Brooklyn Park Recreation & Parks Medication Assistance Procedure Manual

Policies, Procedures, and Safety Guidelines

This manual provides guidance for Recreation & Parks staff on safe and appropriate assistance with participant medications during programs, camps, events, and activities. Included are department policies, procedures, and responsibilities to support participants with medical needs while maintaining a safe and inclusive program environment.

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BROOKLYN PARK RECREATION & PARKS INCLUSION SERVICES STATEMENT

We welcome people of all abilities to participate in our programs! Please let us know if you require an accommodation specific to a disability-related need, a behavioral support, an allergy, or other need for inclusion services. Please register early to allow adequate time to process requests.

The inclusion process is as follows:

  1. Register for program, indicating a need on the form, online or to the person taking your registration.
  2. If you are registering a new participant requesting inclusion services, you will be contacted to discuss strategies for inclusion and to gather participant info.
  3. Inclusion plans will be developed based on individual need.

If you have questions, please contact erin.bonikowske@brooklynpark.org

REGISTRATION AND INTAKE PROCESS

Registration Process:

During registration, Parent/Guardian will complete a household profile either over the phone, in-person, or via the online registration website for each person in their household, updating any accommodation needs that each person may have.

Please let us know if you require an accommodation specific to:

  • Allergy/ Medical Needs
  • Behavior/ Intervention Support
  • Inclusion Support
  • None

The Adaptive Recreation Specialist will receive an automatic notification if someone is coded to ‘Allergy/ Medical Needs’, ‘Behavior/Intervention Support’, and ‘Inclusion Support’ and will reach out to the parent/guardian to begin the intake process.

Parent/Guardian may also disclose accommodation needs via program-specific registration forms. The Adaptive Recreation Specialist works closely with all Program Supervisors/ Specialists to ensure that this information is collected and addressed accordingly.

Intake Process:

The Adaptive Recreation Specialist will engage in phone/in-person/email conversations with parent/guardian to learn more about the accommodations and support needs that their child may have.

During these conversations, the Adaptive Recreation Specialist will share necessary forms related to the medications. These relevant forms are to be completed by the Parent/Guardian:

  • Allergy Action Plan
  • Asthma Action Plan
  • Diabetes Action PlanSeizure Action Plan
  • Medication Assistance Information & Waiver

Medication Assistance Information & Waiver Forms must be completed for any of the following medications that may be taken during program hours with the assistance of Brooklyn Park Recreation & Parks staff and/ or contracted Reach for Resource Inclusion Staff:

  • Prescription/ over-the-counter medications
  • Epi-Pen for allergies (bee, peanuts/tree nuts, etc.)
  • Inhaler for Asthma
  • Seizure Medication
  • Insulin for Diabetes
  • Other

MEDICATION ASSISTANCE PERMISSION

Parents/ Guardians of minors should provide signed permission for the program to provide routine health care, assist with prescribed medication, and seek emergency medical treatment. This is included within the Medication Assistance Information & Waiver form.

I understand it is my responsibility to give the medication directly to the program site supervisor with full instructions in individual dosage containers or original prescription bottle that are clearly labeled with the participant’s first and last name. If any medication or dispensing information changes, it is my responsibility to inform the site supervisor and complete a new Medication Assistance Information Form.

I authorize Brooklyn Park Recreation & Parks to assist with the medications listed above for my child in the manner as stated. I acknowledge that I, the parent/guardian, have given the first dose of this medication without any allergic or unexpected reactions.

In all cases the recommended dosage of any medication will not be exceeded. If after taking medication there is an adverse reaction, I give permission for the Brooklyn Park Recreation and Parks Department to secure from any licensed hospital physician and/or medical personnel any treatment deemed necessary for immediate care. I agree to be responsible for payment of any and all medical services rendered.

CONTACT INFORMATION

The program should have access to contact information for each program participant, including name/birthdate, home address, name/address/phone number of parent/guardian, and any additional emergency contacts.

HEALTH INFORMATION REVIEW & ACCEPTANCE OF MEDICATION

Review of Health Information

The Adaptive Recreation Specialist will review all health information with Program Supervisors/ Specialists and team members on a need-to-know basis. The review of this information will take place prior to the start of the designated program.

