmission of HIV/AIDS through casual contact.  To this end, these students should attend school in an unrestricted setting unless, in the opinion of the student’s physician and the Medical Health Officer, there are special circumstances that necessitate some restriction.  The assessment for attendance or restrictions should be based on the behaviour, development, and physical condition of the student and the expected type of interaction with others in the educational setting.
 
In those instances where, in the opinion of the child’s physician and the Medical Health Officer, a more restrictive educational environment may be required, the type of educational setting and attendant restrictions are best determined by a team consisting of the student’s physician, the Medical Health Officer, the student’s parent or guardian and appropriate school personnel.  Confidentiality of medical information and the child’s right to privacy are required.
 
School Safety in Regards to Exposure to Blood and Body Fluids
Although the risk of casual contact with blood is small, all blood and body fluids should be considered potentially infectious with a blood-borne disease (i.e., hepatitis B, hepatitis C, HIV/AIDS).  School personnel in the everyday social contact setting of the school are reminded to take all reasonable precautions to minimize the risks of accidental spillage of and/or exposure to blood and other fluids.  Additionally, procedures for first aid practices and routine cleansing of materials and surfaces contaminated with blood or body fluids should be reviewed by the School District’s Occupational Health and Safety Manager.  Additional information regarding school safety in regards to Exposure to Blood and Body Fluids can be obtained through Public Health Services.
 
Referrals for Public Health Services
School personnel who consider students to need a referral to public health services (Public Health Nursing, Nutrition, Tobacco Reduction, Dental) should refer these students to Vancouver Coastal Health-North Shore using the Individual Services Request Form available at schools.
 
Referrals to the Child and Adolescent Program (Mental Health, Behaviour, Concurrent Disorders or Audiology) are to be made directly to these programs through Vancouver Coastal Health-North Shore.
 
In emergency situations or in suspected child abuse cases, school personnel shall not refer a pupil directly to Vancouver Coastal Health.  These referrals should follow the appropriate procedures as laid out in Board Policy 306: Suspected Child/Youth Abuse.
 
Administration of Medication
The Board recognizes that the parent is the primary care giver to their child and is responsible to administer or supervise the self-administration of medication.  The Board recognizes that there may be situations where it is necessary that medication must be administered during school hours and where a parent is not available.  Therefore, with explicit written direction and authority from the parent, the principal or designate will administer physician-prescribed medication in accordance with the procedures set out in this policy.
 
It is the belief that the safe management of medication with children should lead to the following outcomes:  
    • Promote the maximum learning potential for the student
    • Provide the framework to support school staff in their medication management role
    • Promote self-management in the student when it is developmentally appropriate
    • Lead to medication compliance.
All physician-prescribed medications to be given by a staff member at school must be managed in accordance with the procedures for Student-Focused Medication Management Plan.  These procedures apply to short and long term medications.  Over the counter or herbal medications do not apply to these guidelines.
 
Definitions
“Student-Focused Medication Plan” – Clear details of physician-prescribed medications to be given or monitored for a specific student are written out and agreed upon by the parent and school staff.
“Medication Management” – Administration and monitoring of physician-prescribed medication.
“Administration of Medication” – Direct involvement in preparing and giving medication.
“Monitoring of Medication” – Observing a student who is self-medicated and/or ensuring medication is taken.
“Therapeutic Effect of Medication” – Desired outcome of taking medication.
“Side Effect of Medication” – Undesirable effect of medication.
 
Guidelines for Administration of Medication
Staff designated by the principal or vice-principal should administer (or supervise the self-administration of medication) to students only if the following conditions are met:
    • The medication is required while the student is attending school
    • A parent requested the school’s assistance and has given their written authorization on the Student-Focused Medication Management Parental Consent Form
    • The staff has received adequate instruction from the parent and/or medically trained personnel, as outlined in the Student-Focused Medication Management Plan.  Assistance from the Public Health Nurse, where necessary, concerning the administration can be accessed by using the Individual Service Request Form.
    • Adequate records are kept on the Student-Focused Medication Management Form
    • More than one employee at a school shall be adequately instructed in the administration of the medication in order to provide an alternative person in cases of absence or unavailability.
Student-Focused Medication Management
Student-Focused Medication Management falls into six categories:
    • Developing a Student-Focused Medication Management Plan
    • Safety considerations
    • Location of medication
    • Preparation of medication
    • Medication administration or monitoring
    • Record keeping.
For success in each category and to ensure student safety, the partnership between the parents, student, school staff, and the public health nurse is critical.  Parents are the link between their child, the physician, and the school.  As such, they need to ensure that accurate, complete information about their child’s medication is shared with all partners.  Students are partners in managing their medication needs as developmentally appropriate.  The student’s role can vary from being aware for the need for medication to self-managing their medications.  School staff plays a critical role in the implementation of a medication management plan for a student.  The school staff needs to make sure they are following the procedures of the Student-Focused Medication Management Plan.  Public Health Nurses are available, upon request, to assist with the development and implementation of a medication management plan for a student.
 
All students requiring medication management for physician-prescribed medications should have a Student-Focused Medication Management Plan to ensure that their medication information is complete and accurate.  A copy of the plan should be provided to the parent.  The Medication Management Plan should be updated on a regular basis as needed, minimally on an annual basis.
 
Procedures for the Student-Focused Medication Management Plan
When it is necessary to administer medication to a student, the following must occur: 
    • Send home
      • Request for Medication to be Given at School Letter
      • Student-Focused Medication Management Parent Consent Form
      • Student-Focused Medication Management Plan Form
    • Upon return of these forms, school personnel complete and sign the school section of the forms
    • Receive the prescribed medication and instructions and arrange for its safe storage and control while in the school
    • Medication preparation, administration, monitoring, and recording.

Procedures for Emergency Situations at School
In emergency situations (e.g., Anaphylaxis), every employee has a duty to render assistance to a student, including the administering of medication in accordance with the procedures outlined in the Emergency Medical Management at School: Guidelines for Schools.