Administering medicines

Policy statement

While it is not our policy to care for sick children, who should be at home until they are well enough to return to the setting, We will agree to administer medication as part of maintaining their health and well-being or when they are recovering from an illness. We ensure that where medicines are necessary to maintain health of the child, they are given correctly and in accordance with legal requirements.

In many cases, it is possible for children’s GPs to prescribe medicine that can be taken at home in the morning and evening. As far as possible, administering medicines will only be done where it would be detrimental to the child’s health if not given in the setting. It is advised that the child is kept away from the setting for the first 48 hours to ensure there are no adverse effects, as well as to give time for the medication to take effect. This includes new and previously prescribed mediaction.

Our manager team are responsible for the correct administration of medication to children. This includes ensuring that parent consent forms have been completed, that medicines are stored correctly and that records are kept according to procedures.  We notify our insurance provider of all required conditions, as laid out in our insurance policy.

Procedures

§  Children taking prescribed medication must be well enough to attend the setting.

§  We only usually administer medication when it has been prescribed for a child by a doctor (or other medically qualified person). It must be in-date prescribed for the current condition and kept in its original container.

§  Non-prescription medication, such as pain or fever relief (e.g. Calpol) and teething gel, may be administered, but only with prior written consent of the parent and only when there is a health reason to do so, such as a high temperature. Children under the age of 16 years are never given medicines containing aspirin unless prescribed specifically for that child by a doctor. The administering of un-prescribed medication is recorded in the same way as any other medication. NB We may administer children’s paracetamol (un-prescribed) for children under the age of one year with the verbal consent of the parents in the case of a high temperature. This is to prevent febrile convulsion and where a parent or named person is on their way to collect the child.

§  Children's prescribed medicines are stored in their original containers, are clearly labelled and are inaccessible to the children. On receiving the medication,managment team administrating it  ensures that it is in datecprescribed specifically for the current condition.

§  Parents must give prior written permission for the administration of medication. The staff member receiving the medication will ask the parent to sign a Medication form stating the following information. No medication may be given without these details being provided:

-       the full name of child and date of birth;

-       the name of medication and strength;

-       who prescribed it;

-       the dosage and times to be given in the setting;

-       the method of administration;

-       how the medication should be stored and its expiry date;

-       any possible side effects that may be expected; and

-       the signature of the parent, their printed name and the date.

§  The administration of medicine is recorded accurately each time it is given and is signed by the person administrating the medication and a witness. Parents are shown the Medication form at the end of the day and asked to sign to acknowledge the administration of the medicine. The medication  form records the:

-       name of the child;

-       name and strength of the medication;

-       name of the doctor that prescribed it;

-       date and time of the dose;

-       dose given and method;

-       signature of the person administering the medication [and a witness]; and

-       parent’s signature.

• If the administration of prescribed medication requires medical knowledge, we obtain individual training for the relevant member of staff by a health professional.
• If rectal diazepam is given, another member of staff must be present and co-signs the Medication form.
• No child may self-administer. Where children are capable of understanding when they need medication, for example with asthma, they should be encouraged to tell their key person what they need. However, this does not replace staff vigilance in knowing and responding when a child requires medication. 
• We monitor the medication records, They are monitored to look at the frequency of medication given in the setting. For example, a high incidence of antibiotics being prescribed for a number of children at similar times may indicate a need for better infection control.

Storage of medicines

§  All medication is stored safely in a cupboard at reception or refrigerated as required. Where the cupboard or refrigerator is not used solely for storing medicines, they are kept in a marked plastic box.

§  The management team is responsible for ensuring medicine is handed back at the end of the day to the parent.

§  For some conditions, medication may be kept in the setting to be administered on a regular or as-and-when- required basis. Management team check that any medication held in the setting, is in date and return any out-of-date medication back to the parent.

