15. Administration of Medication policy

13.POLICY ON ADMINISTRATION OF MEDICATION

1. RATIONALE AND POLICY CONSIDERATIONS

The early years service must take appropriate actions to ensure the health, safety and welfare of children in their care, including the administration of medication where required, especially in an emergency situation. This policy sets out the procedures to ensure that the administration of medication is carried out in a safe way. It also needs to ensure that no child’s care is compromised and no child will have to leave the service because medication is refused or delayed.

A clear policy with procedures that are understood and accepted by staff members and parent(s)/guardian(s) provides a sound basis for ensuring that children requiring medication receive proper and appropriate care and can attend the service regularly.

The purpose of this policy is to ensure:

· The provision of a clear, structured procedure for staff members to help deal with any need to administer medication to a child

· That any medications required are administered safely and appropriately to children

· That medications are stored appropriately

· That the appropriate procedure is followed by parent(s)/guardian(s) and by staff members

· That there is thorough documentation and recording of any medication administered

Legislation and regulatory requirements

Having a clear, written policy and procedure to ensure the safe storage of medication and the safe administration of medication to a child attending the service is a requirement under Regulation 10 of the Child Care Act 1991 (Early Years Services) Regulations 2016.

Parent/guardian consent for the administration of medication is required under Regulation 16 (1) (j) of the Child Care Act 1991 (Early Years Services) Regulations 2016 .

Under the Safety Health and Welfare at Work Acts 2005 and 2010 and the Safety, Health and Welfare at Work (General Application) Regulations 2007, employers have a duty to ensure the employees’ safety, health and welfare at work as far as is reasonably practicable and to carry out risk assessments and provide safety statements

Children need:

· This policy to ensure that staff responsible for their care have the information and guidance required for the safe storage and administration of medication.

· Their parents/guardians to be kept fully informed of any administration of medication to them and any issues relating to it.

Parents and families need:

· To be confident that procedures are in place in the service that ensure that the service is a safe place for their child and their child’s medication needs will be properly met.

· To clearly understand the service’s role and responsibilities regarding administration and storage of medication including the need for sharing information.

· To clearly understand their own role and responsibilities in relation to the administration of medication for their child, including the need for sharing information.

· To know that should any incident relating to the administration of medication involving their child occur in the service, they will be contacted at the earliest possible time and appropriate action will be taken by staff to ensure their child’s wellbeing, for example calling the emergency services if required.

· To know that, following any investigation, all relevant information will be shared with them.

The staff members need:

· Absolute clarity on the service’s approach to dealing with the administration and storage of any medications

· To be competent (have the knowledge, skills, experience) to administer and safely store medication.

· To know that they will receive appropriate training if required. This may be from a professional (nurse, doctor, pharmacist) if necessary and reasonably possible, to ensure their confidence and ability to store and administer medications safely.

· To be clear on:

· what consent must be obtained;

· the information to be recorded;

· how this information is to be recorded (in what format); and

· who must be informed/notified of any matter relating to administration of medication, what information must be notified, when and in what way.

Management needs:

· To know that this policy provides the information and clarity that both staff members and parent(s)/guardian(s) need in order to ensure that medication is stored and administered correctly thereby maintaining the safety, health and welfare of the children while in the care of the service.

· To ensure that any safety issues and/or notifications of any incidents related to the storage or administration of any medications are brought to their attention, that all required reporting and notifications are carried out appropriately and efficiently.

National Quality Frameworks

Tusla Quality and Regulatory Framework

Síolta: The National Quality Framework for Early Childhood Education

2. Definitions/Glossary

MEDICATION

(OR MEDICINE)

A medication is a substance that is taken into or placed on the body to cure or treat a disease or condition, to relieve symptoms of an illness or to prevent diseases.

ANTI-FEBRILE MEDICATION

Medication used to reduce a raised body temperature. The most common anti-febrile medications used are Paracetamol and Ibuprofen.

HEALTH CARE PROFESSIONAL

Can include the child’s general practitioner (GP), dentist, Public Health Nurse (PHN) or an allied health professional such as a pharmacist.

