The Linn-Mar Community School District seeks to provide a safe environment for students, staff, and visitors who are at risk of potentially life-threatening incidents including severe allergic reactions, respiratory distress, and opioid overdose. Therefore, it is the policy of the district to annually obtain a prescription for epinephrine auto-injectors, bronchodilator canisters and spacers, and/or opioid antagonists from a licensed health care professional, in the name of the school district, for administration by a school nurse or personnel trained and authorized to administer to a student or individual who may be experiencing an anaphylactic reaction, respiratory distress, or acute opioid overdose.
PROCUREMENT AND MAINTENANCE OF SUPPLY
The district shall stock a minimum of the following for each attendance center:
- Two epinephrine auto-injectors;
- Two bronchodilator canisters and spacers; and
- Two doses naloxone or other opioid antagonist.
The supply of such medications shall be maintained in a secure, easily accessible area for an emergency within the school building, or in addition to other locations as determined by the district.
The school nurse or trained and authorized personnel shall routinely check stock of medication and document in a log monthly:
- The expiration date;
- Any visualized particles or color change for epinephrine auto-injectors, or
- Bronchodilator canister damage.
The school nurse or trained and authorized personnel shall be responsible for ensuring the district replaces, as soon as reasonably possible, any logged epinephrine auto-injector, bronchodilator canister or spacer, or opioid antagonist that is empty after use, damaged, or close to expiration. The district shall dispose of stock medications and delivery devices in accordance with state laws and regulations.
TRAINING
A school nurse or personnel trained and authorized may provide or administer any of the medications listed in this policy from a school supply to a student or individual if the authorized personnel or school nurse reasonably and in good faith believes the student or individual is having an anaphylactic reaction, respiratory distress, asthma or other airway-constricting disease, or opioid overdose. Training to obtain a signed certificate to become personnel authorized to administer an epinephrine auto-injector, bronchodilator canister or spacer, or opioid antagonist shall consist of the requirements of medication administration established by law and an annual anaphylaxis, asthma, other airway-constricting disease, opioid overdose training program approved by the Department of Education.
Authorized personnel will be required to retake the medication administration course, training program, and provide a procedural skills demonstration to the school nurse demonstrating competency in the administration of stock epinephrine auto-injectors, bronchodilator canisters or spacers, or opioid antagonist to retain authorization to administer these medications if the following occur:
- Failure to administer an epinephrine auto-injector, bronchodilator canister or spacer, or opioid antagonist according to generally accepted standards of practice (“medication error”); or
- Accidental injury to school personnel related to improperly administering the medication (“medication incident”).
REPORTING
Authorized personnel will contact the school nurse or emergency medical services (911) immediately after a stock bronchodilator canister is administered to a student or individual. The school nurse retains accountability for professional nursing judgment with the administration of stock bronchodilator and whether to contact emergency medical services in accordance with Iowa law.
The district will contact emergency medical services (911) immediately after a stock epinephrine auto-injector or stock opioid antagonist is administered to a student or individual. The school nurse or authorized personnel will remain with the student or individual until emergency medical services arrive.
Within 48 hours, the district will report to the Iowa Department of Education:
- Each medication incident with the administration of stock epinephrine; bronchodilator canister or spacer, or opioid antagonist;
- Each medication error with the administration of stock epinephrine, bronchodilator canister or spacer, or opioid antagonist; and
- Administration of a stock epinephrine auto-injector, bronchodilator canister or spacer, or opioid antagonist.
As provided by law, the district, board, authorized personnel or school nurse, and the prescriber shall not be liable for any injury arising from the provision, administration, failure to administer, or assistance in the administration of an epinephrine auto-injector, bronchodilator canister or spacer, or opioid antagonist provided they acted reasonably and in good faith.
The superintendent [or designee] may develop an administrative process to implement this policy.
Adopted: 4/16
Reviewed: 11/17; 12/20
Revised: 3/23; 4/23; 8/23
Related Policy: 504.31; 504.31-E1-E4
Legal Reference (Code of Iowa): §§ 135.185, .190; 279.8; 281 IAC 14.3; 655 IAC 6.2(2)
IASB Reference: 804.05