Nursing (10)
4193 MEDICATION POLICY
References: Utah Code Ann. §26-41-101, et. seq.
Utah Code Ann. §53G-9-501, et. Seq.
1) PURPOSE AND PHILOSOPHY
Weber School District seeks to ensure all students are safe at school. It is the intent of Weber School District that all students who need medication at school are able to receive such medication, and that the administration of medication to students complies with state and federal law. The policy also ensures immunity from liability for authorized personnel.
2) POLICY
It is Weber School District’s policy to allow medication to be administered at school under certain conditions. Personnel and students may store, carry, and/or administer medication in accordance with the procedures set forth in this policy. School personnel will not honor Do Not Resuscitate Orders at school or school activities.
3) DEFINITIONS
a) Prescription medications: a pharmaceutical drug that legally requires a medical prescription to be dispensed.
b) Over-the-counter medication: any medication that can be purchased without a prescription from a licensed medical provider. This includes alternative, herbal, or homeopathic substances.
c) School personnel: any person, 18 years or older, who is employed by Weber School District and assigned to a school in the district.
d) School sponsored activity: an activity, field trip, class, program, camp, or clinic that is sponsored by Weber School District
e) Seizure rescue medication: a medication, prescribed by a prescribing health care professional, to be administered as described in a student's seizure rescue authorization, while the student experiences seizure activity.
4) ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNEL
a) All arrangements for school personnel to administer medication at school are to be made only with the school principal or designated personnel.
b) In addition to the specific procedures for certain medications set forth in the Procedures attached to this Policy, prescription and/or over-the-counter medication may be administered to a student by school personnel only if:
i) The student’s parent or legal guardian has provided a completed, current, signed and dated “Authorization of School Personnel to Administer Medication” form [http://wsd.net/docman-list/documents/nursing-1/health-care-plans/medications/611- medication-administration-authorization-form/file] providing for the administration of medication to the student during regular school hours (This request must be updated at the beginning of each school year (within the 1st ten school days) and whenever a change is made in the administration of medication); AND
ii) The student’s licensed medical provider has also signed and dated the “Authorization of School Personnel to Administer Medications” form stating the name, method of administration, dosage, and time to be given, the side effects that may be seen in the school setting from the medication, and a statement that administration of medication by School Personnel during the school day is medically necessary; AND
iii) The medication is delivered to the school by the student’s parent/guardian, or authorized adult. A one week’s supply or more is recommended; AND
iv) The medication is in its original container, clearly labeled with the student’s name and dose. Prescription medication must be properly labeled by a pharmacy. Medication improperly labeled on the container cannot be accepted and/or administered to the student.
c) The side effects of a medication shall determine if the drug is appropriate to delegate its administration to school personnel. Any medication with known, frequent side effects that can be life threatening shall not be delegated. Medications that require the student’s heart rate, blood pressure, or oxygen saturation to be obtained before, during, or after administration of the drug shall not be administered by school personnel.
d) Narcotic pain medication may not be brought to school, kept at school, nor administered by school personnel.
e) All medications (both prescription and over-the-counter) specified in a student’s IEP, Health Care Plan, or 504 accommodation plan will be administered as outlined in the relevant plan.
f) Administration of medication by school personnel may be discontinued by the school at the school’s discretion any time after notification to the parent/guardian.
i) Discontinuation of administration of medication by school personnel is appropriate under either of the following circumstances:
(1) The parent/guardian has been non-compliant with this Policy; or
(2) The student has been non-compliant with this Policy by refusing medication repeatedly or continued resistance to respond to school personnel for administration of medication at the appointed time
ii) If a student has a 504 or an IEP, the school’s determination to discontinue administration of medication for the above reasons may only occur after meeting with the student’s parent/legal guardian.
g) School personnel will not be required to administer medical cannibas or any derivative thereof, or CBD oil, lotion, or other form of CBD product, to students at school. Students who wish to bring and self-administer CBD products containing zero amounts of THC to school must allow school personnel to store the CBD product in a locked health medication drawer.
