Section 216-RICR-20-10-4.24 - Medication AdministrationA. Each school district or authority must develop protocols or procedures related to medication administration in schools that include, at a minimum, the following provisions:1. A school nurse must administer medication(s) to student(s) within the public school setting except as provided in §§ 4.21.4(F), 4.22.1, 4.24.3, 4.24.4, or 4.24.5 of this Part. The school nurse must be licensed in Rhode Island in accordance with the requirements of R.I. Gen. Laws Chapter 5-34. He or she must also be certified in accordance with the provisions of R.I. Gen. Laws § 16-21-8. a. All medications, including prescription and over-the-counter (OTC), must be administered only in accordance with a written order from a licensed health care prescriber, except as provided in §§ 4.21.4(F), 4.22.1, 4.24.3, 4.24.4, or 4.24.5 of this Part. All medications must be administered in keeping with safe standards of health care practice and in accordance with all applicable State and Federal laws and Regulations.2. A school nurse or other registered nurse must administer medication to student(s) in a non-public school except as provided in §§ 4.21.4(F), 4.22.1, 4.24.3, 4.24.4, or 4.24.5 of this Part. Such a registered nurse must be licensed in Rhode Island in accordance with the requirements of R.I. Gen. Laws Chapter 5-34.3. No lay person, other than a parent, may administer medication to a student in the school setting. Exceptions: §§ 4.21.4(F) and 4.22.1 of this Part (related to the administration of epinephrine and glucagon).4.24.1Provisions Related to Nurse AdministrationA. Each dose of medication administered by a school nurse or other registered nurse must be documented. Documentation must include: date, time, dosage, route of administration and the signature of the school nurse or other registered nurse administering the medication or supervising the student in selfadministration. In the event a dosage is not administered as ordered, the reason(s) therefore must be noted.B. All medications to be administered by the school nurse or other registered nurse, as provided in this Part, must be kept in a secured cabinet.C. A licensed provider's (with prescriptive privileges) order must be obtained and verified by the school nurse or other registered nurse for all medications to be administered by the school nurse or registered nurse, including school physician standing orders. Verbal orders to the nurse and facsimile transmissions may be accepted. Verbal orders must be followed up by a written order from the licensed prescriber within three (3) working days. Upon receipt, the orders must be confirmed with the parent by the nurse.D. For prescription medications, all parent authorizations and licensed provider's orders must be renewed no less than annually by the school nurse or other registered nurse. 4.24.2Controlled SubstancesExcept as provided in § 4.2.5 of this Part, no controlled substance is permitted to be in the possession of or administered by anyone other than a school nurse, other registered nurse, licensed prescriber, or parent of the child for whom the medications have been prescribed. A student may deliver his/her own medication to school in accordance with protocols or procedures developed by the school but may not self-administer the controlled substance while on school property.
4.24.3Self-Carry and Self-Administration of MedicationA. All school districts or school authorities must develop protocols or procedures to permit students to self-carry and/or self-administer prescription medication if the student, parent, school nurse or registered nurse, and licensed prescribing health care provider enter into a written agreement that specifies the conditions under which the prescription medication must be self-carried and/or self-administered. The school principal must be informed of the existence of said agreement.1. School districts or school authorities may develop protocols or procedures to permit students to self-carry and/or self-administer medication that does not require a licensed prescriber's note. In developing such protocols or procedures, school districts or school authorities must give consideration to such factors as the age of the child, the duration of the need for the medication, and the ability of the child to self-administer.B. The protocols or procedures related to student self-administration of medication must include provisions for the following:1. All medication must be stored in its original prescription or manufacturer-labeled container.2. For prescription medication, a licensed health care prescriber's written order is required.C. A student is prohibited from sharing, transferring, or in any way diverting his/her own medication(s) to any other person.4.24.4InhalersA. Each school district must develop a procedure to allow students to carry and use prescription inhalers while in school or at a school sanctioned function or event, when prescribed by a licensed healthcare provider with prescriptive privileges. Students who carry inhalers must provide the school with medical documentation that the inhaler has been legitimately prescribed and that the child needs to selfcarry due to a medical condition. No child shall be disciplined for failure to provide such documentation in advance.1. No school teacher, school administrator, or school health personnel, or any other school personnel will be liable for civil damages which may result from acts or omissions in the use of prescription inhalers by children which may constitute ordinary negligence. This immunity does not apply to acts or omissions constituting gross negligence or willful or wanton conduct.4.24.5Medication Administration at Off-site School-sponsored ActivitiesA. Each school district or non-public school authority must develop a procedure or protocol to allow students to self-carry and self-administer a day's supply of medication for each day off-site, including a controlled substance, during an offsite school-sponsored activity. 1. The medication must be supplied by the parent with a parent's written authorization for use of the medication during the off-site school-sponsored activity and must be stored and transported in its original prescription-labeled container (in the case of a prescription medication) or its manufacturer-labeled container (in the case of a non-prescription medication).2. In the case of a prescription medication, a licensed health care prescriber's written order must be provided, if it is not already on file in the school.3. A student is prohibited from sharing, transferring, or in any way diverting his/her own medication(s) to any other person.216 R.I. Code R. 216-RICR-20-10-4.24
Amended effective 4/11/2022