Medication Administration Practices in United States’ Schools: A Systematic Review and Meta-synthesis

Abstract

Schools often provide medication management to children at school, yet, most U.S. schools lack a full-time, licensed nurse. Schools rely heavily on unlicensed assistive personnel (UAP) to perform such tasks. This systematic review examined medication management among K-12 school nurses. Keyword searches in three databases were performed. We included studies that examined: (a) K-12 charter, private/parochial, or public schools, (b) UAPs and licensed nurses, (c) policies and practices for medication management, or (d) nurse delegation laws. Three concepts were synthesized: (a) level of training, (b) nurse delegation, and (c) emergency medications. One-hundred twelve articles were screened. Of these, 37.5% (42/112) were comprehensively reviewed. Eighty-one percent discussed level of training, 69% nurse delegation, and 57% emergency medications. Succinct and consistent policies within and across the United States aimed at increasing access to emergency medications in schools remain necessary.

School Stock Inhaler Statutes and Regulations in the United States: A Systematic Review*

“…Another key component of stock inhaler laws is to ensure medication administration is not required to be completed by a nurse. The benefits of the licensed, school nurse are well established 82 . Children who attend schools with a full‐time, licensed nurse have less chronic absenteeism and improved academic outcomes 83 .…”

“…The benefits of the licensed, school nurse are well established. 82 Children who attend schools with a full-time, licensed nurse have less chronic absenteeism and improved academic outcomes. 83 Furthermore, asthmatic children who attend schools with a full-time, licensed nurse experience improved disease management and health outcomes.…”

Factors associated with continuing education needs in medication administration among school nurses

“…Responsibilities and duties related to medication management in schools can vary due to regulations at the country or state level (Lowe et al., 2022; Maughan et al., 2018). In the United Kingdom, health visitors and school nurses, particularly those trained and guided by the ‘Standards for Medicines Management’ (Nursing and Midwifery Board of Ireland, 2015), are authorized to prescribe medication to students (Public Health England, 2021).…”

“…Despite the importance of continuing education in medication administration within school settings, few studies have explored this area. To establish guidelines aligned with those of the United States (Lowe et al., 2022) for medication administration in schools, a quantitative study was conducted to gather information regarding nurses' needs in executing medication administration within the school setting. Hence, the primary objective of this study was to investigate the continuing education needs and associated factors among school nurses concerning medication administration on school campuses.…”

“…Given that the government in Taiwan mandates the presence of a school nurse in each school, our study contributes valuable insights to the continuing education needs of school nurses in medication administration. The findings serve as a point of reference for future policy development and training interventions aimed at improving campus medication administration.Responsibilities and duties related to medication management in schools can vary due to regulations at the country or state level(Lowe et al, 2022;Maughan et al, 2018). In the United Kingdom, health visitors and school nurses, particularly those trained and guided by the 'Standards for Medicines Management'(Nursing and Midwifery Board of Ireland, 2015), are authorized to prescribe medication to students(Public Health England, 2021).…”