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Daily Health Observation Training for Child Care Providers

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use proper handwashing and gloving techniques to prevent the ... Exclude: for fever over 101 or if you suspect scabies/lice or other communicable illness ... – PowerPoint PPT presentation

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Title: Daily Health Observation Training for Child Care Providers


1
Daily Health Observation Training for Child Care
Providers
  • Division of Child and Adolescent Health
  • Virginia Department of Health

2
Learning Objectives
  • Participants will be able to
  • learn how infectious illnesses are spread
  • perform a Daily Health Assessment on children.
  • use proper handwashing and gloving techniques
    to prevent the transmission of infectious
    diseases
  • understand DSS Licensing Standards that address
    health observation and prevention of illness
  • identify signs and symptoms of common contagious
    diseases in children to prevent the spread of
    disease.

3
Learning Objectives (continued)
  • Understand current immunization requirements
    Instruct child care staff on how to document
    activities
  • Understand OSHA requirements for health and
    safety practices for child care staff

4
Ways Diseases/Illnesses Spread(California Child
Care Health Program)
  • Source of germs must be present
  • Route or (ways) of transmission along which germs
    can be carried must be present, e.g., direct
    contact, respiratory, fecal-oral, contact with
    blood
  • A host or vulnerable person who is not immune to
    the germ must be present and come in contact with
    the germs

5
Ways to Keep Children and Yourself Healthy
(California Child Care Health Program)
  • Attack the source of the infection or first
    link by identification, treatment and, if
    necessary, isolation of the sick person
  • Attack the route of transmission or the second
    link by personal and general hygiene, healthy
    practices, e.g., disinfecting toys, etc.
  • Protect the vulnerable person or the third
    link through immunization, balanced nutrition,
    and health practices such as proper hand washing,
    etc.

6
Daily Health Assessment
  • Do upon arrival
  • Look
  • Listen
  • Feel
  • Smell
  • Goal is to assess, not diagnose an illness.
    The key to detecting an illness in a child is a
    change in the childs behavior

7
Should She Stay or Should She Go?
  • What signs and symptoms may tell you a child is
    not well enough to participate that day?
  • flip chart

8
  • Skin
  • Is the face flushed or is the child perspiring?
  • Is the skin jaundiced or discolored?
  • Are there bruises, sores or a rash present?
  • Is the child scratching?

9
Fever
  • be consistent in where /how you take the childs
    temperature
  • Axillary temps are best in child care. Do not
    take temperature rectally.
  • If child is overdressed retake temperature
  • Look for other signs of illness
  • Exclude Temp.over 101

10
Head
  • Scratching his head
  • Has child vomited?
  • Squinting at objects?
  • Is the child drowsy or have a poor appetite?
  • Headache after school?
  • Other complaints?

11
Rashes
  • is the child on medication?
  • change in soap or food?
  • playing outside in grass or woods?
  • Exclude for fever over 101 or if you suspect
    scabies/lice or other communicable illness

12
Eyes
  • Is the eyelid swollen?
  • Bruises around the eye
  • Is there a thick discharge from the eyes?
  • Is the child rubbing her eyes?
  • Can you see a foreign object in the eye?
  • Exclude if you suspect Conjunctivitis-eyeball is
    pink/red and thick drainage. 24 hrs. of
    antibiotic and no thick drainage

13
Nose
  • Is there a discharge from the nose?
  • What color?
  • Can the child breathe through the nose?
  • Having a cold is not a reason for exclusion
  • Exclude Fever and child is noticeably
    uncomfortable/cranky

14
Ears
  • Discharge from ear
  • Is the child pulling at the ear?
  • High temperature?
  • Complaints of dizziness
  • Walking unsteadily
  • some ear infections are viral
  • Exclude Fever

15
Throat
  • Does child have trouble swallowing?
  • Are there spots or sores in the mouth?
  • Does child have a cough or runny nose?
  • Does child have a rash?
  • Is the temperature over 101 degrees?
  • Cavities can cause sore throat
  • Exclude Strep throat-24 hrs. of antibiotic

16
Cough
  • What does the cough sound like? hacking-sinus cro
    upy-cold wheezing-asthma
  • Is the cough productive?
  • Exclude Pertussis, breathing so hard cant play,
    cry, drink

17
Stomachaches
  • Check for other complaints
  • Change in appetite?
  • Has child vomited?
  • Is child constipated?
  • Does child have loose stools/diarrhea?
  • Does child want to lie down?
  • Persisting after school hours?
  • Exclude Recurrent vomiting or diarrhea

18
Hygienic Practices
  • Hand washing is the first fine of defense against
    infectious disease
  • Wash hands and lather, rubbing front and back for
    10- 20 seconds with soap
  • Rinse under running water from wrists to
    fingertips
  • Dry with paper towel and turn faucet off with
    paper towel

19
When to wash
  • upon arrival
  • before preparing, handling, or serving food
  • before and after eating
  • after coming in from play, handling pets
  • after toileting (self or child)
  • after diaper changing or cleaning up a mess
  • after handling used tissues or body fluids,
  • after using water/sand table

20
Glo Germ Activity
  • Centers for Disease Control Prevention
    (CDC) estimates that
  • 75 of infection could be prevented in child
    care if proper hand washing techniques were
    followed.

www.glogerm.com
21
Sanitizing Surfaces
  • 1/4 cup bleach to gallon water (1 tbsp per quart)
  • prepare daily
  • spray on and allow to air dry
  • clean heavily soiled areas with detergent and
    water first

