Case Study: How Schools are Improving Medication Safety Protocols

Ensuring the safety and well-being of students in schools extends beyond academics. It also includes various aspects of health, including medication management. There are many serious medical conditions that may require a child to take medication in school, including long-term and sometimes life-threatening conditions, such as epilepsy, asthma, diabetes, cystic fibrosis and anaphylaxis, as well as short-term conditions, such as administering antihistamines for allergies.

Although there is no legal requirement for a teacher to administer medication to pupils, with the increasing complexity of medical needs among students, schools are continually striving to improve their medication safety protocols. Medication safety is not only essential to ensure compliance with regulations, such as:

• The Children and Families Act(2014).
• The School Premises Regulations (2012).
• Education Act (1996).
• Health and Safety at Work etc Act (1974).
• Misuse of Drugs Act (1971).

but it is also essential for student health, well-being and academic success.

The landscape of healthcare in schools is constantly changing, with new medications, treatments and protocols emerging regularly. Schools must continually adapt and improve their medication safety protocols to meet the ever-changing needs of their students.

This case study explores the proactive measures taken by three schools to improve medication safety on their premises. Through innovation, collaboration and a commitment to excellence, these schools are paving the way towards safer and more supportive environments with improved medication safety protocols.

Case Study Schools

When selecting schools for this case study, there was a careful and deliberate consideration of diverse characteristics to ensure there was a comprehensive representation of schools in the UK. The criteria used to identify these schools included various factors, such as location, size and student demographics.

The schools included in the case study are:

 High School A

• Location: South London.
• Size: Large student population (1,500 pupils).
• Student population: Diverse population, reflective of inner-city schools.

High School A is located in a low socio-economic area in London. It is a large high school with a diverse student body. With its large student population, the school encounters a wide range of health needs among its students, meaning that robust medication safety protocols are necessary. Because of the age of the student population, the school must ensure that all medication is safely and securely stored and is only accessible to designated staff.

Primary School B

• Location: A small village in Derbyshire.
• Size: Small student population (175 pupils).
• Student population: Primarily students from middle-class families. 85% of the student population is white British.

Primary School B is a small primary school with single-form entry (one class per year group) with approximately 25 students per class. Despite its smaller size, the school faces unique challenges in medication management due to its rural location and potentially limited access to healthcare resources. For example, the school is located 40 minutes away from the nearest hospital in the case of an emergency. This means the school must have clear medication protocols in place for students with serious health conditions or in the case of emergency, such as anaphylaxis. Examining medication safety initiatives in such a context provides valuable insights into addressing rural healthcare disparities.

Academy C (high school)

• Location: City centre of Cardiff.
• Size: An average-sized student population for a high school (1,100 pupils).
• Student population: Fairly diverse population, reflective of inner-city Cardiff.

Academy C is an academy school located in a city centre in Wales. Unlike other schools in the UK, academies are independent of local authorities and are not overseen by local councils. Although they still need to comply with government laws and regulations regarding medication protocols, they have more freedom in the way the school is run and can create their own policies. Although they are not required to administer medication by law, Academy C has forward-thinking protocols in place and demonstrates how modern solutions can be utilised to improve medication safety in schools.

By featuring schools with distinct characteristics in terms of location, size and student demographics, this case study aims to provide a comprehensive understanding of medication safety initiatives that are applicable across diverse educational settings. Each school’s unique context offers valuable insights into tailoring medication safety protocols to meet the specific needs of their respective student populations.

Improvement Initiatives

Each of the selected schools has implemented specific initiatives and innovations aimed at enhancing medication safety protocols. These initiatives utilise technology, staff training and collaborative efforts to ensure the safe and effective administration of medications to students.

High School A:

• Digital medication records:
  High School A has transitioned from traditional paper-based medication logs to digital medication records. They now use a secure online platform to maintain comprehensive records of each student’s medications, dosage schedules and relevant medical information. This digital system allows for real-time updates and ensures accuracy in medication administration.
• Medication management software
  In addition to digital records, High School A also utilises specialised medication management software. This software integrates with electronic health records and pharmacy systems to provide seamless coordination between healthcare providers, school staff and families. Automated alerts and reminders ensure medication is administered on time and helps to prevent errors.

Primary School B:

• Telemedicine consultations
  Recognising the challenges posed by its more rural location, Primary School B has implemented telemedicine consultations for medication-related concerns and questions. Through secure videoconferencing platforms, first-aiders and other school staff can consult with off-site healthcare providers, if necessary. This can help to ensure medication is administered correctly and pupils are given the same level of care as more accessible schools.
• Parent education workshops
  Primary School B hosts regular parent education workshops focused on medication safety and management. These workshops cover topics such as proper medication storage, administration techniques and recognising potential adverse reactions. By empowering parents with knowledge and skills, the school can ensure a collaborative approach to medication safety.