All healthcare specific information will be kept on-site at the program in a designated binder. This information will remain confidential and under lock in designated area when not in use.

Inform Staff of Inclusion Support Needs

The program should inform appropriate staff of any specific inclusion support needs of program participants for whom they are responsible. This includes Program Supervisors/ Specialists, Program Coordinators/Leads, Inclusion Specialists, contracted Reach for Resources Inclusion Staff, and program staff who work directly with the individual. The program should ensure that only staff that need to be aware of the specific needs have this information to maintain confidentiality and Americans with Disabilities Act (ADA) compliance.

Acceptance of Medication

Designated team members who are 18+ years old will accept medication upon drop-off at the program and complete the medication check-in form.

Designated team members include:

  • Recreation Supervisors/ Specialists
  • Program Coordinators/ Leads
  • Inclusion Specialists
  • Contracted Reach for Resources Inclusion Staff

Designated team members must ensure that they themselves are directly receiving the medication from the Parent/Guardian, that proper paperwork is completed, including the Medication Assistance and Waiver Form, and that full instructions on individual dosage containers or original prescription bottles that are clearly labeled with the participants’ first and last name are received. Team members must also ensure that the first dose of the medication has already been given by the parent/guardian to ensure that no allergic or unexpected reactions have previously occurred.

PARENT/ GUARDIAN NOTIFICATION

Parent/ Guardian should be informed in writing of situations when they will be notified of participant illness or injury, and the program should document when parent/ guardian has been contacted or attempts to contact have been made.

HEALTHCARE POLICIES AND TREATMENT PROCEDURES

Program healthcare policies, treatment procedures, and inclusion services policies and procedures are reviewed annually by Recreation Supervisors, Recreation Specialists, and the Adaptive Recreation Specialist to ensure compliance with state and local guidelines and requirements of the Americans with Disabilities Act (ADA).

Healthcare Equipment, Supplies, and Emergency Assistance

  • The program should identify necessary healthcare equipment and supplies and methods to obtain them, and procedures for obtaining emergency healthcare assistance. (general first aid kits, etc.)

Availability of an AED

  • The program should have continual access to an AED managed by trained personnel. These will be available at most program locations. If an AED is at your site, you will be informed of the location.

MEDICATION STORAGE AND ASSISTANCE

Storage Procedures

All medications (prescription and over-the-counter) for program participants and staff must be stored under lock. The exception to this is if parent/guardian indicates that a certain medication, such as insulin, EpiPen, or

Inhaler, need to be kept with the participant or group staff member for safety purposes. Staff must oversee or assist with administration of all medications per signed instructions on the Medication Assistance and Waiver Form.

Medications that need to be kept with a staff member/ near program participant will be stored in the designated red PracMedic bag. These bags are bright red and easy to spot, insulated to help moderate the internal temperature, as well as water resistant.

Only designated 18+ year old staff members may assist with medications. Designated staff members include: Program Supervisors/ Specialists, Program Coordinators/Leads, Inclusion Specialists, contracted Reach for Resources Inclusion Staff.

Assistance Procedures

All designated staff must follow ‘The 6 Rights (Rs) of Medication’. A copy of this information will be on a laminated card in the PracMedic bags:

  1. Right person
    • Staff must verify participant’s first and last name prior to assisting with medications.
  2. Right medicine
    • Staff must verify that they are offering the right medication.
  3. Right route
    • Staff must learn what medications the participant needs to take, including how to take them.
  4. Right dose
    • Staff must ensure that the right dosage of the medication is being offered.
  5. Right time
    • Staff must ensure that the medication is offered at the correct time as indicated by Parent/ Guardian.
  6. Right to decline
    • Staff recognize that participants have the right to decline medication. Staff must ensure that this is properly noted on the medication log.
Administration of Lifesaving Medications

On a case-by-case basis, staff may administer lifesaving medications in an emergency such as:

  • Rescue inhaler
  • EpiPen
  • Glucagon (diabetes rescue med)

Details for training guidelines will be outlined below.

