- Email: [email protected]
Medication management in North Carolina elementary schools: Are pharmacists involved?
Research Notes
Medication management in North Carolina elementary schools: Are pharmacists involved? Jennifer Stegall-Zanation and Kelly L. Scolaro
Abstract Objective: To determine the extent of pharmacist use in medication management, roles of school nurses, and use of other health care providers at elementary schools in North Carolina. Methods: Prospective survey of 153 (130 public and 23 private) elementary schools in four counties of North Carolina. A 21-question survey was e-mailed to the head administrator of each school (e.g., principal, headmaster) containing a Qualtrics survey link. Questions were designed to elicit information on school policies and procedures for medication management and use of health care providers, including pharmacists, in the schools. Responses were collected during a 2-month period. Results: Representatives from 29 schools participated in the survey (19% response rate). All 29 schools reported having a school policy regarding medication administration during school hours. Of those, 27 schools reported consulting with nurses on their policies. Only 1 of 27 respondents reported consulting with pharmacists on medication management policies. The majority of the respondents (93.1%) stated that administrative staff was responsible for medication administration at the schools. Conclusion: Use of pharmacists in creating and reviewing policies for schools and actual medication management at schools was extremely low. The findings in this study reinforce the findings in previous studies that pharmacists are not being used and are not a major presence in elementary school health. Keywords: Pediatrics, medication management, elementary schools, pharmacy services. J Am Pharm Assoc. 2010;50:720–722. doi: 10.1331/JAPhA.2010.09180
C
hildren with disabilities and chronic or acute medical conditions may need to take medications during school hours; however, school personnel are concerned about the safety and liability surrounding medication use during school hours.1 Data from the 2007 National Health Interview Survey indicated that 12% of U.S. children had a health problem that required prescription medications for at least 3 months.2 Approximately 17% of children aged 12 to 17 years, 12% of those 5 to 11 years, and 8% of those younger than 5 years were on regular medications.2 Common chronic conditions reported by school nurses included attention deficit hyperactivity disorder (ADHD), asthma, seizures, and diabetes.3 A survey in Minnesota schools noted that on an average day, a school nurse administered 46 medications.4 A policy statement of the American Academy of Pediatrics (AAP) guides school districts in implementing policies and procedures on medication administration and provides recommendations on several issues (e.g., training and certification of unlicensed assistive personnel [UAP], when to require a written medication form, when to permit responsible students to carry and self-administer emergency medications).3 Provision of medication use services within schools may result in use of UAP, such as teachers and administrative staff.5 North Carolina schools have general statutes that allow UAP to deliver health services to students. NCGS 115C-375.1 states, “It is within the scope of duty of teachers, including substitute teachers, teacher assistants, student teachers or any other public school employee when authorized by the board of education or its designee, (i) to administer any drugs or medication prescribed by a doctor upon written request of the parent.”6 Historically, medication management at schools has been handled by certified or registered school nurses, and the American Nurses Association has advocated for daily availability of registered school nurses, with a ratio of 1 nurse to 750 children.7 The recent policy statement by AAP still endorses full-time licensed registered school nurses for medication administration. If a school nurse is not available, AAP recommends using trained and supervised UAP.3 Nursing shortages and changes in the economy are forcing schools to consider other means of managReceived October 27, 2009, and in revised form February 19, 2010. Accepted for publication May 1, 2010. Jennifer Stegall-Zanation, PharmD, BCPS, is a clinical pediatric pharmacist, UNC Hospitals and Clinics, University of North Carolina, Chapel Hill. Kelly L. Scolaro, PharmD, is Director of Pharmaceutical Care Labs and Assistant Professor, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Correspondence: Jennifer Stegall-Zanation, PharmD, BCPS, UNC Hospitals and Clinics, University of North Carolina, Campus Box 7600, Chapel Hill, NC 27514. Fax: 919-843-0156. E-mail: [email protected] Disclosure: The authors declare no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, gifts, stock holdings, or honoraria. Acknowledgments: To Tim Ives, Lisa Dinkins, and Mary Roederer for reviewing support.
