ADMINISTRATION OF MEDICATION POLICY

In supporting the health and wellbeing of children, the use of medications may be required for children at the Service. All medications must be administered as prescribed by medical practitioners and first aid guidelines to ensure the continuing health, safety, and wellbeing of the child.Under the Education and Care Services National Law and Regulations, early childhood services are required to ensure medication records are kept for each child to whom medication is or is to be administered by the service (reg 92).

NATIONAL QUALITY STANDARD (NQS)

QUALITY AREA 2:  CHILDREN’S HEALTH AND SAFETY
2.1.1	Wellbeing and comfort	Each child’s wellbeing and comfort is provided for, including appropriate opportunities to meet each child’s needs for sleep, rest and relaxation.
2.1.2	Health practices and procedures	Effective illness and injury management and hygiene practices are promoted and implemented.
2.2	Safety	Each child is protected.
2.2.1	Supervision	At all times, reasonable precautions and adequate supervision ensure children are protected from harm and hazard.
2.2.2	Incident and emergency management	Plans to effectively manage incidents and emergencies are developed in consultation with relevant authorities, practiced and implemented.

EDUCATION AND CARE SERVICES NATIONAL REGULATIONS
90	Medical conditions policy
90 (1) (a)	The management of medical conditions, including asthma, diabetes or a diagnosis that a child is at risk of anaphylaxis
91	Medical conditions policy to be provided to parents
92	Medication record
93	Administration of medication
94	Exception to authorisation requirement – anaphylaxis or asthma emergency
95	Procedure for administration of medication
136	First Aid qualifications
168	Education and care service must have policies and procedures
170	Policies and procedures are to be followed

RELATED POLICIES

Administration of First Aid Policy Dealing withInfectious Disease Policy Child Protection Policy Code of Conduct Policy Delivery of Children to, and collection from Education and Care Service Premises Diabetes Management Policy Enrolment Policy Epilepsy Policy

Family Communication Policy Health and Safety Policy Incident, Injury, Trauma and Illness Policy Medical Conditions Policy Privacy and Confidentiality Policy Respect for Children Policy Safe Storage of Hazardous Substances Policy Sick Children Policy Supervision Policy Work Health and Safety Policy

PURPOSE

To ensure all educators of the Service understand their liabilities and duty of care to meet each child’s individual health care needs. To ensure all educators are informed of children diagnosed with a medical condition and strategies to support their individual needs. To ensure that all educators are specifically trained to be able to safely administer children’s required medication with the written consent of the child’s parent or guardian. Educators will follow this stringent procedure to promote the health and wellbeing of each child enrolled at the Service.

SCOPE

This policy applies to educators, families, staff, management, approved provider, nominated supervisor, students, volunteers and visitors of the Service.

IMPLEMENTATION

Families requesting the administration of medication to their child will be required to follow the guidelines developed by the Service to ensure the safety of children and educators. The Service will follow legislative guidelines and adhere to the National Quality Standard to ensure the health of children, families, and educators at all times.

For children with a diagnosed health care need, allergy or relevant medical condition a Medical Management Plan must be provided prior to enrolment and updated regularly. A Risk Minimisation Plan and Communication Plan must be developed in consultation with parents/guardians to ensure risks are minimised and strategies developed for minimising any risk to the child. (See Medical Conditions Policy).

THE APPROVED PROVIDER/MANAGEMENT/NOMINATED SUPERVISOR WILL ENSURE:

