First Aid and the Administration of Medicines (including EYFS)

This policy needs to be read in conjunction with –

$1·       Health and Safety Policy – Administration of Medication and First Aid.

$1·       Medicine Administration record

Staff can discuss with medical staff the impact of medication on students and the main types of drugs used at Barnardiston Hall Preparatory School. It is important that staff recognise the most common side effects of medication as listed on the medical condition sheets or highlighted in staff meetings.

The key to the medication cupboard is kept on the Duty Keys Lanyard issued to Boarding Staff on Duty. Sister and Mr Whittles have their own set of keys.

At no time should an unlocked medication cupboard be left unsupervised.

What is medication?

Within the School, medication is defined as a drug that is used in the treatment or prevention of disease. This is in comparison to a drug which can be any substance which, when taken into the body, may modify one of its functions or structures. Consent for both prescribed and household medications is obtained on the school medical form, which is completed when the child joins the school.

When staff are asked to administer medication by the Medical Sister or the child’s own GP, they are encouraged to research and understand that medication. Leaflets produced by pharmaceutical companies are good sources of information and should be retained.

 

When may medication be given?

The school’s policy on medication states that it is the responsibility of parents to send medication with clear instructive label issued by the pharmacy. Staff must not administer any medication without these clear instructions.

Pharmacy labels serve as our permission to administer medication to the prescribed instructions of a medical doctor. The pharmacist label should state the following –

$1l  Who the drug is for.

$1l  When the medication was dispensed.

$1l  How many tablets were dispensed.

$1l  What the medication actually is – e.g. Amoxycillin.

$1l  What the strength of the medication is –i.e. 100mg tablets or amount of medicine in suspension within a liquid medicine.

$1l  Directions as to how they should be taken i.e. one to be taken twice a day.

$1l  Specific advice, the most commonly given include –

$11.    Take at regular intervals.

$12.    Complete the course.

$13.    Take before or after food.

$14.    Do not drink alcohol whilst taking.

All pharmacy labels give directions as to how, when and how much medication ought to be taken.

Staff should note that Latin abbreviations are often used on pharmacy labels. The following is a list of the most commonly used abbreviations, however all pharmacy labels have an English annotation as well.

            Other Important Directions

$1·       Swallow whole, do not chew – this can be a challenge with very young children or those that are very rigid in their likes and dislikes. However, we cannot crush tablets that are directed to be taken as whole. The drugs product license will have been granted on the grounds of them being taken whole. A number of medications are designed to slow release the active ingredient throughout a set period of time, if crushed they lose the chemical capacity to do this.

$1·       Apply sparingly. As a rule, cream ought to be applied to the skin until it becomes slightly tacky. Within the school it is good practice to wear protective gloves when applying any type of cream.

$1·       Medication that is directed to be taken before food is so directed because food will retard the absorption of the medication. Other reasons that medication should be taken immediately before food might include the fact that some medication suppresses the appetite if taken well before a meal.

$1·       Medication prescribed with or after food can be affected by the acids in the stomach or cause irritation to the stomach so need the food to act as a buffer

$1·       The ‘As Directed’ direction can be confusing. It is the school’s policy for Sister to seek more specific advice from the parents or school doctor before administering at school.

Other issues

$1·       directions for staff to give fractions of tablets should be referred to Sister. Wherever possible medicines should be administered in whole tablets. The use of liquid medicine should be considered instead of dealing with the issue of fractions. Sister will advise.

The school advocates an approach that emphasises the six rights of administration when dealing with medication. These are:

$11.    The right CHILD/YOUNG PERSON.

$12.    The right MEDICINE.

$13.    The right DOSE.

$14.    The right TIME.

$15.    The right ROUTE.

$16.    The right WAY.

Giving medicines protocol

 

$11.    Check that the child is the right one.

$12.    Concentrate on the task at hand.

$13.    Find the medicine in the medication cabinet and check the label.

$14.    Measure the dose.

$15.    Take the medicine to the child or bring the child to the medicine.

$16.    Give the medicine and offer a drink of water.

$17.    Record immediately what has been given or declined.