5) STUDENT SELF- ADMINISTRATION OF MEDICATION AT SCHOOL
a) If a student’s parents and medical provider sign and return the appropriate individualized health care plan, and if applicable, associated medical orders, any student with the requisite maturity and competency, as determined by the health plan team or 504 team, may possess and self-administer the following:
i) inhalers
ii) epinephrine auto-injectors
iii) diabetes medication
b) Except for what is provided in 5)a), students in grades kindergarten through grade 6 may not possess or self-administer any other medications. Students needing medications described in 5)a)i) through iii) must have an individualized health care plan.
c) In addition to 5)a), students in grades 7 through 12 may possess and self-administer medication under the following circumstances:
i) The student may only carry one day’s dosage of medication, excluding narcotics; and
ii) The student has the requisite maturity and competency as determined by the health plan team or 504 team; and
iii) For 5)a)i) through iii), a student must also have an individualized health care plan.
d) Students who possess medication not prescribed, or medication not properly labelled, or in Elementary school, medication not listed in 5)a)i) through iii) may be subject to discipline according to policy 5200.
6) SCHOOL RESPONSIBILITIES
a) Each school in Weber School District will comply with the following obligations under this Policy regarding administration of medication to students at school:
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Nurses Resources
Documents and Forms
| # | Name | Size | Downloaded |
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| 1 |  WSD Diapering Procedures | 97.67 KB | 99 times |
| 2 | Toileting/Diapering Documentation Log | 50.81 KB | 62 times |
| 3 |  The Role of the School Nurse | 19.4 KB | 1071 times |
| 4 | Stop the Bleed Bleeding Control Certificate | 294.44 KB | 1270 times |
| 5 | Report of Naloxone Administration | 24.9 KB | 1683 times |
| 6 | Release of information13 | 14.2 KB | 1625 times |
| 7 | Referral for Mental Health Services | 99.26 KB | 437 times |
| 8 | Naloxone Standing Orders | 135.18 KB | 1955 times |
| 9 |  Medication Training for Teachers | 484.56 KB | 1822 times |
| 10 | Medical History fillable form SPANISH October 2021 | 203.65 KB | 453 times |
| 11 | Medical History fillable form October 2021 | 375.77 KB | 793 times |
| 12 | HB 308 - Changes to Utah Immunization Law Effective July 1, 2018 | 228.4 KB | 1373 times |
| 13 | Diabetes information for teachers | 14.14 KB | 1652 times |
| 14 | Communicable Disease Protocol | 172.54 KB | 1175 times |
| 15 | Chronic Illness Verification Form | 15.84 KB | 1194 times |
| 16 | Assessment Screening Tool | 263.64 KB | 1250 times |
| 17 | 211 Community Resources | 214.77 KB | 1477 times |
Asthma Training Forms
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| 1 | Side by Side MDI Transition Guide with Pic | 1.3 MB | 1489 times |
| 2 | Asthma Questionnaire | 207.74 KB | 279 times |
| 3 | Asthma Inhaler Checklist | 104.18 KB | 1387 times |
Bite Forms
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| 1 | Nursing Protocol for Human Bite Incident at School | 434.58 KB | 1853 times |
| 2 | Human Bite Parent Notification | 148.55 KB | 1193 times |
Field Trip Forms
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| 1 | Medication Procedures for Fieldtrips | 54.23 KB | 1150 times |
| 2 | Field Trip Medication Worksheet | 32.84 KB | 1307 times |
Head Injury Forms
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|---|---|---|---|
| 1 | Parent Notification of Head Injury Signs and Symptoms- Spanish | 174.91 KB | 390 times |
| 2 | Parent Notification of Head Injury Signs and Symptoms- English | 585.13 KB | 316 times |
| 3 | Head Injury Parent Notification - Spanish | 25.08 KB | 289 times |
| 4 | Head Injury Parent Notification - English | 92.67 KB | 655 times |
| 5 | Head Injury Flowchart | 205.34 KB | 533 times |