720 • JAPhA • 50 : 6 • N ov /D e c 2009
720
www.japha.org
Journal of the American Pharmacists Association
11/5/10 12:13 PM
Research Notes
ing medication administration at schools and increasing use of UAP. Few publications describe pharmacist involvement at the school level and focus on medication education rather than medication management. The few existing studies discuss how pharmacists could provide education programs to students, parents, and school personnel on topics such as poison prevention, common disease states, and general information on medications.1,8 As drug experts, pharmacists and student pharmacists are well suited to offer medication education to non–health professionals and consultation regarding medication administration policies. They also can provide guidance to schools facing increasing rates of prescription and nonprescription drug misuse in adolescents as a result of self-medication or recreational drug use.9,10
Objective We sought to determine the extent of pharmacist use in medication management, roles of school nurses, and use of other health care providers at elementary schools in North Carolina.
Methods This prospective study was a survey of principals, headmasters/ mistresses, and directors/directresses of record for public elementary (grades kindergarten through 6) and private (grades kindergarten through 6, kindergarten through 8, and kindergarten through 12) schools in a region of North Carolina. Four counties were targeted: Chatham, Durham, Orange, and Wake. Public records from the school districts and school websites were used to obtain the contact information for the principal, headmaster/mistress, and director/directress of record, and information was found for 153 schools (130 public and 23 private). The 21-question survey consisted of drop-down boxes, yes/no questions, fill-in-the-blank questions, and defined selection options (Appendix 1 in the electronic version of this article, available online at www.japha.org). The survey was created using the Qualtrics survey system sponsored by the Odum Institute for Research in Social Science at the University of North Carolina at Chapel Hill. In June 2009, an e-mail was sent to the head administrator explaining the study and containing a link to the survey. Participants had 4 weeks to complete the survey, and nonrespondents were e-mailed a reminder, then provided an additional 4 weeks to complete the survey. Descriptive statistics were used to analyze the results. The study was approved by the university’s institutional review board.
Results Of the 153 potential respondents, 29 schools participated (19% response rate); however, some failed to respond to all questions. A total of 16 schools from Wake County, 8 schools from Durham County, 4 from Orange County, and 1 from Chatham County participated and included 26 public schools and 3 private schools. The average school enrollment for the public schools was 637.1 (range 347–950) and 215 for private schools (125–290). All 29 schools reported having a school policy regarding medication administration during school hours, and 27 Journal of the American Pharmacists Association
721
of those schools reported consulting health care personnel concerning these policies. Of note, 27 of 27 schools (100%) used nurses, 17 of 27 (63%) used physicians, and 1 of 27 (3.7%) consulted pharmacists. Students were allowed to take prescription medications during school hours in 89.3% of the schools (25 of 28) and nonprescription or over-the-counter (OTC) medications in 62.1% (18 of 29) of the schools. Parents/caregivers were required to check in their child’s medications by 89.7% (26 of 29) of the schools, and 96.6% (28 of 29) required communication of the medication plan with the person overseeing medications at the school. Medication details most commonly required by the schools included dose (29 of 29), frequency (29 of 29), physician’s care plan (28 of 29), and drug name (28 of 29). Additionally, some schools requested a prescription (24 of 29), food interactions (23 of 29), adverse drug reactions (20 of 29), indication (17 of 29), adverse effects (16 of 29), length of therapy (15 of 29), and medical form/note (5 of 29). Most of the schools required medications to be kept in the administrative office (19 of 29). Of the schools that responded, 96.3% (26 of 27) reported using directly observed therapy procedures to ensure children took medications. When asked who is primarily responsible for overseeing medications taken during school hours, 86.2% (25 of 29) used their administrative/office staff, 34.5% (10 of 29) used nurses, 13.8% (4 of 29) used teachers, 6.9% (2 of 29) used teacher assistants, and 3.4% (1 of 29) used anyone completing an online training program. Approximately 82.8% (24 of 29) of the schools provided training classes to their non–health care personnel concerning medications. Respondents reported using a variety of health care personnel at their schools, and 89.7% (26 of 29) reported having a nurse. The amount of time on campus for nurses ranged from 0.5 to 5 days per week (mean 1.83). None of the three private schools reported having a school nurse compared with 100% of public schools. Of note, the other most commonly employed personnel were speech pathologists (23 of 25) and social workers (23 of 25). None of the schools reported employing a pharmacist, nurse practitioner, physician, physician assistant, or respiratory therapist. Most schools used consultants instead of employing health care personnel (Figure 1). Speech pathologists also were consulted more frequently than other health care professionals (25 of 28). A pharmacist was consulted by only 1 of 28 schools, and the respondent from that school stated, “I regularly consult with pharmacists regarding specific medications, dosages, side effects, reactions with other meds, etc.” However, 41% (11 of 27) thought that a pharmacist could provide assistance concerning medication administration at their school. Of those who elaborated further, 50% (10 of 20) wanted drug information from pharmacists and 3 of 20 were unsure how a pharmacist could provide assistance.
