Questions to Consider When Developinga School Program for the Administration ofStock Emergency Medication(s)

State Laws:

  1. Are there state laws that currently prohibit the administration of stock emergency medications in schools?
  2. Does the state have a Good Samaritan law or equivalent?
  3. Does the state have exemption from liability laws for medication administration or emergency care?
  4. Does your state nurse practice act and other relevant laws allow the school nurse to delegate the administration of stock emergency medication to unlicensed assistive personnel (UAP)?
  5. Does the state law allow administration of stock emergency medication to school staff and visitors?

District Policies:

  1. Is a policy required to develop a stock emergency medication program for the school corporation?
  2. Does the school board support a stock emergency medication program?
  3. Does your school corporation medical advisor support a stock emergency medication program?
  4. Does the district policy allow the delegation of stock emergency medication to UAPs?

School Nurse Practice:

  1. Is delegation to a UAP regarding the administration of stock emergency medication a safe decision based on the structure of the school environment, school nurse: pupil ratio, and other roles and responsibilities of the school nurse?
  2. Are there enough UAPs willing and competent, in each school building, to administer a stock emergency medication to ensure a safe and timely response to a potential life-threating emergency?

Education for Administration of Stock Emergency Medications:

  1. How will the UAP determine when a stock emergency medication should be administered?
  2. What education and training should be provided regarding the potential side effects that can be expected?
  3. What education will be provided on supportive care to be provided before and after a stock emergency medication has been administered?
  4. How often will education and training be provided?
  1. Will the UAPs trained to administer a stock emergency medication also be required to be certified in CPR?

Medication and Storage:

  1. Who will be responsible for procuring and maintaining any of these stock emergency medications?
  2. How many doses will schools have in each building?
  3. Where will the stock emergency medication(s) be stored?
  4. Will a standing order allow for administration of a second dose?
  5. How will the district fund further supplies of the stock emergency medication(s)?
  6. Will the continued procuring and maintenance of any of these stock emergency medications be cost prohibitive for the school district?
  7. Will the stock emergency medication(s) be available for before/after school events and school sponsored events?
  8. Will the stock emergency medication(s) be available for community groups using the building for non-school sponsored events?
  9. Will the standing order for the stock emergency medication(s) allow the administration of the medication(s) to staff and visitors?
  10. Which formulation of the stock emergency medication will your district stock (i.e. intramuscular vs. intranasal)?
  11. Does the standing order require a specific formulation of the stock emergency medication?

Community Need:

  1. What is the average response time in the community for emergency medical services (EMS)?
  2. Do local EMS, fire department and/or law enforcement personnel carry any of these stock emergency medications?
  3. Have EMS had to administer any of these emergency medications in a school setting or school sponsored activity before?
  4. Do school police officers or safety resource officers carry any of these emergency medications?
  5. Are there other groups/individuals working onstock medication(s) access and administration issues in your community?

Adapted from the materials developed by the National Association of School Nurses

June 2017

SPECIFIC CONSIDERATIONS for STOCKING NALOXONE

  1. What are the steps or the process that needs to take place when stocking any emergency medication in a school?

Several items should be considered by schools when they are developing their stock emergency medication policy and procedures. These items include:

a. Determine, by involving all stakeholders and through a school assessment,

whether stocking a particular emergency medication would be something the school should purse

b. Contact your local school health medical advisor to determine his/her willingness

to write a prescription and a standing order for a particular emergency medication to be stored and administered by school personnel

c. Establish policies and procedures identifying who can administer a particular

medication, under what conditions, what training is required and who will conduct the training, how many doses will be stocked at each building location, where will the medication be stored, how the medication will be replaced if used, will the medication be available during, before and after school activities, and who will complete the reporting requirements

d. Refer to the document “Questions to Consider When Developing a School

Program for the Administration of Stock Emergency Medication” to review other important items to consider when implementing a stock emergency medication program

e. Involve legal counsel and medical expertise to understand state and local regulations, position statements, immunities available, liability exposures, etc. in

order to help determine if this program is something the school should pursue

  1. Are there specific items to consider regarding Naloxone?

Yes, for schools to stock Naloxone, they must follow the items listed in both SEA 392 and IC 16-42-27.

  1. What are the key components of SEA 392?
  2. Allows schools to stock any of the following emergency medications: albuterol, epinephrine, and/or naloxone
  3. Allows a school to fill a prescription for an emergency medication if a licensed health care provider writes a prescription for the medication and the school stores the medication in a safe location where only school employees have access
  4. Requires a pharmacy to dispense epinephrine that has at least a 12-month expiration date
  5. Allows a school nurse (RN) to administer emergency stock medication(s) to students, school employees, or visitors
  6. Allows a school employee to administer emergency stock medication(s) to students, school employees, or visitors if:
  7. The school employee has voluntarily received training in recognizing a life-threatening emergency and the proper administration of the medication
  8. The school employee was trained by a health care provider who is licensed or certified in Indiana, for whom the administration of the emergency medication is within the health care provider’s scope of practice, who has received training in the administration of the medication, and who is knowledgeable in recognizing the symptoms of a life-threatening emergency and the administration of the emergency medication
  9. Allows a licensed health care provider to write a prescription, drug order or protocol for an emergency medication for the school
  10. Allows a pharmacist to dispense the emergency medication
  11. Provides civil liability protection for a school nurse or school employee who administers an emergency medication in accordance with the manufacturer’s guidelines and the training requirements listed above
  12. Provides civil liability protection for a health care provider who writes a prescription, drug order, or protocol for the school
  13. Provides civil liability protection for the health care provider who provides training to school employees
  14. Requires the Indiana Department of Education to develop guidance materials for each emergency medication
  15. Requires a school employee or school nurse to submit a report to the Indiana Department of Education within 10 days of administering a stock emergency medication
  1. What are the key components of IC 16-42-27?

IC 16-42-27 requires that entities who stock naloxone must:

a.Obtain naloxone from a prescriber through a standing order

b. Annually register as a Naloxone Entity at in a manner

prescribed by the Indiana Department of Health

c. Provide education and training on drug overdose response and treatment,

includingthe administration of an overdose intervention drug and the legal requirement to call 911 immediately before or after administering the drug

d. Provide drug addiction treatment information and referrals to drug treatment

programs, including programs in the local area and programs that offer medication assisted treatment that includes a federal Food and Drug Administration approved long acting nonaddictive medication for the treatment of opioid or alcohol dependence

  1. Where can I find more information regarding IC 16-42-27?

More information, including a Naloxone FAQ document, a training toolkit, a training video, and treatment resources can be found at