• children with specific health care needs or medical conditions have a current medical management plan detailing prescribed medication and dosage by their medical practitioner
• medication is only administered by the Service with written authority signed by the child’s parent or other responsible person named and authorised in the child’s enrolment record to make decisions about the administration of medication [Regulation 92(3)(b)]
• enrolment records for each child outline the details of persons permitted to authorise the administration of medication to the child [for emergency situations]
• medication provided by the child’s parents must adhere to the following guidelines:
  • the administration of any medication is authorised by a parent or guardian in writing
  • medication is prescribed by a registered medical practitioner (with instructions either attached to the medication, or in written form from the medical practitioner)
  • medication is from the original container/packaging
  • medication has the original label clearly showing the name of the child
  • medication is before the expiry/use by date
• the Administration of MedicationRecord is completed for each child
• a separate form must be completed for each medication if more than one is required
• any person delivering a child to the Service must not leave any type of medication in the child’s bag or locker. Medication must be given directly to an educator for appropriate storage upon arrival.
• written and verbal notifications are given to a parent or other family member of a child as soon as practicable if medication is administered to the child in an emergency when consent was either verbal or provided by medical practitioners
• if medication is administered without authorisation in the event of an asthma or anaphylaxis emergency the parent of the child is notified as soon as practicable
• if the incident presented imminent or severe risk to the health, safety and wellbeing of the child or if an ambulance was called in response to the emergency (not as a precaution) the regulatory authority will be notified within 24 hours of the incident by the Approved Provider
• reasonable steps are taken to ensure that medication records are maintained accurately
• medication records are kept in a secure and confidential manner and archived for the regulatory prescribed length of time following the child’s departure from the Service
• children’s privacy is maintained, working in accordance with the Australian Privacy Principles (APP)
• educators receive information about Medical Conditions and Administration of Medication Policies and other relevant health management policies during their induction
• educators, staff and volunteers have a clear understanding of children’s individual health care needs, allergy or relevant medical condition as detailed in Medical Management Plans, Asthma or Anaphylaxis Action Plans
• written consent is requested from families on the enrolment form to administer emergency asthma, anaphylaxis, or other emergency medication or treatment if required
• families are informed of the Service’s medical and medication policies at time of enrolment
• safe practices are adhered to for the wellbeing of both the child and educators.

EDUCATORS WILL:

• not administer any medication without the writtenauthorisation of a parent or person with authority, except in the case of an emergency, when the written consent on an enrolment form, verbal consent from an authorised person, a registered medical practitioner or medical emergency services will be acceptable if the parents cannot be contacted
• ensure medications are stored in the refrigerator in a labelled and locked medication container with the key kept in a separate location, inaccessible to children. For medications not requiring refrigeration, they will be stored in a labelled and locked medication container with the key kept in a separate location, inaccessible to children.
• ensureadrenaline autoinjectors and asthma medication arekept out of reach of children and stored in a cool dark place at room temperature. They must be readily available when required and not locked in a cupboard. A copy of the child’s medical management plan should be stored with the adrenaline autoinjector or asthma medication. 
• ensure that two educators administer and witness administration of medication at all times(Reg. 95). One of these educators must have approved First Aid qualifications as per current legislation and regulations[this is best practice and not mandated in regulation 95] Both educators are responsible for:
  • checking the Administration of Medication Recordis completed by the parent/guardian
  • checking the prescription label for:
    • the child’s name
    • the dosage of medication to be administered
    • the method of dosage/administration
    • the expiry or use-by date
  • confirming that the correct child is receiving the medication
  • signing and dating the Administration of Medication Record
  • returning the medication back to the locked medication container
• follow hand-washing procedures before and after administering medication
• discuss any concerns or doubts about the safety of administering medications with management to ensure the safety of the child (checking if the child has any allergies to the medication being administered)
• seek further information from parents/guardian, the prescribing doctor or the Public Health Unit before administering medication if required
• ensure that the instructions on the Administration of Medication Recordare consistent with the doctor’s instructions and the prescription label
• ensure that if there are inconsistences, medication is not to be administered to the child
• invite the family to request an English translation from the medical practitioner for any instructions written in a language other than English
• ensure that the Administration of Medication Record is completed and stored correctly including name and signature of witness, time and date
• if after several attempts of encouraging the child to take medication, but they still refuse, contact the parent or guardian. Educators cannot use restrictive practices to make a child take medication at any time.
• observe the child post administration of medication to ensure there are no side effects
• respond immediately and contact the parent/guardian for further advice if there are any unusual side effects from the medication
• contact emergency services on 000 immedicatelyif a child is not breathing or having difficulty breathing following administration of any medication