3. Policy Statement

Parents/guardians have the prime responsibility for their child’s health and should provide the service with information about their child’s medical needs including information on medicines their child needs as well as contact information for their child’s GP. In general Play Together advises parent(s)/guardian(s) to ensure medicines are administered to children before arrival at the crèche and after they have left.

The service manager will discuss and agree with the parent(s)/guardian(s) on what is to be the service’s role in relation to meeting the child’s medication needs, in accordance with this policy.

The written consent of the parent(s)/guardian(s) must be obtained in all cases using Consent Form (see Appendix A). The consent form must be completed in full.

Both prescription and non-prescription medicines (such as Paracetamol) can only be administered where specific written consent has been obtained from the child’s parent(s)/guardian(s). Only medications suitable for children will be given to a child. Where a parent/guardian requests any other medication, the service will seek written confirmation from a registered medical practitioner.

All medications will be administered by a staff member competent and authorised to do so. All medications will be stored safely away from children’s reach and according to manufacturer’s instructions including refrigeration if required. All medication received from parent(s)/guardian(s), administered to children and/or returned to parent(s)/guardian(s) will be fully and accurately recorded (see Appendix B - Medication Administration Record Form).

In respect of those children who have long-term medical needs such as chronic conditions (e.g. asthma, epilepsy, diabetes, severe allergic reactions), written consent of parent(s)/guardian(s) must be renewed when any change to the administration of the medication is made and all the information should be updated in child’s individual care plan.

Any child who may require emergency medication will always be in the care of a staff member who has received the required specific training.

Parents/guardians remain responsible for ensuring that the service has adequate supplies of the medication their child needs (prescription and non-prescription) and renewing any medication for chronic conditions.

In some cases an Individual Care Plan may have been developed and the service ensures that the medication required in the plan is given as detailed. The Individual Care Plan may be drawn up by the relevant health care professional in conjunction with the service if appropriate. Such a plan will include details of any chronic diseases or health issues the child is currently receiving treatment and care for, such as allergies or asthma. The plan documents current medications, medical treatments and other therapeutic interventions and specifies how the service will meet the child’s needs.

The service will only accept prescribed medicines that have been provided in the original container marked with the date, name of the dispensing pharmacist, expiry date and clear directions. The service will only administer medications as prescribed and will not change this at the request of parents/guardians without a registered medical practitioner’s written direction. The service reserves the right to contact a health care professional if authorised staff members are unsure about administering medication to a child, even if the parent/guardian has requested the medication to be administered.

4. Procedures &Practices

Parents’/guardians’ role and responsibilities:

· The parent/guardian must provide the following details on the child’s enrolment to the service:

· Details of any medical condition

· Emergency contact numbers

· GP details – name, address and phone number

· Written details of any medication required (instructions on dosage and times and written consent for staff to administer the medication – see below for further details)

· Information on any allergies

· Special dietary needs

· Parent(s)/guardian(s) provide training for Play Together Staff members regarding each medicine which they expect the service will administer to their child. If additional training is required (epi-pen, inhalers etc) parents/guardians cover the cost of additional staff training. Otherwise the place in Play Together might be refused.

· Parent(s)/guardian(s) must make every possible effort to ensure that the child’s medication needs are met before arriving at the service and after returning home.

· The child must have received the medication for at least 24 hours prior to it being given in the service.

· BEFORE leaving any medicine in crèche, parent(s)/guardian(s) must complete in full the Consent Form for Administration of Medication (see Appendix A) and provide all of the information the service will need to:

· safely store medicines

· administer the necessary medication to their child

deal with any issues or incidents arising relating to their child’s condition or the administration of the medication.

· The Consent Form will also include:

· expected response for medication,

· contra-indications and possible side effects

· how the medication reacts with food, fluids or other medications, e.g. some medications cannot be given with milk, or when taking another medication

· what adverse reactions are possible and what should the staff do if they occur

· In the morning on the first day under the medication : the parents/guardians must fully complete the Medication Consent Form (Appendix A)

· On the following days under the same medicine the parents/guardians don’t have to sign the consent form again but they must inform staff if the medicine was given at home before coming to crèche (on the same day) and fill in the Medication Administration Record (Appendix B) including date, time, dosage and signature. If the medicine was given to a child on the previous day at home, it is not recorded in the medication administration form.

