Emergency Medication Access and Administration in Schools: A Focus on Epinephrine,Albuterol Inhalers,and Glucagon

Abstract

Access to emergency medications is a growing concern, particularly regarding the availability, safety, and use of these medications in schools. The purpose of this article is to report results not previously published from a national survey, specifically regarding the emergency use of epinephrine, albuterol inhalers, and glucagon. A nonexperimental, cross-sectional design was utilized for this descriptive study. An online survey was distributed to school nurses in 2015, and data from 6,298 school nurse respondents are presented in the analysis. Findings related to stock and student-specific emergency medication use and storage, epinephrine usage data, and delegation of emergency medication administration to unlicensed assistive personnel are presented in this article. Further development of policies and procedures regarding emergency medication administration in schools is needed. School nurses are a valuable resource for obtaining knowledge in this area and keeping students safe at school.

Keywords

epinephrine albuterol glucagon medication administration school nursing emergency medication

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References

American Diabetes Association. (2018). Statistics about Diabetes. http://www.diabetes.org/diabetes-basics/statistics/

American Lung Association. (2014). Creating asthma friendly environments. https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/living-with-asthma/creating-asthma-friendly-environments

Centers for Disease Control and Prevention. (2015). Food allergies in schools toolkit. U.S. Department of Health & Human Services. https://www.cdc.gov/healthyschools/foodallergies/toolkit.htm

Centers for Disease Control and Prevention. (2017). Health, United States. U.S. Department of Health & Human Services. https://www.cdc.gov/nchs/data/hus/2017/035.pdf

Council on School Health. (2008). Medical emergencies occurring at school [policy statement]. Pediatrics, 122(4), 887–894. https://doi.org/10.1542/peds.2008-2171

Farris

K. B.

McCarthy

A. M.

Kelly

M. W.

Clay

Gross

J. N.

(2003). Issues of medication administration and control in Iowa schools. Journal of School Health, 73(9), 331–337. https://doi.org/10.1111/j.1746-1561.2003.tb04188.x

Federal Interagency Forum on Child and Family Statistics. (2019). America’s children: Key national indicators of well-being, 2019. https://www.childstats.gov/americaschildren/tables/health8a.asp

Food and Drug Administration. (2019). FDA approves first treatment for severe hypoglycemia that can be administered without an injection. U.S. Department of Health & Human Services. https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-severe-hypoglycemia-can-be-administered-without-injection

Fortner

(2018, May 14). Food allergies: Helping schools prepare to respond. U.S. Department of Agriculture. https://www.usda.gov/media/blog/2018/05/14/food-allergies-helping-schools-prepare-respond

10.

Gerald

L. B.

Snyder

Disney

Gerald

J. K.

Thomas

Wilcox

Brown

M. A.

(2016). Implementation and evaluation of a stock albuterol program for students with asthma [Letter to the editor]. Annals of the American Thoracic Society, 13(2), 295–296.

11.

Harris

P. A.

Taylor

Thielke

Payne

Gonzalez

Conde

J. G.

(2009). Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381. https://doi.org/10.1016/j.jbi.2008.08.010

12.

Hogue

S. L.

Muniz

Herrem

Silvia

White

M. V.

(2018). Barriers to the administration of epinephrine in schools. Journal of School Health, 88(5), 396–404. https://doi.org/10.1111/josh.12620

13.

Jackson

C. C.

Albanese-O’Neill

Butler

K. L.

Chiang

J. L.

Deeb

L. C.

Hathaway

Kraus

Weissberg-Benchell

Yatvin

A. L.

Siminerio

L. M.

(2015). Diabetes care in the school setting: A position statement of the American diabetes association. Diabetes Care, 38(10), 1958–1963. https://doi.org/10.2337/dc15-1418

14.

Kelly

M. W.

McCarthy

A. M.

Mordhorst

M. J.

(2003). School nurses’ experiences with medication administration. The Journal of School Nursing, 19(5), 281–287. https://doi.org/10.1177/10598405030190050601

15.

Kids with Food Allergies. (2018, July 19). Share our teal classroom kit with your child’s school to promote food allergy awareness. Asthma and Allergy Foundation of America. https://community.kidswithfoodallergies.org/blog/share-our-teal-classroom-kit-with-your-child-s-school-to-promote-food-allergy-awareness

16.

Maughan

E. D.

McCarthy

A. M.

Hein

Perkhounkova

Kelly

M. W.

(2018). Medication management in schools: 2015 Survey results. The Journal of School Nursing, 34(6), 468–479. https://doi.org/10.1177/1059840517729739

17.

McCarthy

A. M.

Kelly

M. W.

Johnson

Roman

Zimmerman

M. B.

(2006). Changes in medications administered in schools. The Journal of School Nursing, 22(2), 102–107.

18.

McCarthy

A. M.

Kelly

M. W.

Reed

(2000). Medication administration practices of school nurses. The Journal of School Health, 70(9), 371–376. https://doi.org/10.1111/j.1746-1561.2000.tb07277.x

19.

National Association of School Nurses. (2017). Medication administration in the school setting: Medication administration in schools [Position statement] . https://www.nasn.org/advocacy/professional-practice-documents/position-statements/ps-medication

20.

National Coordinating Council for Medication Error Reporting and Prevention. (2007). Recommendations to reduce medication errors in non-health care settings. https://www.nccmerp.org/recommendations-reduce-medication-errors-non-health-care-settings

21.

Reutzel

T. J.

Patel

(2001). Medication management problems reported by subscribers to a school nurse listserv. The Journal of School Nursing, 17(3), 131–139. https://doi.org/10.1177/10598405010170030401

22.

Sicherer

S. H.

Simons

F. E. R.

(2017). Epinephrine for first-aid management of anaphylaxis. Pediatrics, 139(3), Article e20164006. https://doi.org/10.1542/peds.2016-4006

23.

Wang

Sicherer

S. H.

(2017). Guidance on completing a written allergy and anaphylaxis emergency plan. Pediatrics, 139(3). https://doi.org/10.1542/peds.2016-4005

24.

White

M. V.

Hogue

S. L.

Odom

Cooney

Bartsch

Goss

Hollis

Herrem

Silvia

(2016). Anaphylaxis in schools: Results of the EPIPEN4SCHOOLS survey combined analysis. Pediatric Allergy, Immunology, and Pulmonology, 29(3), 149–154. https://doi.org/10.1089/ped.2016.0675

25.

White

M. V.

Silvia

Muniz

Herrem

Hogue

S. L.

(2017). Prevalence and triggers of anaphylactic events in schools. Allergy and Asthma Proceedings, 38(4), 286–293. https://doi.org/10.2500/aap.2017.38.4066

26.

Willgerodt

M. A.

Brock

D. M.

Maughan

E. D.

(2018). Public school nursing practice in the United States. The Journal of School Nursing, 34(3), 232–244. https://doi.org/10.1177/1059840517752456

27.

Wilt

Foley

(2011). Delegation of Glucagon® in the school setting: A comparison of state legislation. The Journal of School Nursing, 27(3), 185–196. https://doi.org/10.1177/1059840511398240

28.

Wood

(2018, June 4). As opioid overdose numbers rise, so does the cost of naloxone. Bill of Health. http://blog.petrieflom.law.harvard.edu/2018/06/04/as-opioid-overdose-numbers-rise-so-does-the-cost-of-naloxone/