FAMILIES WILL:

• provide management with accurate information about their child’s health needs, medical conditions and medication requirements on the enrolment form
• provide the Service with a Medical Management Plan prior to enrolment of their child if required
• develop a Risk Minimisation Plan for their child in collaboration with management and educators and medical practitioner for long-term medication plans
• notify educators, verbally when children are taking any short-term medications (at home)
• complete and sign an Administration of Medication Recordfor their child requiring any medication whilst they are at the Service
• update (or verify currency of) Medical Management Plan annually or as the child’s medication needs change
• be requested to sign consent to use creams and lotionsshould first aid treatment be required(list of items in the first aid kit provided at enrolment)
• keep prescribed medications in original containers with pharmacy labels. Please understand that medication will only be administered as directed by the medical practitioner and only to the child whom the medication has been prescribed for. Expired medications will not be administered.
• adhere to our Service’s Sick Children Policy and Control of Infectious Disease Policy
• keep children away at home while any symptoms of an illness remain
• keep children at home for 24 hours from commencing antibiotics to ensure they have no side effects to the medication
• NOT leave any medication in children’s bags
• give any medication for their children to an educator who will provide the family with anAdministration of MedicationRecord to complete
• complete the Administration of Medication Recordand the educator will sign to acknowledge the receipt of the medication
• provide any herbal/ naturopathic remedies or non-prescription medications (including Paracetamol) with a letter from the doctor detailing the child’s name and dosage.

GUIDELINES FOR ADMINISTRATION OF PARACETAMOL

• families must provide their own Paracetamol for use as directed by a medical practitioner
• Paracetamol will be kept in the locked medication container for emergency purposes should authorised collectors not be contactable
• to safeguard against the incorrect use of Paracetamol and minimise the risk of concealing the fundamental reasons for high temperatures, educators will only administer Paracetamol if it is accompanied by a doctor’s letter stating the reason for administering, the dosageand duration it is to be administered for except for in emergency situations (onset of fever whilst at the Service).
• administration of Paracetamol must follow the procedure for Administration of Medication requiring two qualified educators to witness the administration and complete the required records
• an Administration of Medication and/or Administration of Paracetamol Record will be completed with both educator’s full name, signature, time and date of administration clearly recorded
• if a child presents with a temperature whilst at the Service, the family will be notified immediately and asked to organise collection of the child as soon as possible (within 30 minutes)
• the family will be encouraged to visit a doctor to find the cause of the temperature. While waiting for the child to be collected, educators will:
  • remove excess clothing to cool the child down
  • offer fluids to the child
  • encourage the child to rest.
  • monitor the child for any additional symptoms
  • maintain supervision of the ill child at all times, while keeping them separated from children who are well.

MEDICATIONS KEPT AT THE SERVICE

• any medication, cream or lotion kept on the premises will be checked monthly for expiry dates
• a list of First Aid Kit contents close to expiry or running low will be given to the Nominated Supervisor who will arrange for the purchase of replacement supplies
• if a child’s individual medication is due to expire or running low, the family will be notified by educators that replacement items are required
• it is the family’s responsibility to take home short-term medication (such as antibiotics) at the end of each day, and return it with the child as necessary
• MEDICATION WILL NOT BE ADMINISTERED IF IT HAS PAST THE PRODUCT EXPIRY DATE
• families are required to complete an Administration of Medication Recordfor lotions to be administered.

EMERGENCY ADMINISTRATION OF MEDICATION[REG. 93(5)]

In the occurrence of an emergency and where the administration of medication must occur, the Service must attempt to receive verbal authorisation by a parent of the child named in the child’s enrolment form who is authorised to consent to the administration of medication.

• If a parent of a child is unreachable, the Service will endeavour to obtain verbal authorisation from an emergency contact of the child named in the child’s enrolment form, who is authorised to approve the administration of medication.
• If all the child’s nominated contacts are non-contactable, the Service must contact a registered medical practitioner or emergency service on 000
• In the event of an emergency and where the administration of medication must occur, written notice must be provided to a parent of the child or other emergency contact person listed on the child’s enrolment form
• The Service will contact the regulatory authority within 24 hours as soon as practicably possible (if urgent medical attention was sought or the child attended hospital)
• The child will be comforted, reassured, and removed to a quiet area under the direct supervision of a suitably experienced and trained educator.