Discussion Why pharmacists are not being consulted and continue to be underused in school health is unclear. As stated by Reutzel et al.,1 pharmacists need to be partners with schools. Pharmacists need to be involved in the medication management process to www.japha.org
N ov /D e c 2009 • 50:6 •
JAPhA • 721
11/5/10 12:13 PM
Research Notes
health aides, and the current study found that 86.2% used administrative staff.4,11 Of the schools we surveyed, 82.8% reported providing training classes to non–health care personnel or UAP; however, we failed to gather information on the frequency and content of these classes. Although all schools in the current study reported having policies and procedures guiding medication management at the schools, nurses and physicians were more likely to be consulted than pharmacists. In addition, the use of pharmacists in creating and reviewing medication management policies for schools and employment or consultation by schools appears to be low based on study results.
Speech pathologist Social worker Respiratory therapist Psychologist Physician assistant Physician Physical therapist Pharmacist Occupational therapist Nurse practitioner Certified nursing assistant Nurse Dietitian
Conclusion
0
5
10
Consulted
15
20
25
30
Employed
Figure 1. Use of health care personnel and consultants by North Carolina elementary schools ensure that school personnel are taught appropriate administration techniques (e.g., inhaler, subcutaneous injection, take medication with or without food), adverse effects of common drugs, and interactions (e.g., drug–drug, drug–food, drug–disease) that require intervention. Pharmacists are also crucial in the fight against medication misuse in schools. Pharmacists and student pharmacists can help provide education about drug misuse to school personnel, students, and parents. Reviews of prescription refills for overuse, increased presence in nonprescription or OTC aisles, and increased adult patient counseling on storage and disposal of medications are also ways community pharmacists and student pharmacists can help ensure proper medication use in children and adolescents. Approximately 41% of respondents thought a pharmacist could provide assistance concerning medication administration at their schools. Pharmacists should proactively approach school administrators about drug information programs for staff, reviewing medication administration policies and procedures, strategies to minimize missed doses, and drug abuse and poison prevention programs. A 2008 publication described how pharmacists solicited topics from local school nurses, provided in-service education to participants on ADHD and depression, and performed pre- and posttests to assess the impact of their sessions.8
Limitations Some potential limitations of our study include failure to pretest the survey, participants’ omission of questions, misinterpretation of questions, and launching the survey during the summer. Despite our low response rate, this study uncovered some valuable information about medication management in a region of North Carolina. A survey study in Pennsylvania reported that 55% of schools used administrative staff to administer medications, a study from Iowa indicated that 49% used secretaries or 722 • JAPhA • 50 : 6 • N ov /D e c 2009
722
www.japha.org
The use of pharmacists in creating and reviewing policies for schools and actual medication management at schools was extremely low. Similar to previous studies, the findings in the current work reinforce that pharmacists are not being used and are not a major presence in elementary school health. Our hope is that this study will encourage pharmacists and student pharmacists to become involved in the community and reach out to schools to help ensure proper medication management for children during school hours. References 1. Reutzel TJ, Patel R, Myers MA. Medication management in elementary and secondary schools. J Am Pharm Assoc. 2001;41:67– 77. 2. Bloom B, Cohen RA. Summary health statistics for U.S. children: National Health Interview Survey, 2007. Accessed at www.cdc. gov/nchs/data/series/sr_10/sr10_239.pdf, October 1, 2009. 3. Council on School Health. Policy statement: guidance for the administration of medication in school. Pediatrics. 2009;124:1244– 51. 4. Ficca M, Welk D. Medication administration practices in Pennsylvania schools. J Sch Nurs. 2006;22:148–55. 