Children who have long term medical conditions and who may require ongoing medication

• We carry out a risk assessment for each child with a long term medical condition that requires on-going medication. This is the responsibility of our manager alongside the key person. Other medical or social care personnel may need to be involved in the risk assessment.
• Parents will also contribute to a risk assessment. They should be shown around the setting, understand the routines and activities and point out anything which they think may be a risk factor for their child.
• For some medical conditions, key staff will need to have training in a basic understanding of the condition, as well as how the medication is to be administered correctly. The training needs for staff form part of the risk assessment.
• The risk assessment includes vigorous activities and any other activity that may give cause for concern regarding an individual child’s health needs.
• The risk assessment includes arrangements for taking medicines on outings and advice is sought from the child’s GP if necessary where there are concerns.
• A health care plan for the child is drawn up with the parent; outlining the key person’s role and what information must be shared with other adults who care for the child.
• The health care plan should include the measures to be taken in an emergency.
• We review the health care plan every six months, or more frequently if necessary. This includes reviewing the medication, e.g. changes to the medication or the dosage, any side effects noted etc.
• Parents receive a copy of the health care plan and each contributor, including the parent, signs it.

Managing medicines on trips and outings

• If children are going on outings, the key person for the child will accompany the children with a risk assessment, or another member of staff who is fully informed about the child’s needs and/or medication.
• Medication for a child is taken in a sealed plastic box clearly labelled with the child’s name and the name of the medication. Inside the box is a copy of the consent form and a card to record when it has been given, including all the details that need to be recorded in the medication record as stated above.
• On returning to the setting the card is stapled to the medicine record book and the parent signs it.
• If a child on medication has to be taken to hospital, the child’s medication is taken in a sealed plastic box clearly labelled with the child’s name and the name of the medication. Inside the box is a copy of the consent form signed by the parent.
• This procedure should be read alongside the outings procedure.

  Policy and procedure for EPI-PEN

  If a child has been prescribed an EPIPEN, the parent/career will provide a care plan for the individual child and a clearly named box containing 2 EPIPENS and any other medication to be kept in the setting. 

• ·  The medication should be prescribed for the child by a doctor and be clearly labelled. 
• ·  It is the parent’s responsibility to ensure that the EPIPENS are within expiry date. 
• ·  The care plan provided by the parent will provide a thorough guide to the use of the EPIPEN for that individual child and should be followed accordingly. 
• ·  Only staff within the nursery that have received current training in the use of an EPIPEN will administer the EPIPEN. However, staff that have not received the training may witness the administration of the EPIPEN and assist with the necessary procedures and paperwork. 
• ·  Staff will be required to attend yearly EPIPEN training as long as there is a child or an adult in the setting that has been prescribed with an EPIPEN. 

• In the event of a child showing signs of allergic reaction or anaphylaxis, the child’s INDIVIDUAL CARE PLAN should be followed. If EPIPEN or PIRITON is administered, all necessary paperwork must be completed, and signatures obtained as soon as possible. When ever an epi pen has been administered emergency services will be called, the epi pen box must be stabled to the incident form. Once an epi pen has been administered the time of administration and the type of epi pen should be clearly written across the child’s forehead in marker. 

  If EPIPEN has been used, a child MUST NOT return to nursery until EPIPEN medication has been replaced and there are 2 EPIPENS for the child on site. Obtain support and assistance from the Health Visitor.
  We are unable to accept children who have been prescribed epi pens onto the premises without their medication. Children who have out of date epi pens will also be unable to attend until we have been provided with two in date epi pens. Although we will Endeavour to remind parents when their child’s epi pen expires, it is the responsibility of the parents to ensure that their child’s epi pen is in date. 

  Preventative measures to avoid anaphylaxis or allergic reactions are taken in the nursery including – 

• ·  Staff and other families should be made clearly aware. 
• ·  All food should be checked for possible allergens and avoided. 
• ·  Cooking recipes should be adapted accordingly to avoid the allergens. 
• ·  Food packaging used for junk modeling etc should be carefully checked and avoided if necessary. 
• No foods or snack from outside are permitted in nursery, all food is cooked an prepared on site. 

• EPIPENS marked with child’s name and photograph will be kept in first aid cupboard at reception  All necessary paperwork, medication and a telephone should be taken on any occasion when leaving the Nursery for a walk or trip. Necessary documentation should be obtained as per insurance details attached.