ChildNet Module 7: Germs – Yours, Mine, and Ours A training series by Iowa’s Child Care Resource & Referral with funding from Iowa Department of Human Services Welcome and announcements Module 6 It’s Your Business review of homework Intro topic by explaining objectives: understand ways disease is spread and how to interrupt the spread learn key points in developing policies know the resources and people who can help us how to reduce the risk of SIDS Review Best Practices for Module 7 Conduct the “Spreading Disease Awareness” activity Review key terms on handout 7-6 Give “Guide to Childhood Illness” ask “What illnesses did they experience as a child?” “what have they experienced in child care? “are there illnesses that used to be common that are no longer common? “what has happened to make them less common?

Germs: How they Spread Person to Person Person – Object – Person Skin contact Cough or sneeze droplets Feces, blood, or body fluid Person – Object – Person Animal to Person Germs: They are all around, in our environment and on our bodies. Some are good and some can cause illness , disability, and death. Use module 7 ChildNet notes to give info on person to person contact Person-object-person activity: List the items as participants answer the question: “what are some common objects found in your child care setting? Animal to Person Follow DHS rules for allowable animals, animal health checks, and supervision and handling of animals

Stopping Germ Spread Wash Hands Frequently Clean and Disinfect Use gloves Get and maintain vaccinations We can stop the spread of germs and most illnesses by using these 4 practices

Wash Hands BEFORE: Starting work and play Moving from one group of children to another (B & C homes) Eating and handling food Giving medication Water play Give Hand-washing poster and review steps How long do you lather with soap? 20 seconds or the length of the alphabet song. Children should also wash when they arrive, when they eat, and play in water

Wash Hands AFTER: Toileting and diaper checks/changes Touching body fluids Caring for pets Water, sand, or other sensory play Touching uncooked foods Cleaning waste containers and handling garbage Suggest books for children

Cleaning, Sanitizing, and Disinfecting Follow a schedule Use an EPA registered product and follow the instructions Bleach solution: Find specific product information for dilution Mix new solution after 24 hours Keep out of children’s reach Read definition of sanitizing and disinfecting from pg. 440 Caring for Our Children EPA registration info is on label. Follow directions! Some need a “sit time” of 10 minutes! Impossible – they evaporate before time is up. Bleach is best, cheapest, and safest Give or pass around appendix K “Guide for Cleaning, Sanitizing, and Disinfecting” (schedule)

Using Gloves Non-latex gloves Exam / first-aid quality Use when: Changing diaper Cleaning up bodily fluids, blood Gloves designed for food service are not appropriate. They are not designed to protect you from exposures to germs we may be dealing with in child care Give each participant a pair of gloves. Demonstrate proper glove removal. Demonstrate again as they follow along.

Vaccinations Maintaining up-to-date vaccinations disrupts the spread of illness Get brochures by calling 888-398-9696 Give Immunization law, child, and adult immunization brochures Allow time to look through Review list of occupational health hazards from CFOC pg. 426 Emphasis regular consultation with physician and current immunizations Use handout 7-4 to answer statements 1 and 3 (handwashing and cleaning-disinfecting)

Diaper Changing Use a clean, non-porous, non-fibrous surface Wear gloves Handle the diaper as little as possible Disposable diapers reduce the spread of germs that cause diarrhea, hepatitis A, and other viruses and parasites Disinfect the diapering surface between changes Check diapers hourly and change when wet or soiled Surfaces: Cloth surfaces allow germs to live in the fibers Plastic mats may split or crack and give places for germs to live Disposable waxed paper offers a good barrier between child and surface for added protection against germ spread Handle the diaper as little as possible, using gloves. The less you handle the diaper, the less you risk coming into contact with germs, as well as unknowingly transferring them to the environment and others in your home. Ask if anyone uses cloth diapers… Cloth diapers need to have a waterproof covering. The soiled diapers should be placed in a container that is lined with a plastic bag and can be sealed closed – preventing children from accessing the diapers. Soiled cloth diapers as well as soiled clothing are sent home with parents daily or sent off with a diaper service for laundering and sanitizing Check diapers often – changing when needed When children develop rash, they need creams. Creams and other diapering lotions and ointments should be treated as medication with a signed form from the parent explaining their use. The containers are not to be disinfected in order to prevent contamination of the product…therefore they should always be handled as if contaminated. Label each item with the child’s name and keep out of reach and stored away from other medications.

