สถานการณ์และรูปแบบการจัดการด้านยาในโรงเรียน จังหวัดเชียงราย

Abstract

Objective: To analyze the situation of medication management in schools (MMS), Chiang Rai Province and to develop the MMS model for the school in Phan District, Chiang Rai Province. Method: This mixed method research had two phases. Phase 1, quantitative research, data were collected by questionnaire in 566 schools of primary and secondary schools under the Office of the Basic Education Commission in Chiang Rai province during July-September 2021. Data were analyzed by descriptive statistics, frequency, and percentage. Phase 2, quality research, the results of the first phase were used as input data for a group discussion of 7 school nurses in Phan District, Chiang Rai Province, and in-depth interviewed with 10 stakeholders including school nurses, school directors, officer under Chiang Rai Primary and Secondary Educational Service Area, and student parents during December 2021-January 2022. The data were analyzed by using content analysis. Result: The majority of schools, 90.44% had one first aid room. About 72% of school had one school nurse, with 73.48% of school nurses did not receive training in medicine use in the past one year. The drugs selection criteria were indication, safety, and efficiency, etc. The schools (82.19%) purchased medicines from drug stores, that the budget was allocated by the schools themselves. However, it was found that the budget was insufficient for medication management. About 13% of schools found dangerous drugs such as Diclofenac, Mefenamic acid and Loperamide, etc. 68.01% of schools did not have a drug practice guideline. As a result, 89.34% of school nurses searched for information on treatment and dispensed medications to students from the Internet. For the services of first aid room, there were 85% routine procedures such as asking students' names and surnames, drug allergies, symptom of illnesses, then dispensing medicines, follow-up treatment and recording data into a service form. In case of referring, students normally referred to primary health care center. There was no clear drug policy in school from policy makers. The participants indicated that the problems in medication management in schools were insufficient number of school nurse, lack of knowledge, lack of medication management budget and no clear drug policy. They suggested to solve problems by training nursing teachers or hiring staff and creating project plans. Participants were required the standard practice guidelines. Conclusion: According to situations and problems about medication management in schools, related stakeholders including health care workers and teachers must cooperate in the development of the MMS model. All sectors should have a meeting to formulate policies, set indicators, determined personnel responsible for medicine in schools that receive medication knowledge training, regularly collect data, plan to use the budget for drug management in schools to be sufficient. And as a result, students are safe to use medicines.