5. Francis EE, Hemmat JP, Treloar DM, et al. Who dispenses pharmaceuticals to children at school? J Sch Health. 1996;66:355–8. 6. General Assembly of North Carolina. NCGS chapter 115C: elementary and secondary education: 115C-375.1 To provide some medical care to students. Accessed at www.ncleg.net, October 1, 2009. 7. McNamara M, Stewart M. ANA advocates for daily availability of school nurses for nation’s children. Accessed at www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/2007/schoolnurse.aspx, October 1, 2009. 8. Reutzel TJ, Desai A, Workman G, et al. Medication management in elementary and secondary schools: evaluation of mental health related in-service education in local schools. J Sch Nurs. 2008;24:239–48. 9. Twombly EC, Holtz KD. Teens and the misuse of prescription drugs: evidence-based recommendations to curb a growing social problem. J Prim Prev. 2008;29:503–16. 10. Romanelli F, Smith KM. Dextromethorphan abuse: clinical effects and management. J Am Pharm Assoc. 2009;49:e20–7. 11. Farris KB, McCarthy A, Kelly MW, et al. Issues of medication administration and control in Iowa schools. J Sch Health. 2003;73:331–7. Journal of the American Pharmacists Association
11/5/10 12:13 PM
Medication management in North Carolina elementary schools: Are pharmacists involved? Jennifer Stegall-Zanation and Kelly L. Scolaro
Abstract Objective: To determine the extent of pharmacist use in medication management, roles of school nurses, and use of other health care providers at elementary schools in North Carolina. Methods: Prospective survey of 153 (130 public and 23 private) elementary schools in four counties of North Carolina. A 21-question survey was e-mailed to the head administrator of each school (e.g., principal, headmaster) containing a Qualtrics survey link. Questions were designed to elicit information on school policies and procedures for medication management and use of health care providers, including pharmacists, in the schools. Responses were collected during a 2-month period. Results: Representatives from 29 schools participated in the survey (19% response rate). All 29 schools reported having a school policy regarding medication administration during school hours. Of those, 27 schools reported consulting with nurses on their policies. Only 1 of 27 respondents reported consulting with pharmacists on medication management policies. The majority of the respondents (93.1%) stated that administrative staff was responsible for medication administration at the schools. Conclusion: Use of pharmacists in creating and reviewing policies for schools and actual medication management at schools was extremely low. The findings in this study reinforce the findings in previous studies that pharmacists are not being used and are not a major presence in elementary school health. Keywords: Pediatrics, medication management, elementary schools, pharmacy services. J Am Pharm Assoc. 2010;50:720–722. doi: 10.1331/JAPhA.2010.09180
C
hildren with disabilities and chronic or acute medical conditions may need to take medications during school hours; however, school personnel are concerned about the safety and liability surrounding medication use during school hours.1 Data from the 2007 National Health Interview Survey indicated that 12% of U.S. children had a health problem that required prescription medications for at least 3 months.2 Approximately 17% of children aged 12 to 17 years, 12% of those 5 to 11 years, and 8% of those younger than 5 years were on regular medications.2 Common chronic conditions reported by school nurses included attention deficit hyperactivity disorder (ADHD), asthma, seizures, and diabetes.3 A survey in Minnesota schools noted that on an average day, a school nurse administered 46 medications.4 A policy statement of the American Academy of Pediatrics (AAP) guides school districts in implementing policies and procedures on medication administration and provides recommendations on several issues (e.g., training and certification of unlicensed assistive personnel [UAP], when to require a written medication form, when to permit responsible students to carry and self-administer emergency medications).3 Provision of medication use services within schools may result in use of UAP, such as teachers and administrative