Who can administer medications?
Any adult in your program who is administering medication should complete a standardized training course that includes skill and competency assessment. This course is designed as an overview. It's giving you the basics, but it is not sufficient for an adult who is administering medication, especially specialized medications such as injections. You should have one or more people who are designated in your program to give medications and they must be trained. The trainer should be a licensed health care professional. It may be a child care health consultant, the child's physician, a registered nurse, or a licensed practical nurse, but it should be a licensed health care professional.
The skill and competency should be monitored at least annually or if an error occurs. For example, if someone is giving medications to a child and something happens such as the child vomits after it and the person is not sure what to do, that would require that the medication administrator be retrained. Another example is if the wrong medication is given, then be sure that that person is retrained and their skill and competency are frequently checked.
If you have programs where several children require daily medication or even weekly medication, the best practice is to hire a licensed health care professional to give those medications. That's not always possible especially in family child care or small child care programs as you may not be able to have someone there on-site. It is admissible to have a trained teacher, administrator, or someone who is a responsible adult who can be trained to give medication.
However, all staff should be trained and that's the purpose of this webinar. Think about why people need to be trained? Teachers are the ones who greet parents and children every day. They can look for any kind of illness or side effects that might occur from medication. If you know that a particular medication sometimes causes a side effect, then you look for that when they come in. Also, as a teacher or caregiver, you may be the first one to ask, "Has the child had their medication today? What time was it given? Did everything go okay? How's the child feeling?"
Home visitors need to be trained because they may be discussing medication with families. For example, you never know what is going to come up just in conversation. I was walking out on the playground with a parent who mentioned that her child wasn't feeling well and she was giving her medication. Being the nosy person that I am sometimes, I said, "What's wrong and what are you giving her?" Then, for some reason, I said, "How much are you giving her?" It was a liquid medication and she said, "Well, I'm giving one tablespoon three times a day." I immediately knew there was a problem because a tablespoon is not a typical dosage. It turned out that the pharmacy had made a mistake on the label. The parent was doing what was written but it was not correct. In your conversations with parents, ask what's going on. If something strikes you that it might not be right, then go ahead and check further into it.
Vehicle drivers and attendants must administer first-aid, transport medication, and talk with parents. They might be dealing with emergency medications. Your food service staff may be avoiding ingredients that interact with medication. For example, some medications cannot be taken with dairy products. Also, a child may have an allergic reaction to food, so food service staff would need to know about emergency medications.
This Ask the Expert is an edited excerpt from the course, Administration of Medication in ECE Settings, in partnership with Region 9 Head Start Association, by Charlotte Hendricks, PhD.