Current through Register Vol. 40, No. 6, March 31, 2022
The school nurse is accountable and responsible for the nursing care delivered
to students under the nurse's jurisdiction.
Over-the-counter (OTC) medications may be
administered to school children by the school nurse with a parent's written
authorization and without a physician's authorization, unless the school system
policy requires a physician authorization. Parental authorization requirements
require the following documentation:
purpose of the OTC medication.
The circumstances under which the over-the-counter medication can be
Licensed nurses who provide nursing care in the school setting through the
twelfth grade may delegate specific tasks to unlicensed assistive
(4) The registered nurse
is accountable for determining the tasks that may be safely performed by the
unlicensed assistive personnel following appropriate training and demonstration
(5) Delegation of
the use of the vagal nerve stimulator (VNS) in selected cases is not
delegated tasks shall not require the exercise of independent nursing judgment
or intervention. Specific tasks that require independent nursing judgment or
intervention that shall not be delegated include, but are not limited to:
(a) Catheterization, clean or
injectable medications, other than premeasured medication for allergic
reactions, premeasured injection for opioid-related drug overdose and treatment
of diabetes symptoms with insulin and glucagon, as described in Alabama
(c) Administration of rectal or vaginal
(d) Calculation of
medication dosages other than measuring a prescribed amount of liquid
medication or breaking a scored tablet.
(e) Tracheotomy care, including
(f) Gastric tube
insertion, replacement, or feedings.
(g) Invasive procedures or
(j) Receipt of verbal or
telephone orders from a licensed prescriber.
The task of providing prescribed oral,
topical, ear, eye, nasal, and inhalation medications to a student through
twelfth grade may be delegated to unlicensed assistive personnel by the school
nurse only when the following conditions are met:
(a) The school nurse identifies the
appropriate individual(s) to assist in providing prescribed
(b) The unlicensed
assistive personnel selected by the school nurse shall attend a minimum
seven-hour course of instruction that includes a curriculum approved by the
Board and have demonstrated competency to perform the delegated task.
(c) The school nurse shall provide periodic
and regular evaluation and monitoring of the individual performing the
nurse shall routinely and periodically conduct quality monitoring of the tasks
performed by the unlicensed assistive personnel, including but not limited to:
4. Error reporting.
5. Performance of the seven (7) rights of
(8) The school nurse delegating the task may,
at any time, suspend or withdraw the delegation of specific tasks to unlicensed
(9) The School
Nurse Administrator, or his or her designee, shall conduct on-site compliance
monitoring no less than once every three (3) years.
(10) The School Nurse Consultant or School
Nurse Administrator shall submit a report(s) to the Alabama Board of Nursing in
a format specified by the Board upon request. The report shall include, but not
be limited to, the results of all compliance monitoring conducted during the
designated reporting period.
Ala. Admin. Code r.
Filed September 29, 1982.
Repealed: Filed October 29, 2001; effective December 3, 2001. New Rule: Filed
November 23, 2009; effective December 28, 2009.
Administrative Monthly Volume XXXIV, Issue No. 10, July 29, 2016,
Administrative Monthly Volume XXXV, Issue No. 10, July 31, 2017,
Administrative Monthly Volume XXXIX, Issue No. 12, September 30,
2021, eff. 11/14/2021.
Author: Alabama Board of Nursing
Code of Ala.