Vision Forms
| # | Name | Size | Downloaded |
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| 1 | Vision Symptoms Questionnaire | 880.5 KB | 1274 times |
| 2 | Vision Screening Opt Out Form | 143.68 KB | 1152 times |
| 3 | Vision Screening Guidelines | 2.82 MB | 2417 times |
| 4 | Vision Referral Form Spanish | 88.42 KB | 298 times |
| 5 | Vision Referral Form | 893.78 KB | 1280 times |
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Monday, 31 October 2016 12:56
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Asthma
Asthma# Name Size Downloaded 1 Asthma Questionnaire Spanish65.4 KB 95 times 2 Asthma Questionnaire 2020 English107.23 KB 108 times 3 Asthma Guidelines 7 22 20 FINAL1.97 MB 93 times 4 Asthma AP 6 4 20 ADA fillable1.07 MB 150 times
Diabetes
Diabetes
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| 1 | WSD Procedures for Diabetes Management in the School Setting | 180.79 KB | 68 times |
| 2 | Utah DHHS Standards of Care for Diabetes Management in the School Setting | 709.33 KB | 111 times |
| 3 | Glucose Log for Lunchtime Dosing | 13.69 KB | 133 times |
| 4 | Glucose Log for Classroom Monitoring | 12.46 KB | 105 times |
| 5 | DMMO 9 13 21 ADA fillable | 923.86 KB | 111 times |
| 6 | Diabetes IHP 9 13 21 ADA fillable | 891.07 KB | 138 times |
| 7 | Diabetes EAP 9 8 22 fillable | 801.42 KB | 126 times |
| 8 | ADD Pump 3 28 22 ADA fillable | 755.36 KB | 106 times |
| 9 | ADD Injection 9 13 21 ADA fillable | 771.54 KB | 113 times |
| 10 | ADD CGM 9 13 21 ADA fillable | 423.46 KB | 112 times |
Allergies
Allergies# Name Size Downloaded 1 Medical Special Meal Request 2019544.51 KB 105 times 2 Epi Pen Procedures1.17 MB 104 times 3 Allergy and Anaphylaxis Guidelines 7 16 20823.71 KB 97 times 4 AAEAP 8 10 21 ADA fillable850.37 KB 131 times
Medications
Medications
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| 1 | WSD Medication Administration Check List | 91.08 KB | 330 times |
| 2 | Medication Error or Adverse Reaction Reporting Form | 9.58 KB | 1896 times |
| 3 | Medication Check-in and Disposal Form | 116.33 KB | 2192 times |
| 4 | Medication Authorization (DHHS) | 824.72 KB | 59 times |
| 5 | Medication Administration Record 2022 23 | 159.67 KB | 96 times |
| 6 | 2020 Medication Policy | 1.82 MB | 1054 times |
Seizure
Seizure
| # | Name | Size | Downloaded |
|---|---|---|---|
| 1 | Seizure Rescue Medication Management Order 8 13 20 fillable | 806.67 KB | 103 times |
| 2 | Seizure Log 2016 | 106.26 KB | 94 times |
| 3 | Seizure Guidelines 2020 | 3.37 MB | 93 times |
| 4 | Seizure Action Plan 8 3 20 fillable | 880.79 KB | 154 times |
Health Care Plan
Health Care plans
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| 1 | Health Care Plan Initiative Form | 55.54 KB | 2230 times |
G-Tube Feeding
G-tube Feeding
| # | Name | Size | Downloaded |
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| 1 | Tube Feeding Physician Orders Form | 74.55 KB | 2438 times |
| 2 | G-tube Dislodgement at School Procedures | 88.15 KB | 2771 times |
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Suicide Resources
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| 1 | Warning Signs of Suicide | 55 KB | 2027 times |
| 2 | Talking with Your Child about Suicide | 50.19 KB | 2233 times |
| 3 | Preparing Your Child to Attend the Funeral of a Friend | 44.14 KB | 1686 times |
| 4 | How Children Understand Death | 55.19 KB | 1862 times |
| 5 | Guidelines for Helping Students Deal with a Death | 31.76 KB | 1920 times |
| 6 | Frequently Asked Questions about Youth Suicide | 799.45 KB | 1714 times |
| 7 | Dealing with the Empty Desk | 43.31 KB | 3183 times |
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Board Policy
Immunizations of Students 4191
Documents & Forms
Immunizations requirements
| # | Name | Size | Downloaded |
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| 1 | USIIS permission form in Spanish | 69.96 KB | 200 times |
| 2 | USIIS permission form in English | 123.71 KB | 553 times |