staff.5 North Carolina schools have general statutes that allow UAP to deliver health services to students. NCGS 115C-375.1 states, “It is within the scope of duty of teachers, including substitute teachers, teacher assistants, student teachers or any other public school employee when authorized by the board of education or its designee, (i) to administer any drugs or medication prescribed by a doctor upon written request of the parent.”6 Historically, medication management at schools has been handled by certified or registered school nurses, and the American Nurses Association has advocated for daily availability of registered school nurses, with a ratio of 1 nurse to 750 children.7 The recent policy statement by AAP still endorses full-time licensed registered school nurses for medication administration. If a school nurse is not available, AAP recommends using trained and supervised UAP.3 Nursing shortages and changes in the economy are forcing schools to consider other means of managReceived October 27, 2009, and in revised form February 19, 2010. Accepted for publication May 1, 2010. Jennifer Stegall-Zanation, PharmD, BCPS, is a clinical pediatric pharmacist, UNC Hospitals and Clinics, University of North Carolina, Chapel Hill. Kelly L. Scolaro, PharmD, is Director of Pharmaceutical Care Labs and Assistant Professor, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Correspondence: Jennifer Stegall-Zanation, PharmD, BCPS, UNC Hospitals and Clinics, University of North Carolina, Campus Box 7600, Chapel Hill, NC 27514. Fax: 919-843-0156. E-mail: [email protected] Disclosure: The authors declare no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, gifts, stock holdings, or honoraria. Acknowledgments: To Tim Ives, Lisa Dinkins, and Mary Roederer for reviewing support.
720 • JAPhA • 50 : 6 • N ov /D e c 2009
720
www.japha.org
Journal of the American Pharmacists Association
11/5/10 12:13 PM
Research Notes
ing medication administration at schools and increasing use of UAP. Few publications describe pharmacist involvement at the school level and focus on medication education rather than medication management. The few existing studies discuss how pharmacists could provide education programs to students, parents, and school personnel on topics such as poison prevention, common disease states, and general information on medications.1,8 As drug experts, pharmacists and student pharmacists are well suited to offer medication education to non–health professionals and consultation regarding medication administration policies. They also can provide guidance to schools facing increasing rates of prescription and nonprescription drug misuse in adolescents as a result of self-medication or recreational drug use.9,10
Objective We sought to determine the extent of pharmacist use in medication management, roles of school nurses, and use of other health care providers at elementary schools in North Carolina.
Methods This prospective study was a survey of principals, headmasters/ mistresses, and directors/directresses of record for public elementary (grades kindergarten through 6) and private (grades kindergarten through 6, kindergarten through 8, and kindergarten through 12) schools in a region of North Carolina. Four counties were targeted: Chatham, Durham, Orange, and Wake. Public records from the school districts and school websites were used to obtain the contact information for the principal, headmaster/mistress, and director/directress of record, and information was found for 153 schools (130 public and 23 private). The 21-question survey consisted of drop-down boxes, yes/no questions, fill-in-the-blank questions, and defined selection options (Appendix 1 in the electronic version of this article, available online at www.japha.org). The survey was created using the Qualtrics survey system sponsored by the Odum Institute for Research in Social Science at the University of North Carolina at Chapel Hill. In June 2009, an e-mail was sent to the head administrator explaining the study and containing a link to the survey. Participants had 4 weeks to complete the survey, and nonrespondents were e-mailed a reminder, then provided an additional 4 weeks to complete the survey. Descriptive statistics were used to analyze the results. The study was approved by the university’s institutional review board.
