MEDICATION SAFETY IN CHILD CARE

Healthy Start in Child CareLexington-Fayette Co. Health

Dept.

Presented by: Karen Jones, MS, RD, LD

Thanks to: Shannon Dunn, RN, BSN

Justification of administering medication’s

in day care• When the medication must be

given 3 or 4 times a day.

• When a child has a chronic medical problem which requires urgent treatment.

• When refusal to give a medication would require day care absence in a child who is otherwise well enough to attend day care.

Conditions necessitating the administration of

medication

• Allergies/Asthma

• ADHD

• Illness requiring antibiotics

• Routine symptom control

Prescription Meds

• Should be administered to a child only with the written order of a physician that indicates the medication is for that specific child.

Non Prescription Meds (OTC)

• Need to have original Label

• Needs a parent/guardian signature with dosage as per label, specific frequency, and child’s name

No medication, whether prescription or nonprescription, will be administered to a child without written parental authorization. This authorization must be signed daily!!!

What medications can be safely given?

• Prescriptions from a licensed health professional.

• Medications with original prescription label.

• Medications which all the criteria on Kentucky Regulation have been met.

Labels

• Name of child (first and last)

• Name of doctor (with phone #)

• Name of medicine• Issue date of

medicine

Labels con’t.

• Dosage• Frequency of dosage• Route of

administration• Storage

requirements• Child proof container• An expiration date

Guidelines

• Only trained staff should give medication

• Same provider should give the child’s medication daily

• Ask pharmacists for an extra labeled bottle for day care

• Be sure you get very specific instructions on administration (food, milk, etc.)

Additional Guidelines

• Do not allow parents to add medications to bottles of formula or milk brought in from home

• Learn the drugs possible side effects

• Keep medication log with meds• Always put meds up first, before

leaving room or answering phone

Ideas for parents

• Consult with doctor may be able to change number of times it’s given in day

• Come during lunch hours to give medicines

• Have medicine split into 2 bottles by pharmacist

Morning Health CheckSigns to Observe

• Activity level• Skin color• Unusual spots or

rashes• Swelling or bruises• Sores

• Severe coughing, sneezing• Discharge from eyes, nose, or ears• Breathing difficulty• General mood/unusual behavior

Where should medications be given?

• Location that is private• Where accidental ingestion by

children is unlikely• Where hand washing facilities are

accessible• In a well-lit area• Close to signed consent forms

Storage

• In a refrigerator separated from food (if refrigeration is required)

• A cool, dry, dark, locked enclosure which is not accessible to children

• All unused medications should be returned to the parents

• In a child-proof container

6 rights of drug administration

• Right Child

• Right Dose

• Right Medicine

• Right Route

• Right Time

• Right Documentation

Routes of administration

• Optic = EYE

• Otic = EAR

• Nasal = NOSE

• Oral = MOUTH

• Topical = SKIN

• Rectal = RECTUM

Tips for Giving Medications

Newborns

• Easier to give when hungry

• Use a syringe or dropper at side of mouth in small amounts

Infants

• Hold in a firm, but comforting manner

• Use a medication dropper or syringe

• Support the head while in your lap

• Give small amounts

• Provide physical and verbal comfort

Toddlers

• Provide a sense of autonomy (give a choice)

• Never tell a child medicine is candy!!

• Mix with applesauce or pudding (with MD approval)

• Give a flavored drink.

• PRAISE!!!!

Preschool Children

• Explain importance of med

• Never lie about the taste

• Never tell them it is candy

• Praise child for taking med

Most Common Forms of Medication Given in Child Care

Centers

•Liquid•Tablet •Capsule •Topical

Liquids

Suspension

• Fluid substance with solid particles

• Must be shaken before administering

• Usually refrigerated• Ex. Amoxicillin

Syrup or Elixer

• Sweetened liquid which contains dissolved medicine

• Refrigerated to enhance taste

• Ex. Robitussin

Tablets

• Chewable- ex. Amoxicillin

• Scored- ex. Ritalin (should be split by pharmacist or parents)

• Uncoated and coated- ex. Advil

Capsules

• Swallow whole• Do not crush• Sprinkles are inside of capsule, they

can be sprinkled on food when directed.

*Sprinkling is only done with written authorization of health care provider

Topicals

• Eye drops and ointments

• Ear drops and ointments

• Creams- wear gloves when applying

• Read directions!! Don’t confuse ear drops and eye drops. Notice whether drops need to be shaken or not.

Dosage

• Amount• Age Appropriate• Proper Measuring Devices

– Dosage Cup– Dosage Spoon– Syringe*Do not use kitchen utensils or

silverware

Specific Medications

• Tylenol• Ibuprofen• Cold Medicines• Antihistamines• Anti-diarrhea

Missed Medication

• Medication is dropped on floor• Child refuses to take

medication• Spits out the medication• Any other unusual occurrence• Make note on medication log• Contact parent

F.Y.I.If medicine is spit up or vomited:• 30-45 minutes medicine has been

absorbed• 5-10 minutes (with abx only) you

may need to repeat the dose……so…….Contact parent who may consult with MD and find out what steps need to be taken.

Medication Errors

• Forgetting to give a dose of medication• Giving medication to the wrong child• Giving the wrong dose of medication• Giving the wrong medication• Giving the medication at the wrong

time• Giving the medication by the wrong

route

Incident Reports

• Notify your director

• Notify the parents

• Fill out an incident report/error report

Field Trips

• Field trip medication sheet:– Child’s first and last name– Age, Teacher– Medication, dosage, route, time to be

given– Person giving med– Date and time med was given– Parents and Doctors number

Emergency Medications

• EpiPen for severe allergic reactions

• Asthma rescue inhaler

• Use of ipecac is no longer recommended

Important Summary Tips

• Never refer to medicine as candy• Be honest about the taste of

medication• Be aware of rules regarding mixing

medicine with food or liquids• Always finish a prescription