Academy C:

• Smart medication dispensers
  Academy C has deployed smart medication dispensers in collaboration with local healthcare partners. These dispensers utilise biometric authentication and barcode scanning technology to ensure accurate medication dispensing. Students/staff scan their identification badges or use biometric authentication to access their medications which can minimise the risk of medication errors.
• Student-led medication awareness campaigns
  In line with its focus on student empowerment, Academy C organises student-led medication awareness campaigns. These campaigns raise awareness about the importance of medication safety, proper dosage adherence and the risks associated with sharing medications. By involving students in advocacy efforts, the school created a culture of responsibility and accountability.

By implementing these initiatives, the selected schools demonstrate a commitment to use innovation and collaboration to improve medication safety protocols. These tailored approaches address the unique needs and challenges faced by each school and ultimately promote a safer and more supportive environment for students.

Outcomes and Impact

Improvement initiatives aimed at enhancing medication safety protocols have produced significant positive outcomes across the selected schools. These outcomes have had a positive impact on medication safety, student well-being and overall school healthcare.

Some of the positive outcomes of improved medication protocols include:

• Reduced medication errors
  Adopting digital medication records and medication management software can significantly reduce instances of medication errors. Accurate documentation and automated alerts can minimise the risk of giving an incorrect dosage and reduce administration errors.
• Improved student health outcomes
  With enhanced medication safety protocols in place, students experience improved health outcomes. Timely administration of medications and proactive monitoring of medication adherence contributes to better management of chronic conditions and overall well-being.
• Enhanced efficiency
  The streamlined medication management processes have led to increased efficiency and productivity among school nurses and administrative staff. Time previously spent on manual record-keeping and communication with healthcare providers is now allocated to direct student care, resulting in a more responsive healthcare system within schools.
• Improved access to healthcare
  Telemedicine consultations have improved access to healthcare for students, particularly those in more rural areas. Through virtual appointments with healthcare providers, students receive timely medication adjustments and medical advice, minimising disruptions to their education.
• Empowered parents
  Parent education workshops have empowered parents to play a more active role in medication management. Armed with the knowledge and skills they learned in these workshops, parents can effectively advocate for their children’s health needs and collaborate with school staff to ensure medication safety both at school and at home.
• Stronger community engagement
  The focus on medication safety initiatives has created stronger community engagement. Parents, healthcare providers and school staff collaborate closely to support student health, creating a cohesive and supportive school community.
• Enhanced medication security
  Smart medication dispensers ensure enhanced medication security and accuracy. Biometric authentication and barcode scanning technology minimise the risk of unauthorised access or medication mix-ups, promoting a safer medication administration process.
• Student empowerment
  Student-led medication awareness campaigns empower students to take ownership of their health and advocate for medication safety within the school community. Creating a culture of responsibility and accountability can instil valuable life skills and promote peer support among students.
• Positive school culture
  The emphasis on medication safety initiatives contributes to a positive school culture. Students feel supported and valued, knowing that their health needs are prioritised and addressed in a proactive manner. This positive environment enhances student engagement and overall well-being.

Challenges Faced

Despite the positive outcomes achieved, implementing improvement initiatives in medication safety protocols came with a unique set of challenges for the schools involved. Each school encountered various obstacles along the way, which required proactive strategies and collaboration to overcome.

High School A:

• Challenge: Resistance to change: Some staff members initially resisted the transition from paper-based medication logs to digital records at High School A. Concerns about technology proficiency and how reliable the digital systems are posed challenges that could have affected how the changes were implemented school-wide.
• Solution: To address resistance, the school provided comprehensive training and ongoing support to staff members. Hands-on workshops, tutorials and personalised assistance were offered to ensure proficiency in using the new digital platforms. Open communication channels allowed staff to voice concerns and provide feedback, creating a sense of ownership in the transition process.

Primary School B:

• Challenge: Limited access to resources: Primary School B faced challenges due to its rural location, including limited access to healthcare resources and technological infrastructure. Telemedicine consultations required reliable internet connectivity, which was not always available.
• Solution: The school collaborated with local healthcare providers and community organisations to address resource limitations. Grants and funding were secured to invest in technology upgrades and expand internet access in the school. Additionally, alternative communication methods, such as phone consultations, were utilised to ensure continuity of care in the event of any connectivity issues.

Academy C:

• Challenge: Technological integration challenges: Implementing smart medication dispensers at Academy C posed technical integration challenges, including compatibility issues with existing systems and software.
• Solution: The school engaged in thorough testing and pilot programmes to identify and address technical issues before full-scale implementation. They collaborated closely with technology vendors and IT experts to create customised solutions to integrate smart dispensers seamlessly into their existing infrastructure. Ongoing technical support and troubleshooting resources were provided to staff members to address any issues promptly.

