Each year, approximately 60,000 young children are treated in our nation’s emergency rooms due to accidental unsupervised medication ingestion. Safe Kids Worldwide compares this to approximately four busloads of children per day visiting the emergency room because they took medication on their own. In fact, 95 percent of medication-related emergency room visits among children under age five are due to a child ingesting medication while unsupervised (the other 5% are due to dosing errors). Each year, 56 children ages fourteen and younger die from unintentional medication overdose. This is an alarming number of children dying from preventable deaths (for more details see the study “Safe Storage, Safe Dosing, Safe Kids”).
Medication storage is of the utmost importance in preventing accidental ingestion of medications. Do you know North Carolina’s child care requirements for medication storage in child care facilities? For purposes of child care, medication INCLUDES prescription, over-the-counter, topical, non-medical ointment, repellant, lotion, cream, or powder. All must be in the original package or container. All purses and bags containing medications should be stored according to these same standards.
Family child care homes must follow Child Care Rule 10A NCAC 09 .1719(a)(5), which states:
- Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container.
- Designated emergency medications shall be stored out of reach of children at least five feet high but are not required to be in locked storage.
Child care centers must follow Sanitation Rule 15A NCAC 18A .2820(d) which states:
- Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food.
- Designated emergency medications shall be stored out of reach of children but are not required to be in locked storage.
- Non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use but are not required to be in locked storage.
In addition to safe storage of medications, safe dosing is vital to medication safety in child care. Consider for example, if a caregiver administered medication to a child later than scheduled on the written permission form, the caregiver may have intended to tell the parent about this time change but forgot or missed seeing the parent at pick-up time. It could be disastrous if the parent gives the child the next dose of medication too soon. Caregivers should follow the written instructions about how medication is to be given, to ensure child safety.
In 2003, the North Carolina General Assembly passed Kaitlyn’s Law. This law prohibits child care providers from administering medication to children without written parental permission and for non-medical reasons, such as inducing sleep. It is illegal to intentionally give a child medication without written permission from the parent. The punishment for doing so is a Class A1 misdemeanor. If a child is seriously injured as a result of being given medication without permission, the punishment is a Class F felony, which may result in imprisonment. To learn more, see “Kaitlyn’s Law”.
Safe disposal is a final component of medication safety. The National Take Back Initiative offers a safe opportunity for expired over-the-counter and prescription medications to be disposed of properly. The fourteenth National Take Back Initiative held on October 28, 2017 collected approximately 456 tons of prescription medications. For more information on medication take back activities and to check when the next event is scheduled near you, visit the Office of Diversion Control website.