| 3 | Seventh Grade Entry 2022 2023 Spanish | 118.4 KB | 202 times |
| 4 | Seventh Grade Entry 2022 2023 English with covid info | 242.3 KB | 297 times |
| 5 | Kindergarten Entry Req 2022 2023 Spanish | 387.84 KB | 231 times |
| 6 | Kindergarten Entry Req 2022 2023 English | 263.83 KB | 276 times |
| 7 | 30 Day Conditional Enrollment Notice Spanish | 14.34 KB | 122 times |
| 8 | 30 Day Conditional Enrollment Notice English | 13.32 KB | 134 times |
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| Elementary Schools | Nurse | Phone | Fax | |
| Bates | Sheila Moesinger | 801-452-4591 | 801-476-7654 | |
| Burch Creek | Miriam Ito | 801-476-5305 | 801-622-8482 | |
| Country View | Patricia Lords | 801-452-4400 | 801-629-7648 | |
| Farr West | Shalene Elgiar | 801-452-4371 | 801-629-7653 | |
| Freedom | Leslie Farmer | 801-452-4116 | 801-622-8481 | |
| Green Acres | Jamie Abney | 801-452-4431 | 801-622-8480 | |
| H. Guy Child | Lisa Phelps | 801-452-4151 | 801-629-7654 | |
| Hooper | Stacie Simpson | 801-452-4320 | 801-629-7651 | |
| Kanesville | Mindy Coombs | 801-452-4694 | 801-629-7644 | |
| Lakeview | Leslie Farmer | 801-452-4380 | 801-622-8481 | |
| Lomond View | Marcia Hollingsworth | 801-452-4780 | 801-629-7643 | |
| Majestic | Shalene Elgiar | 801-452-4260 | 801-629-7653 | |
| Midland | Stacie Simpson | 801-476-5400 | 801-629-7651 | |
| Municipal | Miriam Ito | 801-452-4124 | 801-622-8482 | |
| North Ogden | Jamie Abney | 801-452-4309 | 801-622-8480 | |
| North Park | Melinda Costa | 801-452-4352 | 801-629-7652 | |
| Orchard Springs | Sheila Moesinger | 801-395-5658 | 801-476-7654 | |
| Pioneer | Melinda Costa | 801-452-4570 | 801-629-7652 | |
| Plain City | Mindy Coombs | 801-452-4226 | 801-629-7644 | |
| Riverdale | Miriam Ito | 801-452-4551 | 801-622-8482 | |
| Roosevelt | Debra Mines | 801-452-4520 | 801-629-7649 | |
| Roy | Leslie Farmer | 801-452-4160 | 801-622-8481 | |
| Silver Ridge | Pamela Ballif | 801-395-5611 | 801-629-7641 | |
| Uintah | Janessa Whitesides | 801-452-4993 | 801-629-7645 | |
| Valley | Debbie Campbell | 801-452-4187 | 801-629-7642 | |
| Valley View | Patricia Lords | 801-476-5210 | 801-629-7648 | |
| Washington Terrace | Debra Mines | 801-452-4200 | 801-629-7649 | |
| West Haven | Mindy Coombs | 801-452-4978 | 801-629-7644 | |
| West Weber | Pamela Ballif | 801-452-4280 | 801-629-7641 | |
| Jr. High Schools | Nurse | Phone | Fax | |
| North Ogden | Marcia Hollingsworth | 801-452-4800 | 801-629-7643 | |
| Orion | Janessa Whitesides | 801-452-4709 | 801-629-7645 | |
| Rocky Moutnain | Stacie Simpson | 801-476-5200 | 801-629-7651 | |
| Roy | Patricia Lords | 801-476-5288 | 801-629-7648 | |
| Sand Ridge | Marie Evans | 801-476-5336 | 801-629-7646 | |
| Snowcrest | Debbie Campbell | 801-476-5378 | 801-629-7642 | |
| South Ogden | Debbie Campbell | 801-452-4472 | 801-629-7642 | |
| T.H. Bell | Debra Mines | 801-452-4600 | 801-629-7649 | |
| Wahlquist | Shalene Elgiar | 801-452-4659 | 801-629-7653 | |
| High Schools | Nurse | Phone | Fax | |
| Bonneville | Lisa Phelps | 801-452-4050 | 801-629-7654 | |
| Fremont | Pamela Ballif | 801-452-4000 | 801-629-7641 | |
| Roy | Melinda Costa | 801-476-3615 | 801-629-7652 | |
| Weber | Marcia Hollingsworth | 801-476-3700 | 801-629-7643 | |
| Other Schools | Nurse | Phone | Fax | |
| Canyon View/Pre-K | Meghan Smith | 801-476-3978 | 801-629-7647 | |
| Weber Innovation | Janessa Whitesides | 801-452-6500 | 801-629-7645 | |
| Two Rivers | Lisa Phelps | 801-476-3920 | 801-629-7654 |
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5th & 6th Grade Maturation
Maturation
| # | Name | Size | Downloaded |
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| 1 | Girls 5th Grade Maturation | 83.1 MB | 202 times |
| 2 | Boys 5th Grade Maturation | 80.04 MB | 167 times |
| 3 | 5th Grade Maturation Permission- Spanish | 141.96 KB | 138 times |
| 4 | 5th Grade Maturation Permission- English | 197.45 KB | 249 times |
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