· Medication must be provided by parent(s)/guardian(s) in its original labelled container as dispensed by a pharmacist including the child’s full name, prescriber’s instructions for administration, clear storage instructions, the date it was dispensed and the expiry date.

· Medicines must never be transferred from their original container as dispensed by a pharmacist which includes the prescriber’s instructions for administration.

· Where a recipient needs two or more prescribed medicines, each should be in its own separate container and clearly labelled as above

· At the collection time parents/guardians must sign the completed medication administration form to acknowledge notification for each day that medication is required.

Staff members’ responsibilities:

Parents/guardians must be informed of the policy and procedures on the administration of medications in the service – during the introduction meeting, the policy is signed.

Where informed consent has been obtained for the administration of medicines from at least one of the child’s parents/guardians, then the following will apply:

· Staff will keep the records fully filled in and updated – it has to be clear and recorded properly where the medicine is in the crèche all the time, when it was administrated, and by whom

· Staff must support the parent(s)/guardian(s) at arrival and collection time to follow our procedure of log in and log out of the medicine.

· On the first day of the medication administration (before the staff take the medicine from the parent(s)/guardian(s)) they need to give the parent(s)/guardian(s) the consent form and sign it when received, completed in full

· In the morning on the following days under the same medicine, (before taking the medicine from the parent(s)/guardian(s)) staff need to ask them if the medicine was given at home prior to coming to crèche (on the same day). If the medicine was given to a child on the same day, staff need to give the medication administration record to the parents and ask them to fill it in (including date, time, dosage and their signature).

· All medications will be administered by a staff member competent to do so.

· All medications will be stored safely away from children’s reach and according to manufacturer’s instructions.

· Staff members can only administer medication to a child that has been prescribed for that particular child.

Administering Medication

General points of note:

· Only staff members authorised by the manager to do so, and appropriately trained by the parents for the specific medications, are to administer medication.

· Medication must not be added to the child’s bottle or food unless the registered prescriber has directed that this is how it should be administered.

· The staff members may administer non-prescription medicines (including non-prescription ointments for rashes) according to the written directions but only with prior written informed parental/guardian consent, and supply of the medication.

· No anti-febrile medications are given without the daily approval and notification of the child’s parent/guardian unless not doing so would put the child’s health at risk.

· When a child’s body temperature rises beyond a safe limit it is important that an anti-febrile agent is administered quickly. (See Appendix D for Guidance on the use of Anti-febrile Medication.) Staff members involved must keep records each time they administer medication using the Record of Medication Administration Form – see Appendix B.

· Prescription ointments for nappy rash are not applied unless for specific treatment purposes and where a health care professional has directed their use for the child on whom they are being used. The ointment must be supplied by the parent.

· Instructions which state that a prescribed medication may be used whenever needed must be reviewed with the parent at least at the beginning of each term.

· ‘As needed’ medications for example an inhaler must be labelled with the child’s name and in their original container labelled with the required information (see below for Storage of Medications). Prescription or non-prescription medications are accepted for use only when they are within date. Parents/guardians are responsible for checking an expire date of the medication. If the medicine is out of date, they must replace it.

· Medication must not be used beyond the date of expiration on the container or beyond any expiration of the instructions provided by the health care professional.

· All staff members should follow hygiene procedures for example hand washing and drying.

Before administration of medication

· A second staff member must be present when medications are administered

· Both staff members must confirm:

· That appropriate consent has been given

· That the child’s identification is in accordance with the medication to be administered

· The date and time the medication was last given

· Recipient’s name

· Prescribed dose

· Expiry date

· Written instructions provided by the prescribe on the label/container as dispensed by the pharmacist

· Any possible side effects

· If there is any doubt about any of the procedures, the authorized member of staff should check with parent(s)/guardian(s) and/or a health professional before taking further action.

· It must be checked that the medicine has previously been administered without adverse effect to the child and that parents/guardians have confirmed this is the case– a note to this effect should be recorded in the written parental agreement for the setting to administer medicine.

On administration of medication

· Both staff members must confirm:

· The correct medication

· Medication is given to the correct child.