Results Of the 153 potential respondents, 29 schools participated (19% response rate); however, some failed to respond to all questions. A total of 16 schools from Wake County, 8 schools from Durham County, 4 from Orange County, and 1 from Chatham County participated and included 26 public schools and 3 private schools. The average school enrollment for the public schools was 637.1 (range 347–950) and 215 for private schools (125–290). All 29 schools reported having a school policy regarding medication administration during school hours, and 27 Journal of the American Pharmacists Association
721
of those schools reported consulting health care personnel concerning these policies. Of note, 27 of 27 schools (100%) used nurses, 17 of 27 (63%) used physicians, and 1 of 27 (3.7%) consulted pharmacists. Students were allowed to take prescription medications during school hours in 89.3% of the schools (25 of 28) and nonprescription or over-the-counter (OTC) medications in 62.1% (18 of 29) of the schools. Parents/caregivers were required to check in their child’s medications by 89.7% (26 of 29) of the schools, and 96.6% (28 of 29) required communication of the medication plan with the person overseeing medications at the school. Medication details most commonly required by the schools included dose (29 of 29), frequency (29 of 29), physician’s care plan (28 of 29), and drug name (28 of 29). Additionally, some schools requested a prescription (24 of 29), food interactions (23 of 29), adverse drug reactions (20 of 29), indication (17 of 29), adverse effects (16 of 29), length of therapy (15 of 29), and medical form/note (5 of 29). Most of the schools required medications to be kept in the administrative office (19 of 29). Of the schools that responded, 96.3% (26 of 27) reported using directly observed therapy procedures to ensure children took medications. When asked who is primarily responsible for overseeing medications taken during school hours, 86.2% (25 of 29) used their administrative/office staff, 34.5% (10 of 29) used nurses, 13.8% (4 of 29) used teachers, 6.9% (2 of 29) used teacher assistants, and 3.4% (1 of 29) used anyone completing an online training program. Approximately 82.8% (24 of 29) of the schools provided training classes to their non–health care personnel concerning medications. Respondents reported using a variety of health care personnel at their schools, and 89.7% (26 of 29) reported having a nurse. The amount of time on campus for nurses ranged from 0.5 to 5 days per week (mean 1.83). None of the three private schools reported having a school nurse compared with 100% of public schools. Of note, the other most commonly employed personnel were speech pathologists (23 of 25) and social workers (23 of 25). None of the schools reported employing a pharmacist, nurse practitioner, physician, physician assistant, or respiratory therapist. Most schools used consultants instead of employing health care personnel (Figure 1). Speech pathologists also were consulted more frequently than other health care professionals (25 of 28). A pharmacist was consulted by only 1 of 28 schools, and the respondent from that school stated, “I regularly consult with pharmacists regarding specific medications, dosages, side effects, reactions with other meds, etc.” However, 41% (11 of 27) thought that a pharmacist could provide assistance concerning medication administration at their school. Of those who elaborated further, 50% (10 of 20) wanted drug information from pharmacists and 3 of 20 were unsure how a pharmacist could provide assistance.
Discussion Why pharmacists are not being consulted and continue to be underused in school health is unclear. As stated by Reutzel et al.,1 pharmacists need to be partners with schools. Pharmacists need to be involved in the medication management process to www.japha.org
N ov /D e c 2009 • 50:6 •
JAPhA • 721
11/5/10 12:13 PM
Research Notes
health aides, and the current study found that 86.2% used administrative staff.4,11 Of the schools we surveyed, 82.8% reported providing training classes to non–health care personnel or UAP; however, we failed to gather information on the frequency and content of these classes. Although all schools in the current study reported having policies and procedures guiding medication management at the schools, nurses and physicians were more likely to be consulted than pharmacists. In addition, the use of pharmacists in creating and reviewing medication management policies for schools and employment or consultation by schools appears to be low based on study results.