Administering Topical Medicines

These are considered just as important as any oral medicine. We follow the protocols below when using tubes or drops. When we open a new tube, jar or drop bottle we record the date of opening on the container, i.e., D.O.**/**/**.

Unless labelled otherwise the general guidance for expiry dates is:

$1·       Jars – discard one month after opening.

$1·       Tubes – discard three months after opening.

$1·       Eye drops and eye ointment – discard four weeks after opening.

 

Administering Nasal Drops and Ear Drops

Nasal Drops

$11.    Wash hands.

$12.    Request that the student sits in a chair

$13.    Tilt their head backwards.

$14.    Put the required number of drops into each nostril.

$15.    Keep the student’s head tilted back for two minutes.

$16.    Replace cap on the bottle

Ear Drops

$11.    Wash hands.

$12.    Request that the student lies or sits down and tilt the head to bring the ear uppermost.

$13.    Gently pull the ear backwards.

$14.    Put the correct number of drops into the ear. Do not push the dropper into the ear.

$15.    Get the student to remain in the same position for two minutes.

 

 

 

 

Administering Eye Drops and Eye Ointment

Eye Drops

$11.    Wash hands.

$12.    Tilt the student’s head backwards.

$13.    Pull down the lower eye lid.

$14.    Put the correct number of drops inside the lower lid without touching the eye.

$15.    Ask the student to close their eyes.

$16.    Wipe away any excess with a clean tissue.

$17.    Replace the cap and store in a cool place.

$18.    Discard four weeks after opening.

$19.   

Eye Ointment

$11.    Wash hands.

$12.    Tilt the head of the student backwards.

$13.    Pull down the lower lid.

$14.    Squeeze half an inch of ointment inside the lower lid without touching the eye.

$15.    Close the eyes or blink.

$16.    Wipe away excess with a clean tissue.

$17.    Replace the cap and store in a cool place.

$18.    Discard four weeks after opening.

Transdermal Patches

$11.    Wash your own hands and then put on disposable gloves.

$12.    Ensure that the skin of the student is dry and clean.

$13.    Apply to different sites to void the student developing sore skin.

$14.    Dispose of the old patch by folding in half.

 

Inhalers

$11.    Shake inhaler.

$12.    Ask the child to breathe out and to form a tight barrier around the inhaler. Inhale and count to 10 before asking the child to breathe in again.

$13.    Ask the student to rinse their mouth out with water after using a steroidal inhaler, i.e., pulmicort and becotide.

$14.    If the student is using a spacer to inhale, follow the same instructions as above.

$15.    To not use soapy water to rinse out spacers as the soap can effect the medication.

$16.    Specific pupils may have been asked to take their inhalers whilst lying down on beds, follow the specific directions on an individual’s medication.

Other Routes of Administration

$1·       Dressings

Staff may apply simple dressings such as plasters where they do not compromise the child’s dignity. Child Protection protocols apply.

As of November 2003, school staff must not to administer medication by

Vaginal preparations

Suppositories

Injections

In the case of need we work closely with our health colleagues.

All administration by the methods highlighted above will be cross referenced to an individual student’s intimate care protocols and parental permission slips.

The Law

$1l  Anyone can administer a prescription only medicine to another person provided it is in accordance with the directions of a doctor as outlined on the label. The exception to this rule is in the case of injections.

$1·       Medicines that are prescribed for an individual student are that person’s property and may not be used by any other person.

$1·       Doses of prescribed medicines must not be varied without the doctor’s consent.

Storage of medications

 

Within the school we use locked medication cabinets attached firmly to walls in order to store medication.

Exceptions:

$1·       In –Use of asthma inhalers, which should be kept on or with the child

$1·       Epipens should be with the child for emergency use for Anaphlaxis

$1·       The fridge for to store specific medication which need chilling. Medication is kept within a locked cash tin within the fridge. Never store the box at the back of the fridge, as it is too close to sources of cold. We store medication on a shelf with the temperature of the fridge monitored to be between 2-8C.

In the case of controlled drugs such as Ritalin  it is stored within a designated controlled drug medication cupboard.

Storage of medication whilst out on educational visits is the responsibility of the member of staff leading the activity. That staff then administers them and records when back at school.

