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School Nurse Program Advisory Committee

The South Carolina School Nurse Program Advisory Committee (SNPAC) was started decades ago by the SC State School Nurse Consultant (SNC) who was employed solely by DHEC at the time. The SNC facilitated collaboration with a group of lead nurses from around the state for the purpose of developing best practice guidelines for SC school nurses. In recent years district funding for school nurses required that superintendents select a lead nurse to participate on the committee. This has expanded and enriched the committee and the workgroups continue to look at potential quality improvement projects related to critical public health issues faced by students such as chronic disease, mental health concerns, suicide prevention, and substance use. The SNPAC also reviews or produces written guidance and templates for school nurses to share, adapt or adopt to improve school health services across the state.

Fostering a Just Culture for Medication Errors in the School Setting - Five Step Process


Medication Error Definition: Any preventable event that may cause or lead to inappropriate medication use or student harm while the medication is in the control of a healthcare provider, patient, parent, or consumer.

In this infographic, you will find the five-step process for fostering a Just Culture approach for Managing Medication Errors in The School Setting. This infographic reflects a road map from step one all the way to step five.

  1. The first step of the five-step process is the Self-Assessment, this step states:
    • You must assess current medication administration practices, including systems and documentation
    • In addition, it also explains that you are to assess the work environment
    • Analyze medication error trend data
  2. As we move over to the right side of step one you will find step two. Step two discusses the Policies in Practice. Those policies in practice are:
    • Develop, revise, review and/or update medication policies
    • Establish a fair and objective system for evaluating medication errors
    • Med error reporting form and data analysis.
  3. As we follow the road map, we head over to step three which talks about General Strategies. The four general strategies listed are:
    • Eliminate barriers to reporting medication errors
    • Provide education to students/families on school medication policies and individual medication health teachings
    • Self-accountability
    • Systems evaluation
  4. Step four discusses Support and Education. The four bullets state:
    • Create a supportive and collaborative work environment
    • Establish annual medication competency and training
    • Deliver a structured orientation/training for new school nurses and UAPs
    • Develop strategies to empower staff to report all medication errors and/or near misses
  5. The final and last step is Communication of Medication Errors. This step narrates the Flow of Communication when there has been a medication error.
    • The first step being: complete the Medication Error Report Form
      • Communication
        1. Parent
        2. Healthcare Provider
        3. Lead Nurse/Supervisor
          • No Lead Nurse
          • Consult with State Nurse Consultant
        4. Principal
      • Poison Control, if appropriate
      • External Reporting
        1. SC Board of Nursing
        2. Utilize SC BON ECET, South Carolina Board of Nursing Employer Complaint Evaluation Tool

Medication Error Communication Process in the School Setting

Recommendation Guidelines

This infographic provides an optional guideline for the medication error communication process in a school setting.

  • The first step being Communication
  • The next question you want to ask. “Is there any harm to the student?”
    • If the answer is yes you would need to:
      1. Contact and/or refer to HCP for orders/medical evaluation
      2. Contact lead district nurse
      3. Consult with State Nurse Consultant as advisory if no lead nurse
      4. Contact parent
      5. Notify Principal
      6. Proceed to external reporting and follow recommendations
    • If your answer is no you would need to:
      1. Notify parent
      2. Contact lead district nurse
      3. Notify Principal
      4. Consider use of ECET based on error details
    • For either answer yes or no, you would need to complete a Medication Error/Variance report.
    • Once you have completed the Medication Error/Variance report you will then proceed with ECET recommendations
    • Next you will utilize SC BON ECET as guidance document for evaluation of error
    • Lastly you will Report Externally
Just Culture Environment
  • Self-Assesment
  • Policies in Practice
  • Support and Education
  • General Strategies
  • Fair and Objective

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