22
Diapering
  • Gather supplies
  • Lay child on diapering surface and remove diaper
  • dispose of diaper in lined, covered step can
  • clean bottom with moist, disposable wipe and
    discard
  • wipe your hand with new wipe and discard

23
Diapering
  • diaper child or dress him
  • wash childs hands
  • remove paper liner, wash area with solution
  • wash your hands

DONT USE POWDER LIKE
DARREN DID!
24
First Aid Requirements
  • One staff member must be trained in first aid,
    CPR and rescue breathing and either on premises
    or field trips (available to children)
  • Current certification by American Red Cross,
    American Health Association, National Safety
    Council or other program approved by VDSS
  • First aid kit shall be accessible to adults (not
    to children) and brought on field trips
  • Kit shall contain designated supplies, including
    a cooling agent and activated charcoal (may
    special order)

25
Sleep Requirements
  • Occupied mats need to be at least 2 and 1/2 feet
    from heat source and 12 inches between occupied
    beds
  • No stacked or double decker cots. Stack only
    when not in use.
  • Designate specific cot/crib for each child
  • No pillows or comforters
  • Place infants on back
  • Checked on every 15-20 minutes

26
Gloving
  • Put glove on clean hand
  • Remove by grasping outside at wrist, pull inside
    out with ungloved hand grasp on inside at the
    wrist and pull inside out over hand

27
Cleaning and sanitizing blood/body fluid spills
  • 1. Gather all needed equipment gloves, paper
    towels, plastic bags, cleaning solution and
    sanitizing solution
  • 2. Put on disposable gloves
  • 3. Use generous amount of paper towels to soak up
    the liquid part of the fluid.
  • 4. Place the paper towels and gloves in a
    separate plastic bag, close and tie the bag
  • 5. Place closed and tied bag in regular lined
    trash can.

28
Cleaning and Sanitizing procedures (continued)
  • 6. WASH YOUR HANDS
  • 7. Put on clean disposable gloves
  • 8. Wash area with soap and water or other
    cleaning agent and rinse with water
  • NON POROUS SURFACES spray with 101 bleach
    solution until glistening wet. Allow it to sit
    for 2 minutes before wiping dry, or let air dry.

29
Cleaning Sanitizing procedures (continued)
  • POROUS SURFACES Use paper towels to soak up the
    liquid. Carpets and rugs can be cleaned with
    standard carpet cleaning chemicals.
  • Either discard or launder other fabrics through
    the machine alone with laundry detergent, then
    again using the 101 bleach solution to soak the
    fabric and laundry equipment for at least 2
    minutes

30
Soiled Clothing
  • Place childs or staffs soiled clothing in
    plastic bag and labeled to be washed using proper
    laundering technique.
  • Childs clothing should be sent home with
    parents.

31
Be Aware..
  • The use of commercially pre-saturated bleach
    wipes to sanitize surfaces is not recommended.
  • These wipes have not been tested for
    effectiveness in sanitizing diaper changing
    surfaces found in child care
  • The contamination of the wipe during use may not
    be sufficiently controlled by the bleach solution
    in the wipe

32
Whats Your Plan?
  • An Exposure Control Plan will help you develop a
    plan to reduce exposure to germs in blood and
    other body fluids
  • OSHA requires employers to develop and implement
    plans and policies to protect employees from
    exposure to potentially infectious body fluids.
  • Download a model ECP at www.OSHA.gov under
    bloodborne pathogen standard Standard 29 CFR
    1910.1030 or visit www.paaap.org/ECELS for an ECP
    adapted for child care

33
What should your ECP include?
  • Who is responsible for the overall implementation
    of the ECP?
  • What employees have occupational exposure (at
    least all who give direct care)
  • Methods of implementation and control (policies
    and procedures) including housekeeping, first
    aid, sharps care, laundry, etc.
  • Hepatitis B provision
  • Post exposure evaluation and follow up
  • Record keeping

34
What else should your ECP include?
  • Bloodborne Pathogen exposure control training log
    (all staff should receive training)
  • Exposure Incident Report form
  • Post Exposure Evaluation by health provider form
  • Post Exposure Referral to health provider form
  • Hepatitis B Vaccine Declination (Mandatory)
  • Sharps Injury Log

35
How You Can Prevent the Spread of Disease
  • Perform the Daily Health Check
  • Proper hand washing
  • Proper diapering technique and disposal
  • Proper disinfection of areas, including toys,
    cribs and surfaces

36
Continued........
  • Separation of age groups
  • Separate nap areas by 3 feet
  • Proper storage and care of clothes and bedding
  • Adequate ventilation and daily trips outdoors
  • Exclude children with signs/symptoms of
    potentially dangerous illness
  • No sharing of food, plates, utensils or drinks
  • Insist on up-to-date immunizations

37
Immunizations
  • Are the immunizations up to date?
  • Children born after January 1997 need Varicella
    vaccine
  • Children born after January 1994 need Hepatitis B
    vaccine
  • Current requirements that are mandatory include
    DTaP, IPV, MMR, Hib, HepB, Varicella and
    Pneumococcal conjugate

38
What About You?
  • Have you had your Hepatitis B vaccine?
  • When was your last tetanus- diphtheria vaccine?
  • Have you had chickenpox?
  • Do you get a yearly flu shot?

39
Lets Practice.Can you identify these? Would
you exclude?
40
What illness does this person have?
41
QUESTIONS?
42
Acknowledgements
  • Claire Wood, RN, BSN
  • Healthy Child Care Virginia, VDH
  • Carolyn Sanford, RN, BSN
  • Chesapeake Health Department, VDH
  • Bethany Geldmaker, PhD
  • Virginia Department of Health
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