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St Nicholas - Administration of Medication Procedure

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Section 1 - Purpose

(1) St Nicholas is committed to providing children with an environment that promotes their health, safety, and wellbeing. St Nicholas will provide effective administration of medication to children by suitably trained educators to ensure safe operations when the administration of prescribed medication may be necessary to support children while attending St Nicholas services.

(2) The Education and Care Services National Regulations (2011) require approved providers to ensure their services have policies and procedures in place in relation to administrating medication. This procedure needs to read in conjunction with the St Nicholas Compliance Policy.

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Section 2 - Scope

(3) This procedure applies to all St Nicholas employee who educate and care for children in Early Education and OOSH services and the parents/carers of children who attend St Nicholas services.

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Section 3 - Responsibilities

ROLE	RESPONSIBILITIES
St Nicholas Approved Provider	• Ensure that the obligations under the Children (Education and Care Services National Law Application) Act 2010 (NSW) and Education and Care Services National Regulations (2011) are met. •Take reasonable steps to ensure that the St Nicholas Nominated Supervisor, St Nicholas employee and visitors follow the policy and procedures.
St Nicholas Nominated Supervisor/ Responsible Person	• Ensure St Nicholas educators complete the Medication Training module as part of their induction. • Ensure St Nicholas educators are aware of the St Nicholas Administration of Medication procedure before administering medication. • Ensure medication is not administered without the authorisation of a parent/carer or person with authority, except in the case of an emergency (see Emergency Administration of Medication below). • Ensure that medication is only administered by St Nicholas educators who: are over the age of 18 years; have a valid First Aid Certificate (educators who do not have a valid First Aid Certificate may witness the administration of medication only); are St Nicholas employees. • Ensure that where medication for treatment of long-term conditions such as asthma, epilepsy or anaphylaxis is required, a current action plan from the child's medical practitioner or specialist detailing the medical condition of the child is held at the service. • Ensure parents/carers complete a Medical Risk Minimisation Plan (MRMP) in conjunction with the service (see St Nicholas Medical Conditions procedure). • Ensure that any medication, cream or lotion kept on the premises is checked monthly for expiry dates.
St Nicholas Team Members	• Provide parents/carers with medication forms that are essential for medication to be administered at St Nicholas. • Store medication in a labelled and locked medication container, in an appropriate location with the key in a separate location nearby, and out of reach of children (except emergency medication including EpiPens and Asthma). • All emergency medications, such as EpiPens, adrenaline autoinjectors, antihistamines and asthma medication are kept out of reach of children and stored in a cool dry place at room temperature. They must be readily available and not in a locked cupboard. A copy of the child’s Medical Management Plan should be stored with the child’s emergency medication. • Store records of all medication given in accordance with the Privacy Policy and Information Management Policy. • Administer medication with a second educator witnessing the following: the correct child’s name is on the medication; the correct name of the medication; the correct dosage is written down; the medication is being given at the correct time; the correct dosage is being given; the time when the last dosage was given; and expiry date of medication. • Ensure the Medication Form is completed by both the administrator of the medication and witness, at the time of administration. • Trainees and SBATs are not to administer medication and are to seek support from a qualified St Nicholas team member.
Parents/Carers	• Provide the St Nicholas Nominated Supervisor with accurate information about their child’s health needs, medical conditions and medication requirements on the enrolment form or subsequently in writing, as soon as required if diagnosed after enrolment. • Keep children at home while any symptoms of illness are evident, or the child is not well enough to participate in the program. • Ensure that any medication will be given directly to a St Nicholas educator on arrival at the service. • Ensure a Medication Form is completed for each medication provided to the service. This must be completed accurately, and signed and dated on each occasion the medication is to be administered. Failure to do so will prevent administration of medication (parents are welcome to administer the medication to their own child in these circumstances). • Please note that no authority to administer medication to a child will be accepted verbally, in person, or over the phone. An exception will be applied for emergency situations, or to administer Panadol for high temperatures (with permission already provided in the enrolment record). • Ensure medication is provided in the original packaging bearing: The child’s name; Name of medication; Name of doctor; Expiry date of product, unless the medication is provided in a Webster pack from a chemist; and Dosage to be administered • Complete a Medication Form detailing all of the above information, as well as; Storage requirements for medication; Manner and method of administration; Time and date last administered; and Time and date to be administered; • Under no circumstances will a service be responsible for cutting medication. Tablets required to be cut prior to their administration will need to be precut and packaged in a Webster pack by the pharmacist at the time of dispensing. • In the event of another person other than the parent/carer signing in the child at St Nicholas, a written permission note will be required to be provided to educators, including the above information. The guardian will then be requested to complete the Medication Form on behalf of the parent/carer. • Ensure that in date medication is on site when the child is in attendance for long term medical conditions including, but not limited to asthma, allergies, anaphylaxis and diabetes. • Attendance will be suspended in the case that a child’s medication expires, is not labelled correctly, or is not provided (see St Nicholas Medical Conditions procedure).

