Ms. Mickey welcomes children to the group each day. This morning, Kyra was dropped of by her Aunt Karen. Ms. Mickey noticed that Karen placed her purse on a table, then began to walk around the room with Kyra, looking at the child’s artwork. Ms. Mickey then positioned herself so she could greet children while making sure no one touched Karen’s purse. As Karen prepared to leave, Ms. Mickey gently told her that it was best if she carried her purse with her while in the center. She explained that children are very curious and might get into her purse if it was within reach and that any medications that might be in the purse could be dangerous to young children.

Studies have shown that more than 50 percent of older adults take prescription medication, over-the-counter (OTC) drugs (those that can be bought in a store without a doctor’s prescription), and dietary supplements on a regular basis. This means that there are medicines in the home, and many people carry medications with them.

In childcare, there is not only a need for safe storage of children’s medication, but also a need for precautions related to staff, parents, and visitors who may carry medications in purses, briefcases, and even diaper bags.

According to the Centers for Disease Control and Prevention (CDC), more than two-thirds of emergency room visits by children ingesting poison were for prescription and OTC medications. The most common medications ingested include acetaminophen (pain relievers and fever reducers), cough and cold medicines, and anti-inflammatory drugs.

Childcare settings, both centers and home-based, need clearly defined guidelines for the handling and storage of all medications.

Handling Medication

No medication should be brought into the program unless it is specifically prescribed for a child and it cannot be administered by the parent at home. The Caring for Our Children health and safety guidelines, as well as state licensing standards, require that written permission from the parent or legal guardian be obtained when a child needs medication administered during your care.

Both prescription and OTC medicines should be delivered in the original, childproof container, properly labeled with the following information:

• The child’s first and last names.
• The date of the prescription order and the expiration date.
• The name of the doctor or health care provider.
• The name, strength, and dosage of the medication. Make sure there is a measuring spoon/cup/syringe accompanying liquid medicines; if not, be sure to use measuring spoons/cups/syringes specifically designed for administering drugs.
• Specific instructions on administration (e.g., with food, how often, etc.).
• Specific instructions on the storage of the medication (e.g., refrigerated or not).

Establish a system to alert staff which children are receiving medications on any given day. Using something as simple as marking the child’s name on the sign-in sheet may work. In addition, the childcare provider should have written guidelines for the return of unused medication to the parent or guardian at the end of the day or week.

Storage of Medications

Keep all medications in the original containers in which they were accepted. This applies to prescription and OTC medications.

Medicines should be kept in locked (not latched) secure storage areas. Only designated staff should have access to the medications, and it must be out of reach of children. In a childcare center, a locked closet or storage area close to or in the classroom will allow the staff to supervise children while retrieving medication. If the program has a nurse’s office, this is a suitable alternative.

A home provider may use a locked hall closet, and place medications on a high shelf, making sure the door is securely locked (not latched). Home providers have the additional challenge of keeping their family’s personal medications away from children. These also should be stored in a secure, locked area inaccessible to children.

Store medications at the correct temperatures. Medications that require refrigeration should be stored away from food and in a locked container, preferably in a separate refrigerator.

Store all medications in clearly marked containers and in an orderly manner. In addition, the storage area should be well lit. When administering medications, only handle one medication at a time.

Always double-check that you are administering the proper medicine at the exact dosage to the correct child. Immediately return each medication to proper storage before retrieving medication for another child.

As medications are received in the program, note them on a checklist. Designated staff should update this checklist each time medicine is added or removed. Medication brought in by staff for their personal use should be kept in a separate location from the children’s medicines. It should also be kept in a locked and secure storage area, inaccessible to children.

Preferably, parents and visitors would not bring medication into the program facility, but this may be difficult to enforce. Therefore, ask them to keep their personal belongings with them at all times while at the center, or perhaps provide a locked storage cabinet where parents and visitors can store all personal belongings while visiting the center.

Adult Medications

Your early care and education program’s medication policy and procedure also should address medications required by adult staff members. These should be stored properly, separate from children’s medications, and accessible only by the specific staff member.

Parents, visitors, and part-time staff (e.g., college students who help after school) may carry medications or other potentially hazardous items in their purses, backpacks, or pockets. Arrange a locked storage place for all personal belongings so these items do not become accessible to children.

Check your state and local requirements for specific instructions on the handling and storage of medications in child care settings. Reduce or eliminate the risk of injury by being aware of the medications in the center, following proper storage and handling guidelines, and having a clear understanding between the parent.

Cynthia D Sprouse, BA
Western KY University, Training & Technical Assistance Services, Project Associate

Internet Resources

Accidental Childhood Poisonings Mostly Due To Medicines, Center for Advancing Health, Science Daily,
www.sciencedaily.com/releases/2009/08/090804191323.htm

Administering Medications in Childcare, Healthy Childcare, www.healthychild.net/TheMedicineChest.php?article_id=292

National Resource Center for Health and Safety in Child Care and Early Education, UCHSC at Fitzimons, Aurora CO 80045-0508; 800-598-KIDS;
nrckids.org/SPINOFF/MED/MED.htm