Diaper Changing Procedure Get Organized Help child to diapering surface Open the diaper and clean the child’s diaper area, disposing of wipes Remove the soiled diaper, clothing, and soiled paper from the changing surface Remove your gloves Put on a clean diaper and dress child Use clean gloves to apply creams, then remove/dispose Wash the child’s hands and return them to a supervised play area Clean and disinfect the diapering surface Wash your Hands Engage participants in activity to correctly organize the 9 steps Reveal the answers explain how to fold the dirty diaper over when cleaning skin emphasize a step on trash can for disposing of diapers A wipe can be used on child’s hands and your hands after removing all soiled items Starting at step 6 we should only be working with clean items (gloves are gone…paper is gone…etc) Note when to apply cream

Potty Chairs Keep out of reach Child hand-washing after use Child Care Provider: Empty contents to toilet Rinse with water from sink – pour into toilet Flush toilet Wash and disinfect potty chair Wash and disinfect sink Wash your hands A modified toilet seat and step stool is best; but if a potty chair is used follow these guidelines to prevent the spread of germs. Handout 7-4 respond to statement #2

Exclusion Policy and Practice Two main considerations: Can the child participate comfortably in the day’s activities? Does the child need more care than you can give them while still meeting the needs of the other children? Activity: Have all Stand UP “Remain standing if you’ve ever had a parent try to leave an ill child with you” “Remain standing if you have a written exclusion policy for ill children” “Remain standing if you have given all of your parents a copy of your exclusion policy this year” How to solve the problem of parents bringing ill children is to HAVE A POLICY Reveal the Main Considerations add that we need to consider the other children and the quality and safety of their care

Exclusion Policies & Practice USE the Iowa Department of Public Health’s “Guide to Childhood Illness” Give to parents Post in your home near the phone Get answers to questions from your HCCI Child Care Nurse Consultant Some illness require medical attention and medication. If medication is required; best practice is that the child should not return to care for 24 hours after receiving the first dose. This is to watch for any signs of reaction to the medication as well as to allow the medication time to work. Ex: A child is usually not contagious after 24 hours on an antibiotic. What are the best practices and regulations we know about administering medications? Original container labeled with child’s name, dosage information, doctor and pharmacy information Signed and dated form from parent with instructions for administering the medication Proper storage out of reach of other children – in separate container in fridge to prevent cross contamination Medication administration form J “Heartland Family Child Care Handbook” Pass book and note policies, form J, and Illness/Daily Health Check info

Policies Use “Model Child Care Health Policies” The 2 main considerations for exclusion The IDPH “Guide to Childhood Illness” “The child care provider, not the child’s family, makes the final determination about whether the … ill child can receive care in the child care program.” (from Model Child Care Health Policies) Also refer to DHS guidelines and ChildNet certification requirements to make sure you include written statements that they require. Respond to Handout 7-4 question #4

Daily Health Check Observe for simple signs of well-being when children arrive and parents are still present Look for: Paleness Fever Unusual tiredness Rash Sores Runny nose Watery eyes Hoarseness Coughing Get close to the child and talk to the child. Use all your senses to look, listen, feel, smell, and hear any symptoms. If you notice any of the indicators for possible illness; ask the parent for more information If you don’t feel the child is well enough to stay at child care; remind the parent of your exclusion policy and require the parent to return home with the child For children who come to you from school; contact parent or emergency contact immediately if you suspect contagious illness Conduct the role play scripts with 2 willing participants taking roles of parent and provider Respond to handout 7-4 question

Reducing the Risk of SIDS Follow best practice for infant care All infants under age 1 need to be protected from SIDS Share information with all parents by obtaining brochures from CCR&R Include a Safe Sleep policy in your parent handbook View video Reveal rest of slide / Review main points Handout 7-4 - respond to SIDS question

Going Forward Re-visit the Best Practices worksheet, handout 7-1 At home, look at 1 or more of the page references listed on the agenda Determine a change you can make by next week (turning a new leaf)