What is the policy for TB (Tuberculosis) Medication Administration in Schools? | CCSD HealthOffice Support

What is the policy for TB (Tuberculosis) Medication Administration in Schools?

12-1-2010

Tuberculosis Medication (TB Meds)– Administration in Schools

I. PURPOSE / APPLICABILITY: To define the roles and responsibilities of Southern Nevada Health District (SNHD) and the Clark County School District (CCSD) in meeting the TB medication needs of students requiring medication at school.

II. INDICATIONS:Students who have been diagnosed with active or latent TB and require medication during school hours. 

III. PROCEDURE:A. SNHD will determine what clients are appropriate to receive medication at school: 

  1. Student has been diagnosed with latent or active TB disease
  2. Student is not contagious as determined by: 
  1. 3 negative sputums, and student has been on medication for two weeks
  2. Student is being treated for latent TB and is therefore not contagious

B. Establishing School Based Directly Observed Therapy (SBDOT)

  1. SNHD will coordinate with the CCSD school nurse to establish a medication regimen at a Clark County school.  The regimen will include how frequently the medication will be provided, the medication and who will be bringing the medication to the school. 
  2. SNHD will have on hand the school medication release form (CCF 643). SNHD staff will obtain from the parent/legal guardian their authorization for medication release during the initial intake of the student for SBDOT.  On this form under “reason for medication” SNHD will cite if this is preventative therapy or treatment for TB.
  3. SNHD will make an appointment to visit the school to set up the program and bring the following to the school nurse:
  1.  CCF 643 signed by parent/guardian
  2.  Clinician orders for each medication
  3.  The medication
  4.  Direct Observation Therapy (DOT) log to be signed each time the child receives DOT or for each unsuccessful attempt of DOT with reason, such as absence or refusal of medications
  5.  Directions for giving the medications
  6.  Fact sheet with information that includes: 
  1. Name of the child’s licensed health care provider
  2. Name of the child’s case manager
  3. Phone number of the TB clinic 
  4. Phone number for SNHD clinic contact
  5. Phone number of the parent/guardian

 

  1. SNHD will provide the medication in small plastic bags.  There will be only one type of medication in each bag and each bag must be labeled with:
  1.  Name of student
  2.  Name of medication
  3.  Dosage of each pill and total dosage required
  4.  Schedule to be given (for example, twice per week with a minimum of one day between dosages or daily)
  5.  Time to be given (once per day at lunch time)
  6.  Name of prescribing licensed healthcare provider
  7.  Date medication packaged

 

  1. Medications are to be given all at the same time, one time a day at lunch time
  2. If the child cannot swallow the pill, it is to be crushed and mixed with juice, syrup or water.  SNHD will provide the juice or syrup if needed. 
  3. If the student vomits the medication, becomes ill or the medication is dropped, contact the SNHD TB program for further direction. 
  4. If the student is absent on his/her scheduled day of administration, the school nurse may adjust the days of administration to permit the required number of dosages.  For example, the student normally receives medication on a Monday/Thursday rotation and the student is absent on Monday.  Designated school staff may administer the medication on Tuesday and Thursday for that week, upon approval by the school nurse.  Medication is not to be given two days in a row - for example Thursday and Friday; there must be at least one day between doses. 
  5. CCSD School Nurse must contact the SNHD TB program if the student’s weekly absences prevent the required number of medication administration days at school and for how long, for example: two weeks over spring break, or ongoing absences due to the child being sick.   
  6. Medications must be entered into the school’s documentation system (HMS) and on the monthly DOT form provided by SNHD.  If the student is absent on a medication day, the school nurse or FASA will keep the medications on the schedule log until it is given.  The medication will show up as an overdue item on the day the missed dose is given, and the school nurse or FASA will indicate in the comment section that the student was absent on the due day and document when the medication was actually given. 
  7. At the end of each month the school nurse will provide the completed DOT log to SNHD
  8. If needed, the client’s case manager can contact the school nurse and visit the school to discuss any issues and assist with problem solving. 

IV. QUALITY ASSURANCE: At the end of treatment an SNHD evaluation will be completed by the school nurse which will include reports of success and barriers to DOT related to the client, the client’s family, school environment, and the DOT procedure itself.