Module 4.3 Administering of Medication

Jane Krieg; Janice Quade

Module 4.3 Administering of Medication

Learning Objectives

By the end of this module, you should be able to:

Explain Ontario licensing requirements for handling medication in early learning and childcare programs.
Identify the “Seven Rights” for administering medication.

Administering Medications

Some children in your early learning and childcare program may need to take medications during the hours you provide care for them. In Ontario, early learning and childcare programs are required to have a written policy for the administration of prescription and non-prescription medication.

Ontario licensing requirements specify that:

All prescription and non-prescription medications shall be centrally stored in a locked container inaccessible to children.
All prescription and non-prescription medications must be in the original container labeled with the child’s name, name of the medication, the dosage, the date of purchase, the expiration date and any instructions for storage or administration.
A refrigerator shall be used to store any medication that requires refrigeration.
All medications may only be administered with written authorization by the child’s parent/guardian that includes a schedule for administering the medication and the dosage.

Hands pouring liquid medication from a brown bottle onto a spoon. — Figure 1 – Medication must be given according to the label. (Close-up of a woman pours a spoon of medicinal mixture by Marco Verch is licensed under CC BY 2.0)

Valid reasons for an early learning and childcare programs to consider administering medication:

Some medication dosing cannot be adjusted to be taken before and after care and keeping the child out of care when otherwise well enough to attend, would be a hardship for families.
Some children may have chronic conditions that may require urgent administration of medication (such as asthma and diabetes).

O. Reg. 137/15: GENERAL also sets out requirements for administering 6 items that are not considered a drug or medication (unless prescribed by a physician): sunscreen, moisturizing lotion, lip balm, insect repellant, hand sanitizer and diaper cream. These items must only be administered from their original containers, with written parent/guardian authorization and according to label or instructions on the written authorization.

LICENSING REQUIREMENTS: O. Reg 137/15: GENERAL

40. (1) Where a licensee agrees to the administration of drugs or medications, the licensee shall ensure that,

(a) a written procedure is established for,

(i) the administration of any drug or medication to a child receiving child care at a child care centre operated by the licensee or at a premises where it oversees the provision of home child care, and

(ii) the keeping of records with respect to the administration of drugs and medications;

(b) all drugs and medications on the premises of a child care centre operated by the licensee or at a premises where it oversees the provision of home child care are,

(i) stored in accordance with the instructions for storage on the label,

(ii) administered in accordance with the instructions on the label and the authorization received under clause (d),

(iii) inaccessible at all times to children, and

(iv) in the case of a child care centre, kept in a locked container;

(c) one person in each child care centre operated by the licensee and in each premises where it oversees the provision of home child care is in charge of all drugs and medications and that all drugs and medications are dealt with by that person or a person designated by that person in accordance with the procedures established under clause (a);

(d) a drug or medication is administered to a child only where a parent of the child gives written authorization for the administration of the drug or medication and that included with the authorization is a schedule that sets out the times the drug or medication is to be given and amounts to be administered; and

(e) a drug or medication is administered to a child only from the original container as supplied by a pharmacist or the original package and that the container or package is clearly labelled with the child’s name, the name of the drug or medication, the dosage of the drug or medication, the date of purchase and expiration, if applicable, and instructions for storage and administration. O. Reg. 137/15, s. 40 (1); O. Reg. 254/19, s. 10.

(2) Despite subclauses (1) (b) (iii) and (iv) and clause (1) (c), the licensee may permit a child to carry his or her own asthma medication or emergency allergy medication in accordance with the procedures established under clause (1) (a). O. Reg. 137/15, s. 40 (2).

(3) The following items do not constitute drugs or medication for the purposes of this section, except where the item is a drug, as defined in the Drug and Pharmacies Regulation Act, prescribed for a child by a health professional:

Sunscreen.
Moisturizing skin lotion.
Lip balm.
Insect repellent.
Hand sanitizer.
Diaper cream. O. Reg. 174/21, s. 22.

(4) In respect of an item described in subsection (3) that does not constitute a drug or medication for the purposes of this section, a licensee shall ensure that,

(a) the item is administered to a child only if a parent of the child has given written authorization for the administration of the item;

(b) the item is stored in accordance with the instructions for storage on the label and the container or package is clearly labelled with the child’s name and the name of the item; and

(c) the item is administered to a child only from the original container or package and in accordance with any instructions on the label and any instructions provided by the parent of the child. O. Reg. 174/21, s. 22. (O. Reg. 137/15: GENERAL)

The Seven Rights for Administering Medication

Medication errors can include mixing up medications between children, administering an incorrect dosage, administering a medication at the wrong time, missing a prescribed dose, and not using the correctly route (e.g., topical, oral, nasal, injection). As the administer of the medication make sure that it is being given for the right reason, such as Tylenol for teething pain. The same person who administers the medication needs to record the dose.

The chance of a medication error can be greatly reduced by verifying the:

Right child
Right medication
Right dosage
Right time
Right route
Right reason
Right documentation

Pause to Reflect 💭

Early learning environments are busy with numerous transitions.

How can you ensure that all children receive medication as prescribed?

Indigenous Perspective

The First Nations Health Authority (FNHA), in collaboration with Doctors of BC and the BC provincial government’s Shared Care Committee, launched Coyote’s Food Medicines, an innovative storytelling project and campaign focused on healthy medication use. You can read further about it here.

Important Things to Remember

Children that require prescription or non-prescription medications while in your care will happen often. There may be several children at one time that that are ill or require over the counter medications to support their health and wellness. Documentation to deliver these medications needs to be accurate and current, following licensing requirements and your centre policies.