For any pupil who is prescribed sublingual diazepam it is important that an identified member of staff carries an emergency pack and is trained to administer it.

 

Medication Administration Record

 

We aim to establish a clear audit trail when dealing with the receipt of medication into the school, its storage, administration and dealing with unwanted and discontinued medication.

Requests for the administration of medication can be made by parents by telephone. They then send medication into the school with their child. The school obtains medication for boarding children through the school Doctor.

The recording of controlled drugs is via the drug book. Tablets brought in, their administration and the balance of tablets held must at all times tally.

Emergency Supplies

There are very occasional incidents when the school requires emergency supplies of medication. These come in to the school on GP advice and prescription.

Verbal Orders for Dosage Alteration

It is sometimes necessary to take verbal orders from a doctor in order to change the dosage of a prescribed medication. The following records will be made in such circumstances:

$1·       Record immediately what has been said.

$1·       Record the doctor’s name.

$1·       Record the child’s name.

$1·       Record the name of the medicine.

$1·       Record the new dose and frequency.

$1·       Note any special directions.

$1·       Repeat back to the doctor to check understanding.

$1·       Record the time.

$1·       Sign and date medication sheet with witness.

$1·       Ensure that doctor signs the medication sheet on next visit.

Self Administration of Medication

It is acknowledged that one objective of residential education is to enable the individual student to live as independently as possible. This may be through teaching them to administer their own medication.

To assess whether or not an individual boarder is ready to start the process of self administration the following factors are taken into account –

$1·       The boarder’s motivation to self administer.

$1·       The degree of insight and understanding the boarder has into the issues around medication.

$1·       The boarder’s desire for independence.

$1·       The boarder’s memory: are they likely to remember to take their medication?

$1·       Any relevant personal and health information that may indicate that self administration would prove too risky.

The following practical issues need also to be taken into account –

$1·       The physical ability of the boarder to actually self medicate.

$1·       The toxicity of the medicine itself.

$1·       The need for a particular medication.

First Aid

In the Residential Department all designated first aiders hold a First Aid Certificate.

In the Prep School                 

Debbie Bavester

Anne Jessop

Davina John

Claire Gilliar

Ann Mansfield

Gill Dowsett            Tim Poole         Jack Cliffton

Melinda Statham        Emma Cross

Christine Fuller

David Roach

Lucy Macrae

Hadley Wilcox

John Winter

Paul Conway

Kate Gurney

Tim Dodgson

Tom Clifton

Debbie Clifton

Val Rozier

Hayley Hart

Kath Egan

 hold the Emergency First aid in the Workplace certificate

Mr Whittles

 

Mr Gamble

Mr Wilcox

Mr Conway

hold the First Aid in the Workplace Certificates (3 day course)

All pre prep teaching staff hold the Paediatric First Aid Certificate (2 day course)

All first aid training is updated every 3 years. It is our policy for all staff to receive First aid training to ensure that there is always a qualified person when children are present.  Guidance on when to call an ambulance is given in the First aid training.

It is the policy of the School that a first-aider will in the immediate vicinity whenever children are present.

First Aid boxes are situated in the Surgery, main kitchen, domestic science room, CDT and Art block, and emergency eye wash in the science lab. Sports teachers are issued with First Kits. Travelling First Aid Kit should be taken on all outings. Kits are kept on each of the School vehicles.

The students at the school are registered with a G.P. local to the school. If the child falls ill at home they are to be seen as a temporary resident.

All pupils at the school have a personal medical/accident record kept on the computer in the school surgery in accordance with Data protection, using the Patient Tracker Program. A written daily log of Accidents, illness and medication is also kept. This is found on the desk in the surgery. In accordance with RIDDOR (Reporting of injuries, Diseases and Dangerous Occurrences Regulations 1995) We report to the Health And Safety Executive Telephone 0845 300 99 23) the following:

$1a)      Deaths

$1b)      Major injuries

$1c)      Over–three-day injuries

$1d)     An accident causing injury to pupils, members of the public or other people not at work.

$1e)      A specified dangerous occurrence, where something has happened which did not result in an injury, but could have done.