EMERGENCY INVOLVING ANAPHYLAXIS OR ASTHMA

• For anaphylaxis or asthma emergencies, medication/treatment will be administered to a child without authorisation, following the Asthmaor Anaphylaxis Action Plan provided by the parent/guardian. [National Asthma Council (NAC) or ASCIA]
• In the event of a child not known to have asthma and appears to be in severe respiratory distress, the emergency plans for first aid must be followed immediately
• an ambulance must be called immediately
• place child in a seated upright position
• give 4 separate puffs of a reliever medication (e.g.: Ventolin) using a spacer if required.
• repeat every 4 minutes until the ambulance arrives
• In the event of a child not known to be diagnosed with anaphylaxis and appears to be an anaphylaxisemergency where any of the following symptoms are present, an EpiPen must be administered
  • difficulty/noisy breathing
  • swelling of the tongue
  • swelling or tightness in throat
  • difficulty talking
  • wheeze or persistent cough
  • persistent dizziness or collapse pale and floppy

(Sydney Children’s Hospitals Network – 2020)

The Service will contact the following (as required) as soon as practicably possible:

• Emergency Services 000
  • a parent of the child
  • the regulatory authority within 24 hours (if urgent medical attention was sought or the child attended hospital).

The child will be comforted, reassured, and removed to a quiet area under the direct supervision of a suitably experienced and trained educator.

CONTINUOUS IMPROVEMENT/REFLECTION

The Administration of Medication Policy will be reviewed on an annual basis in conjunction with children, families, educators, staff and management.

SOURCE

Australian Children’s Education & Care Quality Authority. (2014).

Australian society of clinical immunology and allergy. ASCIA. https://www.allergy.org.au/hp/anaphylaxis/ascia-action-plan-for-anaphylaxis

Australian Government Department of Education,Skills and Employment. (2009) (2022).Belonging, Being and Becoming: The Early Years Learning Framework for Australia. V2.02

Early Childhood Australia Code of Ethics. (2016).

Education and Care Services National Law Act 2010. (Amended 2018).

Education and Care Services National Regulations. (2011).

Guide to the Education and Care Services National Law and the Education and Care Services National Regulations. (2017).

Guide to the National Quality Framework. (2017). (Amended 20202023).

National Health and Medical Research Council. (2013). Staying Healthy: Preventing infectious diseases in early

childhood education and care services (5th Ed.). Australia: Commonwealth of Australia. NSW Government. (n.d.).

NSW Department of Health:  www.health.nsw.gov.au

Revised National Quality Standard. (2018).

The Sydney Children’s Hospital Network (2020)

Western Australian Education and Care Services National Regulations

REVIEW

POLICY REVIEWED	APRIL 2023	NEXT REVIEW DATE	APRIL 2024
MODIFICATIONS	minor formatting and grammatical edits within textupdate to new EYLF referencehyperlinks checked and repaired as requiredContinuous Improvement section addedChildcare Centre Desktop Resource section addedlink to Western Australian Education and Care Services National Regulations added in ‘Sources’
POLICY REVIEWED	PREVIOUS MODIFICATIONS		NEXT REVIEW DATE
APRIL 2022	policy maintenance – no major changes to policyminor formatting edits within textminor changes to reflect National Regulationshyperlinks checked and repaired as required		APRIL 2023
APRIL 2021	review of policy/sources checked for currencyadditional information included related to observing children post administration of medication/side effects/managementreference to Administration of Paracetamol record		APRIL 2022
APRIL 2020	rearrangement of some points for better flowaddition of informationinclusion of Medical Management Plan additional information re: anaphylaxis or asthma emergency		APRIL 2021
APRIL 2019	Additional information added to points.Duplicated information deleted.Sources/references updated and alphabetised.		APRIL 2020