Recordkeeping

The program should maintain records for all healthcare provided and reports of all incidents requiring professional medical treatment.

Medication Assistance will be recorded via the Medication Assistance Log that will include date, time, dosage, printed name and signature of staff who assisted, and notes (including if participant declined medication).

A separate Medication Assistance Log will be completed for each individual participant, as well as each documented medication.

FIRST-AID KITS

First-Aid kits stocked with supplies appropriate to the location and activity, including personal protection equipment, should be readily available in activity area, on fieldtrips, in most city vehicles, and in food service area.

UNDOCUMENTED MEDICATION

Brooklyn Park Recreation & Parks Department will not accept undocumented medication. Proper forms, including the Medication Assistance and Waiver Form must be complete before medications can be kept and assisted with at a program site.

Paper copies of all medication forms will be kept on-site for Parent/Guardian to fill out as necessary if they did not do so in advance.

Over the counter (OTC) medications (i.e. Tylenol, Ibuprofen, Benadryl, etc.) must have proper documentation completed prior to being taken at a program site. OTC medications are not kept on site for general program use.

RETURN OF MEDICATION

The Parent/ Guardian is responsible for picking up medication at the end of the program. Brooklyn Park Recreation & Parks Site-Coordinator will complete the ‘Return of Medication’ section on the Medication Log that is kept at a program site and ensure parent/guardian signature is recorded for acknowledging the return of medication.

Returning of medications also includes expired and empty containers.

TRAINING

Designated staff members who will be assisting with medications will receive full medication training prior to the start of a program. This training includes review of this Medication Assistance Procedure Manual, review of storage instructions, medical scenarios, documentation of medication assistance, completion of necessary American Red Cross training(s), and verification of the free ‘American Red Cross First Aid App’* on their mobile device. Training will be led by Program Supervisors/ Specialists and the Adaptive Recreation Specialist, who is also a Certified Therapeutic Recreation Specialist.

Training and Lifesaving Medications

Any additional specialized training will be scheduled accordingly to meet the needs of the participant. A review of general training practices is outlined below. Staff will also need to download the free ‘American Red Cross First Aid App’ which contains help information, quizzes, and FAQ sheets for the following situations:

  • Allergic Reaction/Anaphylaxis
  • Asthma Attack
  • Bites & Stings
  • Bleeding
  • Burns
  • Cardiac Arrest
  • Chocking
  • Cold-related Illness
  • Concussion
  • Dehydration
  • Diabetic Emergencies
  • Diarrhea
  • Fainting
  • Fever (Young Child or Infant)
  • Opioid Overdose
  • Respiratory Distress (TroubleBreathing)
  • Seizures
  • Shock
  • Sickle Cell Crisis/ Acute ChestSyndrome
  • Stroke
  • Unresponsive & Breathing Person
  • Vomiting
  • Wounds

*Disclaimer: This app is utilized as a helpful tool. Downloading this app does not automatically give certification in the above areas. Specific training will still be necessary for certain situations.

Allergies & EpiPen

Site Coordinators/ Leads and Inclusion Specialists on a case-by-case basis will receive a copy of the participants’ Allergy Action Plan, outlining instructions for use of their EpiPen from their parent/ guardian or doctor. These staff will also complete the American Red Cross Anaphylaxis and Epinephrine Auto-Injector online training, which is $35/ person and takes approximately 30 minutes to complete.

All Brooklyn Park Recreation & Parks Department staff receive annual general EpiPen training as part of their seasonal staff training from the Adaptive Recreation Specialist.