Parents are informed of any illness or accidents via the telephone it is logged in the day book and on computer when the call was made. Children who have bumped their head in the playground are issued with printed sheets with head injury advice.  In the case of EYFS children, parents will be asked to sign their individual accident sheet.

Pupils with particular Medical conditions are treated as individuals and care plans devised as appropriate.

The School Health Team

The school Health Team consists of a school nurse and a school doctor.

It is their role to undertake the prescribed developmental checks, to administer vaccinations and attend to the periodic medical checks. The school nurse compiles the student Health Care Plans

The person to contact in case of a communicable disease is: The West Suffolk Health District Communicable diseases dept.

There above numbers are to be found in the daily medical book.

Information from Parents regarding Students Health needs

On induction into the Boarding department all prospective students’ parents are expected to share key medical information. This should detail emergency contact numbers, medical information (including medication, type, time, dosage and route of administration), Allergies, Special Diets, Important Medical needs (asthma diabetes, epilepsy, and anaphylaxis), Name and address of G.P.

Emergency Assistance

If a student becomes unwell or is injured whilst at school they will be looked after either in the Sick-bay or in their bedroom, whichever is thought to be more appropriate, until their parent can collect them to take them home. It is the responsibility of the school nurse or duty first aider to seek medical advice from G.P or hospital.

In case of emergency treatment being needed, the school will phone for an ambulance,  arrange for a staff member to accompany the student to hospital, contact student’s parents and wait with the student until parents arrive.

The staff member is to be aware of any religious/cultural wishes to be communicated to hospital staff in the absence of the students’ parents.

Staff may sign consent forms

$1·       In an emergency when unable to contact parents or guardians

$1·       When parents cannot be present but give consent by telephone

Epileptic Fits

$1·       Protect from injury but do not restrain

$1·       Place in recovery position

$1·       Do not move child unless in a dangerous location.

$1·       Place something soft under the head.

$1·       Do not place anything in the child’s mouth

$1·       Try to ensure privacy

$1·       If fit continues for more than 3 minutes telephone 999. Do not administer Sublingual Diazepam unless trained to do so and it has been prescribed by G.P.

$1·       Do not move child until fully recovered from seizure. Someone should stay with the child until fully recovered.

Asthma attacks

Symptoms may include:

$1·       Increased coughing

$1·       Wheezing

$1·       Tightness in the chest

$1·       Breathlessness- drawing in of rib-cage

$1·       Blueness of lips (CAUTION – a very late sign)

 Management of an Acute Attack

$1·       Stay calm and reassure the child.

$1·       Ensure the ‘reliever’ medicine is taken promptly.

$1·       Encourage the child sit and lean forward without squashing the stomach.

$1·       Loosen tight clothing, offer sips of water (not cold) to keep mouth moist.

$1·       If there is any doubt about the child’s condition – if they are unable to talk, is distressed, reliever has not worked within 5-10 minutes, or child is exhausted – dial 999 call an ambulance.

$1·       If the attack responds quickly to treatment, the child may continue in school. Parents must be informed of the details of the attack.

General Guidance for Day to Day Management

$1·       Medication must be readily available to staff. In the Boarding department the medication are with the child.

$1·       Remember to use the reliever as a preventative measure prior to exercise, if needed.

$1·       Staff are to take the devices & medication on trips out of school.

$1·       Be vigilant for signs of attack.

$1·       In the event of a child not having an inhaler available a spare inhaler, not necessarily their own should be used.

This is the only situation when another person’s medication could be used

Allergy and anphylaxis care

Causative factors

$1·       Food (peanut, egg, dairy produce, shell fish)

$1·       Drugs (penicillin)

$1·       Venom of stinging insects

Symptoms

Usually occur within minutes. A combination of symptoms can be present, such as:

$1·       Itching/tingling sensation

$1·       Swelling of throat and tongue

$1·       Difficulty in swallowing/breathing

$1·       Flushing of skin

$1·       Abdominal cramps/nausea/vomiting

$1·       Sudden feeling of weakness

$1·       Collapse and unconsciousness

Treatment is urgent and essential to prevent severe anaphylactic syndrome.