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Section 4 - Procedure

Temperatures

(4) Important information about fevers:

The normal temperature for a child is up to 38°C.
Fevers are common in children.
Check the child’s temperature using an appropriate digital thermometer. If it is suspected that the child may have a temperature if they feel hot to touch, are lethargic or unsettled.
If the child feels well and is happy there is no need to treat the fever.
Recheck the child’s temperature every 30 minutes if their temperature is between 37.5^oC and 37.9^oC, and record each reading on an incident report in mnResponse.
Phone a parent/carer or authorised nominee if the child’s temperature is 38^oC or higher, and advise to collect their child. Educators should separate the child from other children where possible.
Ensure the ‘Fever’ fact sheet from Staying Healthy 6^th Edition (2024) is available to families.
If the child has gone home from the service with a fever but their temperature is normal the next morning, they can return to the service.

(5) Verbal permission can be granted for the administration of a single dose of Paracetamol, if the parent has provided written permission in the enrolment form. In the event Paracetamol is administered a St Nicholas Paracetamol Administration Form must be completed at the time the medication is administered and the child is required to be collected by a parent/carer or authorised nominee.

Avoid cold water sponging or cold baths that make the child shiver. If sponging or bathing makes the child feel more comfortable use lukewarm water.
Fevers can cause febrile convulsions in children (which are physical seizures). They usually only last a few seconds to minutes. In the case of a febrile convulsion an educator should call an ambulance immediately, and then contact the child’s parent/carer in the first instance, and the authorised nominee if the parent/carer is unable to be contacted.
Complete an incident report in mnResponse.
Advise the child’s parent/carer of any relevant exclusion periods.

Administration of non-prescription creams

(6) Non-prescription creams and medication St Nicholas team members will administer include:

Sunscreen;
Insect repellent;
Sorbolene lotion;
Paw Paw cream;
Teething gel;
Nappy rash creams; and
Medication for travel sickness.

(7) The authorisation for administration of non-prescription cream must be completed by the parent/carer on their enrolment form before the cream can be applied.

(8) The authorisation for administration of non-prescription medication (travel sickness medication) must be completed by the parent/carer on the St Nicholas Medication Form before the medication can be administered.

(9) Creams must be provided by parent/carer in the original container with valid expiration date (if applicable), clearly labelled with your child’s first and last name and be given directly to an educator. Any over-the-counter creams need to have a label from the pharmacist applied.

(10) If the instructions state that the cream is not age-appropriate for the child, St Nicholas team members will not administer, unless accompanied by a letter from the child’s doctor.

(11) Please refer to the St Nicholas Sun Protection procedure for further information on sunscreen.

(12) St Nicholas team members will not accept or administer alternative medications including homeopathic and alternative medications.

Children returning to the service whilst on antibiotics

(13) A child starting a course of antibiotics is recommended to stay home for at least 24 hours from the first day of the course. This is to ensure:

the child does not have an adverse reaction to the antibiotics they have been prescribed. Even if children have had a certain antibiotic previously there is always the chance that a reaction could present unexpectedly.
the child is in an environment they feel comfortable with, as it is assumed that if a child is unwell to a degree that prescribed medication is required, they would prefer a quiet space to recover.

(14) If a child has had repeated doses of antibiotics due to a chronic non-infectious illness, they may return to care within the 24hr period with a medical certificate, if they are deemed well enough by the child’s parent/carer and the St Nicholas Nominated Supervisor.