· The medication is given at the correct time and date.

· The correct dose is given.

· The correct route of administration.

· Appropriate equipment is used to administer the medication dose – for liquids the correct measuring tool provided with the medication.

· The dignity and privacy of the child is ensured as appropriate – for example when medication is required to be administered by a route other than the oral route.

After administration of medication

· Observe child for any possible side effects.

· Where appropriate, observe their response to medication – for example where an anti-febrile agent is administered.

· Return medication to appropriate storage.

· Appropriate management or disposal of any equipment used in administration.

Accidents and Incidents Involving Medications

· Where a child refuses to take the medication prescribed for them, they must not be forced to do so but parent(s)/guardian(s) must be informed as a matter of urgency. If the child not taking the medication leads to an emergency situation, the emergency services and the parent(s)/guardian(s) must be called.

· Failure to administer medication at the time prescribed as requested by a health care professional or parent(s)/guardian(s) should be noted on the Medication Administration Form (Appendix B) with a written explanation of why the medication was not given.

· If a child is mistakenly given another child’s medication, a doctor must be called immediately and the advice given must be followed. The parents of the child who mistakenly received the medication must be called as soon as possible.

· The poisons information line number, GP, Pharmacist and other emergency numbers must be readily available at all times.

Dealing with Emergencies

· Where the emergency plan is created for one child: follow the steps from the plan.

· Where medication is administered in the case of an anaphylaxis or asthma emergency, both the emergency services and the child’s parent(s)/guardian(s) must be notified as soon as possible.

· All relevant staff members need to know where to obtain First Aid and how to summon the emergency services.

· Where a child is taken to hospital by ambulance they must be accompanied by a member of staff who is to remain with them until a parent/guardian arrives (See Accidents and Incidents Policy and Procedures).

· All required information is shared with the emergency services and the child’s parent(s)/guardian(s).

· Staff support is essential following any such incident.

Medications Records

· Staff members involved must keep records each time they administer medication using the Record of Medication Administration Form – Appendix B.

· A medication record must be created and kept for each child to whom medication is, or is to be, administered.

· The record for both prescription and non-prescription medications must include:

· The name of the child

· A consent signed by the parent(s)/guardian(s) to administer each medication

· A medication administration log detailing the checks completed prior to administration of medication to the child including:

· Check of the child’s identification,

· Whether consent was received,

· When the medication was last administered (either at home or in the service),

· Check of the administration instructions, including the name of the medication, the method and times for administration and the required dose,

· Check to ensure the medication is within expiry date,

· The time and date the medication was administered,

· The route and dose of medication administrated,

· The signature of the person who administered the medication and the signature of the witness,

· The time and date, or the circumstances under which, the medication is scheduled to be next administered

· Any side-effects noted after the medication was given or if the dose was not retained because of the child vomiting or spitting out the medication – use Appendix C (Daily Outcome record)

· The number of attempts to give medications that were refused by the child is also documented

Storage of Medications

· All medications brought into the setting are stored according to the manufacturers’ instruction, paying particular note to temperature, sources of moisture, light and sources of contamination and safely out of the reach of children.

· Medicines are stored safely in a secure container in the playroom (labelled) or in the fridge, accessible to authorised persons only.

· Emergency medication such as asthma inhalers and adrenaline pens, must be readily accessible to authorised staff members in case of an emergency when time is of the essence. A copy of the consent form for administration of medication and clear, precise details of the action to be taken should be immediately accessible.

· Sunscreen, special soaps, lotion and nappy creams do not need to be in a locked container but must not be accessible to children.

· Medications requiring refrigeration should be clearly marked and separated from food in an airtight container marked ‘Medications’. Access to the fridge should be restricted.

· Medicines must never be transferred from their original container as dispensed by a pharmacist which includes the prescriber’s instructions for administration.

· Non-prescription medications should be labelled with the child’s full name and the expiry date must be visible and monitored.

· Staff members should only bring their own medication to work when it is absolutely necessary (either prescribed or over the counter). They must ensure that these medications are stored securely so that others (including children and adult service users) do not have access to these medications. This includes for example medications held on the person, held at desks, in their bags, coats or in vehicles.