Speech pathologist Social worker Respiratory therapist Psychologist Physician assistant Physician Physical therapist Pharmacist Occupational therapist Nurse practitioner Certified nursing assistant Nurse Dietitian
Conclusion
0
5
10
Consulted
15
20
25
30
Employed
Figure 1. Use of health care personnel and consultants by North Carolina elementary schools ensure that school personnel are taught appropriate administration techniques (e.g., inhaler, subcutaneous injection, take medication with or without food), adverse effects of common drugs, and interactions (e.g., drug–drug, drug–food, drug–disease) that require intervention. Pharmacists are also crucial in the fight against medication misuse in schools. Pharmacists and student pharmacists can help provide education about drug misuse to school personnel, students, and parents. Reviews of prescription refills for overuse, increased presence in nonprescription or OTC aisles, and increased adult patient counseling on storage and disposal of medications are also ways community pharmacists and student pharmacists can help ensure proper medication use in children and adolescents. Approximately 41% of respondents thought a pharmacist could provide assistance concerning medication administration at their schools. Pharmacists should proactively approach school administrators about drug information programs for staff, reviewing medication administration policies and procedures, strategies to minimize missed doses, and drug abuse and poison prevention programs. A 2008 publication described how pharmacists solicited topics from local school nurses, provided in-service education to participants on ADHD and depression, and performed pre- and posttests to assess the impact of their sessions.8
Limitations Some potential limitations of our study include failure to pretest the survey, participants’ omission of questions, misinterpretation of questions, and launching the survey during the summer. Despite our low response rate, this study uncovered some valuable information about medication management in a region of North Carolina. A survey study in Pennsylvania reported that 55% of schools used administrative staff to administer medications, a study from Iowa indicated that 49% used secretaries or 722 • JAPhA • 50 : 6 • N ov /D e c 2009
722
www.japha.org
The use of pharmacists in creating and reviewing policies for schools and actual medication management at schools was extremely low. Similar to previous studies, the findings in the current work reinforce that pharmacists are not being used and are not a major presence in elementary school health. Our hope is that this study will encourage pharmacists and student pharmacists to become involved in the community and reach out to schools to help ensure proper medication management for children during school hours. References 1. Reutzel TJ, Patel R, Myers MA. Medication management in elementary and secondary schools. J Am Pharm Assoc. 2001;41:67– 77. 2. Bloom B, Cohen RA. Summary health statistics for U.S. children: National Health Interview Survey, 2007. Accessed at www.cdc. gov/nchs/data/series/sr_10/sr10_239.pdf, October 1, 2009. 3. Council on School Health. Policy statement: guidance for the administration of medication in school. Pediatrics. 2009;124:1244– 51. 4. Ficca M, Welk D. Medication administration practices in Pennsylvania schools. J Sch Nurs. 2006;22:148–55. 5. Francis EE, Hemmat JP, Treloar DM, et al. Who dispenses pharmaceuticals to children at school? J Sch Health. 1996;66:355–8. 6. General Assembly of North Carolina. NCGS chapter 115C: elementary and secondary education: 115C-375.1 To provide some medical care to students. Accessed at www.ncleg.net, October 1, 2009. 7. McNamara M, Stewart M. ANA advocates for daily availability of school nurses for nation’s children. Accessed at www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/2007/schoolnurse.aspx, October 1, 2009. 8. Reutzel TJ, Desai A, Workman G, et al. Medication management in elementary and secondary schools: evaluation of mental health related in-service education in local schools. J Sch Nurs. 2008;24:239–48. 9. Twombly EC, Holtz KD. Teens and the misuse of prescription drugs: evidence-based recommendations to curb a growing social problem. J Prim Prev. 2008;29:503–16. 10. Romanelli F, Smith KM. Dextromethorphan abuse: clinical effects and management. J Am Pharm Assoc. 2009;49:e20–7. 11. Farris KB, McCarthy A, Kelly MW, et al. Issues of medication administration and control in Iowa schools. J Sch Health. 2003;73:331–7. Journal of the American Pharmacists Association
11/5/10 12:13 PM