(15) It is always the St Nicholas Nominated Supervisor's right to refuse admission to a child if they feel the child is too unwell to attend care.

Self administration of medication (OOSH only)

(16) A child over pre-school age may self-administer medication under the following circumstances:

a parent/carer provides written authorisation with consent on the child’s enrolment record;
medication is stored safely by a St Nicholas team member, who will provide it to the child when required;
supervision is provided by a St Nicholas team member whilst the child is self-administering medication; and
a recording is made on the St Nicholas Medication Form for the child that the medication has been self-administered.

Emergency administration of medication

(17) In the occurrence of an emergency and where the administration of medication must occur, the St Nicholas Nominated Supervisor or St Nicholas Responsible Person must attempt to receive verbal authorisation by a parent of the child named in the child’s enrolment form who is authorised to consent to the administration of medication.

(18) If a parent/carer of a child is unreachable, the St Nicholas Nominated Supervisor or St Nicholas Responsible Person will endeavour to obtain verbal authorisation from an emergency contact of the child named in the child’s enrolment form, who is authorised to approve the administration of medication.

(19) If all the child’s nominated contacts are non-contactable, the service must contact a registered medical practitioner or emergency services on 000.

(20) In the event of an emergency and where the administration of medication must occur, written notice must be provided to a parent of the child or other emergency contact person listed on the child’s enrolment form.

Refusal of medication

(21) While St Nicholas has a duty to do everything reasonable to facilitate the taking of medication, in circumstances where a child refuses to take medication, the setting will not force compliance unless the immediate health or safety of the child is at risk.

(22) Parents/carers must be informed of the medication refusal at the earliest possible opportunity. If a child refuses to take medication and they cannot remain at the service, parents/carers must be advised to collect their child.

(23) Details of the refusal should be noted in the records kept by the service and an incident report must be submitted in mnResponse.

(24) Ongoing refusals should be discussed with the parent/carer and a plan implemented to effectively manage.

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Section 5 - Legislative Requirements

Children (Education and Care Services) National Law 2010	Section 167	Offence relating to protection of children from harm and hazards
Education and Care Services National Regulations 2011	Regulation 85	Incident, injury, trauma and illness policies and procedures
	Regulation 86	Notification to parent of incident, injury, trauma, and illness
	Regulation 87	Incident, injury, trauma and illness record
	Regulation 89	First aid kits
	Regulation 90	Medical conditions policy
	Regulation 91	Medical conditions policy to be provided to parents
	Regulation 92	Medication record
	Regulation 93	Administration of medications
	Regulation 94	Exception to authorisation requirement – anaphylaxis or asthma emergency
	Regulation 95	Procedure for administration of medication
	Regulation 96	Self-administration of medication
	Regulation 136	First aid qualifications
	Regulation 162	Health information to be kept in enrolment record
	Regulation 168	Education and care services must have policies and procedures
	Regulation 170	Policies and procedures to be followed
	Regulation 171	Policies and procedures to be kept available
	Regulation 172	Notification of change to policies or procedures
	Regulation 183	Storage of records and other documents
National Quality Standards	Element 2.1.1	Wellbeing and comfort: Each child’s wellbeing and comfort is provided for, including appropriate opportunities to meet each child’s need for sleep, rest and relaxation.
	Element 2.1.2	Health practices and procedures: Effective illness and injury management and hygiene practices are promoted and implemented.
	Element 2.2.1	Supervision: At all times, reasonable precautions and adequate supervision ensure children are protected from harm and hazard.
	Element 2.2.2	Incident and emergency management: Plans to effectively manage incidents and emergencies are developed in consultation with relevant authorities, practised and implemented
	Element 7.1.2	Management systems: Systems are in place to manage risk and enable the effective management and operation of a quality service.
	Element 7.1.3	Roles and responsibilities: Roles and responsibilities are clearly defined, and understood, and support effective decision-making and operation of the service.

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Section 6 - Document Review

(25) This procedure will be reviewed when there is a legislative change, organisational change, delegations change or at least every 3 years to ensure it continues to be current and effective.