There are two main types of medication

$11.    Antihistamines (Piriton, Zirtec)

$12.    Preloaded Adrenalin injection (Epipen)

There should be no serious side effects if the medication is given repeatedly or is mis-diagnosed. Relapse is possible after apparent recovery. Medical attention must be sought inn every case.

Emergency Management

$1·       Epipen should be used immediately in a severe reaction.

$1·       If in doubt about the severity use the Epipen anyway!

$1·       Dial 999 call an ambulance

Hygiene procedures for dealing with spillage of body fluids

Children who are vomiting in school will be sent home or back to the boarding house if they are Boarders, in order to curtail the spread of infection.

Children should not return to school for at least twenty four hours and until they have eaten poperly for a whole day.

Any body fluids on floors should be covered with Resolve powder or its generic equivalent. This should be left for a minimum of two hours so that the antibacterial elements can work. This should then be swept up using gloves, a dustpan and brush, and the floor should be hoovered. The swept up vomit should be disposed of in the appropriate manner.

Early Years

Staff should ensure that they have sufficient information about the medical condition of any child with long-term medical needs. Ask parents about the medicines that their child needs to take and provide details of any changes to the prescription or the support required.

If the administration of prescription medicines requires technical/medical knowledge then individual training should be provided for staff from Sister Durrant. Training should be specific to the individual child concerned.

Medicines should not usually be administered unless they have been prescribed for that child by a doctor, dentist, nurse or pharmacist. Written permission for each and every medicine must be obtained from parents.

Non-prescription medication e.g. pain and fever relief or teething gel may be administered, but only with the prior written consent of the parent and only when there is a health reason to do so.

A child under 16 should never be given medicines containing aspirin unless it has been prescribed for that child by a doctor.

Medicines should be stored strictly in accordance with product instructions and in the original container in which dispensed. They should include prescriber’s instructions for administration. Medication should be kept in a locked cupboard inaccessible to children in and in line with our Policy above.

Specific legal requirements

 Early Years/ Pre-Prep School Illnesses and injuries

All regular members of Pre Prep staff have been trained and are qualified in Paediatric First Aid.

Ofsted and Suffolk SCB will be notified by Sister Durrant of any serious accident, illness or injury to, or death of, any child whilst in their care, and of the action taken in respect of it. Notification must be made as soon as is reasonably practicable, but in any event within 14 days of the incident occurring.

First aid boxes with appropriate content to meet the needs of children are located in the Nursery and in each year group classroom. A more substantial first aid box is located in Class 1b area. Staff must inform Sister of items used so they can be replaced. 

A record of accidents and first aid treatment, and the administration of medications, is kept by each form teacher and passed on the the next class as children progress through the school.  Parents of any child who has had an accident or injuries will be given details of the accident and of any first aid treatment or medication that was given.

Early Years Children who are ill or infectious

School will inform parents of infections and the procedure for children who are ill or infectious.

Children who are ill or infectious should be excluded from school and under the care of parents until their infectious period has passed and they are well enough to return to school.

Animals on the premises are safe to be in the proximity of children and do not pose a health risk.

If we have reason to believe that any child is suffering from a notifiable disease identified as such in the Public Health (Infection Diseases) Regulations 1988, Sister Durrant will inform Ofsted , who will be informed of any actions taken by the school.

We actively promote the good health of the children, take necessary steps to prevent the spread of infection, and take appropriate action when they are ill.

Specific legal

 

 

Food and drink

Children provided with meals, snacks and drinks:  The catering department ensure that these are healthy, balanced and nutritious. The catering department are responsible for the preparation and handling of food. They are trained and certified in food handling and the preparation of food.

School obtain, record and act on information from parents about a child’s dietary needs. Special diets are catered for. Parents may choose to provide their own food which should be handed over to the catering department for safe keeping.

Fresh drinking water is available at all times.

Ofsted will be notified by Sister Durrant of any food poisoning affecting two or more children looked after on the premises. Notification will be made as soon as is reasonably practicable, but

in any event within 14 days of the incident occurring.

We are aware of our  responsibilities under food hygiene legislation including registration with the relevant Local Authority Environmental Health Department.

Last Updated on Friday 06/01/12 10:56