· Disposal of Medications

· Medication should be always returned to the child's parent(s)/guardian(s).

· If a parent/guardian has not picked up unused medication by 7 days after the required use or it is not possible to return a medicine to the parent(s)/guardian(s), then it should be taken to a community pharmacy for disposal. No medicine should be disposed of into the sewage system or in the refuse.

Sunscreen Application

· The time and frequency of application of sunscreen is to be recorded (Appendix E)

· Written consent is not required to apply sun protection creams supplied by the parent(s)/guardian(s) for their own child as the supplying of the sunscreen gives implied consent for that specific cream.

· Written consent is required from parent(s)/guardian(s) to apply sun protection creams supplied by the service in order that the parent(s)/guardian(s) can advise if a previous adverse reaction may have occurred with the cream supplied by the service.

· As part of the planning process and risk assessment for outings, the medication needs of children are taken into account. Specific measures may be necessary to support those who need to take medication and to ensure sufficient medical supplies are available.

· All staff members participating in the outing must be aware of the medication needs of the children and any agreed medical emergency procedures. A member of staff who has been trained to administer the required medication must be present. All staff must know their role in the event of a medical emergency. A copy of any individual care plans should be taken on outings as the information may be needed in the event of an emergency.

5. Communication Plan for staff & families

All parent(s)/guardian(s) are to be informed of the policy and procedures regarding the administration of medication on enrolment. Staff members will check with parents that they have read and understood the policy and provide any assistance needed.

A summary of this policy will be included in the parent handbook. This policy will also be reviewed with staff members at induction and annual staff training.

A copy of all policies will be available during all hours of operation to all staff and to parents/guardians in the Policy Folder located on Play Together Creche’s website at www.playtogethergalway.com

Policies are shared with all parents/guardians via email.

Parents/guardians may receive a copy of the full policy at any time upon request. Parents/guardians and staff will receive notification of any updates through Play together Creche’s official communication panel.

6. Related Policies, Procedures and Forms

· Infection Control Policy and Procedures

· Policy on Accidents and Incidents

· Outings Policy

· Risk Management Policy

· First Aid Policy

· Illness and Exclusions Policy

· Confidentiality Policy

· Records and Record Keeping Policy

· Critical Incident Plan

· Admissions Policy Application Form

· Medication Administration Consent Form (Appendix A)

· Medication Administration Record (Appendix B)

· Daily outcome record (Appendix C)

· Tusla Guidance on Use of Anti-febrile Medication within the Service (Appendix D)

· Sunscreen application record (Appendix E)

7. References/Supporting Documents/Related Legislation

Child Care Act 1991(Early Years Services) Regulations 2016 and Child Care Act 1991 (Early Years Services) (Amendment) Regulations 2016

Tusla Quality and Regulatory Framework

INTO 39 Guidance on the Administration of Medicines in Schools Implementing Best Practice

Health and Safety in Childcare 2006 Barnardos and the Border Counties Childcare Network (Now NCN)

Managing Medicines in Schools and Early Years Settings DFES UK March 2005

Caring for our Children National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care 3rd Edition 2015 A Joint Collaborative Project of American Academy of Pediatrics, American Public Health Association and the National Resource Center for Health and Safety in Child Care University of Colorado Health Sciences Center

8. Who Must Observe This Policy

This policy must be observed by all managers and all staff members.

9. Actions to be Followed if the Policy is not Implemented

If the policy is not implemented, investigation will be taken by Manager/Owner (Iwona Sawicka).

If you, as a staff member or a parent, consider that this policy is not being implemented, you can follow the Complaints Policy and Procedure to make a complaint.

10. Contact Information

If you need more information about this policy, contact:

Name

Iwona Sawicka

Phone number or email

0833187143

091/458167 or 091/458999

11. Policy Created

Date this policy was created

March 2016

12. Signatures

	Name and position	Signature
Approved by	Iwona Sawicka

13. Review Date

Reviewed	March 2017	Iwona Sawicka
Reviewed	March 2018	Iwona Sawicka
Reviewed	March 2019	Iwona Sawicka
Reviewed and updated Reviewed	March 2020 March 2021	Iwona Sawicka Iwona Sawicka