By acknowledging and proactively addressing these challenges, the case study schools demonstrated resilience and adaptability in implementing the improvement initiatives. Through collaborative problem-solving and a commitment to continuous improvement, they were able to overcome obstacles and achieve positive outcomes in improving medication safety protocols.

Lessons Learned

Through their experiences in implementing improvement initiatives to improve medication safety protocols, the case study schools have learned valuable lessons that can guide other schools hoping to improve their medication protocols, including:

• Embrace change and innovation
  The importance of embracing change and innovation cannot be overstated. All three schools learned that adopting new technologies and approaches, such as digital medication records and smart dispensers, is essential for improving medication safety protocols. Educational institutions should be open to exploring innovative solutions and leveraging advancements in technology to enhance student care.
• Invest in comprehensive training
  Staff training and development are integral to the successful implementation of medication safety initiatives. High School A, Primary School B and Academy C prioritised comprehensive training programmes for staff members involved in medication management. Other institutions should invest in ongoing training and education to ensure staff proficiency in medication administration protocols and technology use.
• Collaborate across stakeholders
  Collaboration among stakeholders, including school staff, healthcare providers, parents/guardians and technology vendors, is crucial for success. Primary School B’s partnerships with local healthcare providers and Academy C’s collaboration with technology vendors show the importance of working together to address challenges and implement effective solutions. Educational institutions should prioritise building strong partnerships and encouraging open communication among all the stakeholders involved in medication safety.
• Tailor solutions to unique contexts
  Each school’s unique context presented distinct challenges and opportunities for enhancing medication safety protocols. Primary School B’s focus on telemedicine consultations addressed the needs of its remote location, while Academy C’s student-led awareness campaigns reflected its emphasis on student empowerment. Educational institutions should tailor their medication safety initiatives to suit their specific contexts and the needs of their students, considering factors such as location, student demographics and available resources.
• Prioritise continuous improvement
  Continuous improvement is essential for maintaining and enhancing medication safety protocols over time. All three schools recognised the importance of ongoing evaluation, feedback and adjustment to optimise their medication management processes. Educational institutions should encourage a culture of continuous improvement and encourage staff members to identify areas for potential improvement and implement changes to promote student safety and well-being.

By incorporating these lessons into their approach to medication safety, schools and other educational institutions can effectively enhance student care and create safer environments for learning and growth. The experiences of the case study schools serve as valuable examples for others seeking to improve medication safety protocols within their own school communities.

Parent and Student Perspectives

High School A:

Parent Perspective (Mr Riley): 

“I am extremely grateful for the improved medication safety protocols at the school. As a parent of a child with asthma, knowing that the school uses digital medication records gives me peace of mind. I can easily communicate with the school staff about my child’s medication needs and the automated reminders ensure that doses are never missed. This level of organisation and attention to detail has made a significant difference in managing my child’s health while at school.”

Student Perspective (Amelie): 

“Because I have diabetes, managing my medications during the school day used to be stressful. Since my school started using the new medication safety protocols, it’s been much easier. I feel more confident knowing that the school nurse has the right records of my medication schedule and I’m so busy with my lessons and my friends that I like the reminders to take my insulin. It’s made me feel safer and more supported at school.”

Primary School B:

Parent Perspective (Mr Jackson): 

“Living in a rural area, I always worried about what would happen if my son had an allergic reaction and an ambulance couldn’t get to the school quickly enough. Although my wife and I are confident using an EpiPen, I was worried that the school staff wouldn’t know how to use it or wouldn’t be able to get to his medication quickly enough if an emergency happened. Now that the school staff have used telemedicine consultations to speak to my son’s doctor and have training on allergic reactions, this has been a game-changer for us. I now feel much more confident sending my son to school every day.”

Student Perspective (Otis): 

“I have four different food allergies that mean I have to carry an EpiPen. Before, I worried about what would happen if I had something bad happen at school. But now, I feel much safer. The school staff know what to do if I need my EpiPen and someone will always be available to help. The new computer system also means that everyone knows about my allergies. It’s made me less worried at lunchtime.”

Academy C:

Parent Perspective (Mrs Ashraf): 

“Sending my daughter to Academy C has been one of the best decisions we’ve made. The school’s use of smart medication dispensers means I no longer worry about her accidentally being given the wrong dose or forgetting to take her medication. The biometric authentication adds an extra layer of security that gives me peace of mind.”

Student Perspective (Amber): 

“I like that I feel more in control and listened to when it comes to medication safety. My teacher helped me to organise a student-led awareness campaign to raise awareness in my school about the importance of medication safety. Me and my friends learned about taking our medication on time and why we should never share medication. I like that my friends know about my epilepsy and my medication and that I had an important role in teaching everyone in my school about medicine.”