General concepts that will be covered in the all-staff training include:
  • EpiPen Storage Instructions:
    • Store the prescription in a cool, dry place. Avoid prolonged exposure to sunlight or excessiveheat or cold temperatures.
    • EpiPens will be carried by the individual or their group lead/inclusion specialists in a redPracMedic bag.
  • What is Anaphylaxis?
    • Anaphylaxis is a life-threatening allergic reaction that can cause shock and affect the person’sability to breathe. A person with anaphylaxis may have swelling of the face, neck, tongue or lips,trouble breathing, shock or a change in responsiveness.
    • Remember: skin symptoms + difficulty breathing
  • Check – Call – Care
    • Remove participant from the area where the allergen is present
    • If you were not already on the scene, confirm if the individual used their EpiPen yet
    • If you are alone, administer the EpiPen and then call 9-1-1. If others are present, designateindividual by name/clothing who will call 9-1-1 while you administer the EpiPen.
  • Prior to administration:
    • Put on gloves if readily available
    • Do not shake before administering
    • Ensure that the EpiPen is for that person & check the expiration date. Make sure liquid is clear(if cloudy – do not use)
    • EpiPen can go through clothing, but make sure nothing is in pockets to obstruct administration.
  • Administration:
    • Orange down (orange to the thigh), blue pointing up (blue to the sky)
    • Remove blue safety cap
    • Do not put hands over orange area
    • In a 90 degree perpendicular position, quickly and firmly push EpiPen into outer mid-thigh andyou will hear click
    • Hold for 10 seconds (always be sure to follow manufacturer’s instructions for the device used)
  • After Administration:
    • Massage injection area
    • Re-check breathing & how they are responding. Reassure participant to stay calm while waitingfor EMS
    • Put EpiPen in safe container (such as an empty cup) and give to EMS when they arrive. Do notput in the trash.
    • Call parent/guardian/ caregiver
    • Notify Program Supervisor/ Specialist
  • If EMS are delayed and symptoms do not improve, then you can use a second dose if available (5 – 10minutes after initial dose). Each EpiPen contains a single dose of medication.
  • Once EMS arrive, provide the following:
    • What happened
    • Signs and symptoms
    • Care given and time of dose
    • Location of injection
    • How participant responded
    • Give the EpiPen that is stored in a safe container to EMS
Asthma & Rescue Inhaler

Site Coordinators/ Leads and Inclusion Specialists will receive a copy of the participant’s Asthma Action Plan, outlining instructions for use of their rescue inhaler from their parent/guardian or doctor. If in an emergency situation and the participant is unable to administer the rescue inhaler on their own, staff may assist in this specific situation. These staff will also complete the Athletes and Asthma: The Community Coach’s Role – MN Dept. of Health online training which takes approximately 35 minutes to complete.

Diabetes & Glucagon

Glucagon is a rescue medication for someone experiencing a diabetes emergency. Below are the Glucagon rescue medication types approved to be administered by Brooklyn Park Recreation & Parks Staff.

  • Glucagon/ BAQSIMI
    • This method is approved.
    • A dry nasal spray containing glucagon, a hormone that helps raise blood sugar levels. BAQSIMIis a prescription medication and should only be used under the guidance of a healthcareprofessional.
    • Staff will review Diabetes Action Plan provided by the participants’ parent/ guardian/ caregiverand/or doctor and meet for in-person meetings to ensure everyone is aware of the procedure.
    • These staff will also watch How to use BAQSIMI online training video & complete a quiz.
  • Gvoke HypoPen
    • This method is approved on a case-by-case basis and will require training provided by theparent/guardian/caregiver to designated team members who will be working with the participant.
  • Glucagon Injection:
    • This is a more invasive medication. Not approved to be administered by Brooklyn ParkRecreation & Parks Staff.
  • Post Medication Instructions after Administering Glucagon:
    • Move to side lying position in case of vomiting
    • Call 911
    • Call parent/guardian/ caregiver
    • Notify Program Supervisor/ Specialist
    • Monitor pulse/ respirations – begin CPR if needed (by a trained staff member)
    • Once awake – fast acting sugar, such as a juice
    • Once help arrives – share what type of medication was used and send glucagon kit with them
Seizures & Epilepsy

Site Coordinators/ Leads and Inclusion Specialists will receive a copy of the participant’s Seizure Action Plan, outlining instructions from their parent/guardian or doctor. These staff will also complete the Epilepsy Foundation: Seizure Recognition and First Aid Certification online training which takes approximately 90 minutes to complete.

INCIDENT REPORT DOCUMENTATION

Following any incidents involving the use of lifesaving medications, staff must complete an Incident Report and submit it to their supervisor the same day the incident took place. These incident reports, along with any medical patient records and waivers, must be retained by the City of Brooklyn Park for seven years.