Administration of medication - advice

This advice provides information regarding the administration of medication to children on statutory orders placed in out-of-home care.

Introduction

This information relates to children in kinship care, residential care, home-based care and lead tenant however not applicable to a child in out-of-home care on a childcare agreement (voluntary placement) where parents retain their parental responsibilities and must be consulted and provide permission for medical treatment including administration of medication.

Medical and dental needs

Children in out-of-home care must have their medical and dental needs met. Where a child is in an out-of-home care placement as a result of:

  • an interim accommodation order or
  • a family reunification order
  • a care by Secretary order
  • a long-term care order
  • a therapeutic treatment (placement order).

Decisions regarding the provision of any medication rests with the Secretary (or delegate) or a person in a CSO authorised by the instrument of authorisation for community service organisation. See Authorisation for CSOs to provide medical consent - advice. Child protection is required to act in the best interests of the child and may authorise the administration of prescribed medication even where parents object, on the advice of a registered medical practitioner (s. 597(3), CYFA).

Where a child is in an out-of-home care placement, parents should be, as soon as possible, informed, consulted and appropriately involved in any medical treatment planned for their child.

Where a parent objects to the administration of any medication, the practitioner must discuss this with the team manager. Parents must be advised of their right to seek a review of the decision and any complaint mechanisms.

Information gathering

An important task for practitioners is to gather detailed and accurate information on the health needs and medical history of children entering out-of-home care. For kinship care placements this information is recorded on the client profile located in CRIS. For foster care or residential care placements this information is recorded on the looking after children (LAC) essential information record (EIR) located in CRISSP. See LAC processes flowchart.

Health needs and medical history information includes:

  • medicare number
  • immunisation record
  • pre-existing conditions, including allergies
  • current medications and instructions for administering this medication
  • previous medications given, including reactions to previous medications
  • any known medications a child must not be given
  • name and contact of general practitioner, maternal and child health nurse, any other health care professional involved with the child
  • abuse of prescribed medications
  • parents view on administering medications.

Young people

In some circumstances, older children with sufficient maturity and understanding of their medical situation and the proposed treatment are legally able to request or decline treatment without the endorsement of parents or guardians. The powers of the Secretary or their delegates with respect to s. 597, CYFA, do not displace the ability of a competent child to request or refuse treatment. Where such instances involve children on protection orders and the treating doctor believes the child will place themselves or their health at risk, the medical practitioner should consult child protection.

Where there is concern that the child’s actions will place them or their health at risk, the CSO must inform child protection. When a CSO advises the child protection practitioner that a child refuses treatment, the practitioner must speak to a team manager and consult with the legal unit if 'no treatment' places the child at risk.

Administration of prescription medication

Medication prescribed by a doctor or a dentist must be administered according to the prescription. This includes specific doses at specified times during the day, for specified periods of time.

Prescribed medications for a specific child cannot be administered to or shared with any other child. Each individual child requiring prescription medication must have their own prescription from a doctor.

If the prescribed medication is part of ongoing treatment, it must be recorded in the child’s case plan and reviewed on a regular basis.

If the prescribed medication is for a single course of treatment, any medication left at the end of the course of treatment must be safely disposed of. Pharmacists will dispose of surplus medication.

If the child is currently on prescription medication for a pre-existing condition the carer must bring this to the doctor’s attention if a new prescribed medication or over the counter medication is being considered, to ensure there is no adverse interaction between medications.

Administration of over-the-counter medication

Over-the-counter medications such as cough medicines, cold and flu tablets, paracetamol/aspirin may be administered as part of the routine care of a child. The administration should be discussed with the pharmacist and the dose must be given in accordance with the child’s age or weight. If the child is on prescription medication for a pre-existing condition, this must be brought to the pharmacist’s attention to ensure there is no counteraction of medications.

Levels and dosages of over the counter medication must be strictly adhered to. If the child does not respond to the medication and improve within a reasonable time period, then they should be taken to the doctor.

Refusal of medication

If a child refuses to take prescription medication, carers should address the situation in an age appropriate manner. At no time is a child to be forced to take medication. The carer must discuss with the child the reason the medication has been prescribed and the implication for not completing a course of treatment. If this is a kinship care placement, the carers may require support from the child protection practitioner to address this with the child.

Recording requirements

Generally carers will administer and monitor the usage of prescribed and over the counter medication to children in out-of-home care. The use of ongoing medication must be recorded in the child’s care and placement plan (0-14 years) or care and transition plan (15years+), as per the program requirements for home-based care or residential care services in Victoria. CSO's maintain records detailing the child’s medical and dental assessments, including records of any immunisations; and pass these to the child, their family or another relevant CSO, when a child changes placement or at the conclusion of a placement.

Information in relation to medications should be recorded on the LAC EIR (health) (CRISSP) or on the client profile in CRIS, which form part of the case plan and includes the:

  • circumstances under which the medication was required
  • who prescribed or advised the medication was required
  • whether the medication was prescription or over the counter medication
  • when parents were contacted and what their response was, that is, consent or not
  • whether further medication or medical follow-up is required.
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