HEAD START®

Caring for Children with
Chronic Conditions

Training Guides for the Head Start Learning Community

Table of Contents | Preface | Introduction | Module 1 | Module 2 | Module 3
| Continuing Professional Development | Resources

MODULE 2: Activity 6 - Taking Medicine

Module 2 | Activity 1 | Activity 2 | Activity 3 | Key to Activity 3 | Activity 4 | Activity 5 | Activity 6 | Activity 7 | Next Steps

Purpose:

This activity helps Head Start staff improve their program's medication policy. It is most helpful for the program's director and health, disabilities, and education managers.

For this activity you will need:

• Handout S: Medication Policy and Procedure Checklist
  
  
• Your program's medication policy, procedures, and forms
  

Step 1:

Call together a meeting of the program's management team (in particular the health, disabilities, and education managers) to assess the program's medication policies and procedures. Explain that many children with chronic conditions need to take medicine on a routine and/or emergency basis. In order to make "reasonable accommodations" to care for children with disabilities (as required by the Americans with Disabilities Act), and to comply with the Head Start Program Performance Standards, programs need thorough policies and procedures for administering medications.

Step 2:

Distribute Handout S: Medication Policy and Procedure Checklist. Explain that this checklist summarizes the current "best practice" guidelines from national child care and health authorities for accepting, storing, and administering medications in early childhood programs. Review all of the items on the checklist.

Step 3:

Using Handout S as a guide, develop a plan for how you will assess your program's medication policies and procedures. The sources of information should include:

• medication policy, procedures, and forms
  

• documentation of medications given
  
  
• observation of medication storage and administration
  
  
• discussion with staff about accepting, storing, and administering medication
  
  
• discussion with parents about bringing medications

Step 4:

Make arrangements to collect all the information you need. For example, arrange a time to talk with staff designated to handle medication, check medication storage and records, and observe when medication is given. Prepare staff for the discussions and observations by emphasizing that your goal is to learn how medications are handled to improve medication practices throughout the program, not to single out any individual for criticism.

Try to observe as broad a range of medication practices as possible, such as several classrooms, children of different ages, and medications given by different routes (e.g., oral and inhaled).

Step 5:

When the management team has collected the information and completed the checklists, bring the group back together. Review the information. Identify the medication procedures that the program is doing well, and congratulate the team.

Identify where there are gaps in the medication policy or inconsistencies between policy and practice.

Step 6:

Meet with the Health Services Advisory Committee (HSAC) to discuss your review of medication policies and practices. With the HSAC, determine which are the priority issues to address. Develop strategies to make the needed improvements:

• Should the medication policy and procedures be revised?
  
  
• Should the medication documentation forms be revised?
  
  
• Are additional supplies, equipment, or facilities needed for storing and administering medication?
  
  
• Do staff need a training update on accepting, storing, and administering medication?
  
  
• Is parent education needed on Head Start policy on medication?

Part 7:

Be sure to report back to any staff whom you observed or interviewed. People deserve to know what they are doing well and where they can improve.

Points to Consider:

• Early childhood programs are commonly concerned about liability for administering medication–both administering medication (if it is done improperly) and not administering medication (if it is needed). Programs can take a big step toward making medication practices safer by:
  
  – having a comprehensive and up-to-date written medication policy that is approved by the Health Services Advisory Committee and Parent Committee;
  
  – updating staff training on medication practices; and
  
  – keeping complete records of children's medication plans, health care providers' instructions, parents' consent, and documentation of medications given.
  
  
• For Head Start programs that have RNs or MDs on staff as health coordinators and/or health directors, the medication administration procedures must comply with state Medical and Nursing Practice Acts. State Nurses Associations, School Nursing Associations, and Medical Associations are good sources for information on state Practice Acts.
  
  
• The best policy doesn't necessarily help you get medication into a wriggling, spitting, unhappy child. In addition to training on policies and procedures, staff need training and supervision on helping children cooperate in taking their medication.
  
  Most toddlers and preschoolers cooperate better when they are allowed reasonable choice and participation (e.g., "We need to do your eyedrops in the next few minutes, please tell me when you are ready." or "You can hold the nebulizer mouthpiece yourself.") Also, parents can usually tell you what makes taking medicine easier for their child.