📒Sick Children Policy (QA2) (video needed)

National Quality Standard (NQS) - Quality Area 2: Children's Health and Safety

Implementation

Woodlands has adopted the Staying Healthy: Preventing infectious diseases in Early Childhood Education and Care Services publication (Sixth Edition), developed by the Australian Government - National Health and Medical Research Council. We aim to provide families with up to date information regarding specific illnesses and ways to minimise the spread of infection within Woodlands.

An infection occurs when harmful germs (microorganisms) enter the body, multiply and cause disease.

The chain of infection refers to how germs spread (Figure 1.1). When an infection occurs, three things are involved:

• the source – the germs and where they live
• spread – how the germs get out of one person and move to a new person
• the new host – a susceptible person (someone who can be infected) with a way for the germs
to get in.

 

You can break the chain of infection at any stage.

We understand that it can be difficult for families to know when their child is sick. Families may experience problems taking time off work or study to care for their child at home. Obtaining leave from work or study can enhance negative attitudes in the workplace which can cause stress on families. Families may also experience guilt when they send their child to care who is not well. However, it is imperative that families preserve a focus not only on the well-being of their own child but also upon the well-being of other children and the child care professionals at the Woodlands. 

The need for exclusion and the length of time a person is excluded depend on how easily the infection can spread, how long the person is likely to be infectious and how severe the disease can be. To protect the health of children and staff within the Service, it is important that children and staff who are ill are kept away from Woodlands for the recommended period.

Our educators and staff are not medical practitioners and are not able to diagnose whether or not a child has an infectious illness. However, if an infectious illness is suspected, our Service may ask the family to collect their child from care as soon as possible or not bring the child to care. 

Management and Educators may request families seek medical advice and provide a medical certificate stating that the child is no longer infectious prior to returning to care. 

 

Children arriving at Woodlands unwell

Management will not accept a child into care if they: 

• Are unwell and unable to participate in normal activities or require additional attention 
• Have had a temperature, vomiting and/or diarrhoea in the last 24 hours
• Have started antibiotics in the last 24 hours 
• Have a contagious illness or disease 
• Have been given medication for a temperature (Panadol, Nurofen etc.)

 

Children who become ill whilst at Woodlands

Children may become unwell throughout the day, in which Management and Educators will respond to children’s individual symptoms of illness. 

• Educators will monitor and document the child’s symptoms as an illness report.
• A child who has passed runny stools/vomited whilst at the Service will be sent home. Keep your child at home until there has been no vomiting or diarrhoea for at least 48 hours and they feel well ensuring that a doctors clearance letter is produced on the child's return.
• Educators will take the child’s temperature if a fever is suspected. If the child’s temperature is 38°C or higher, management will contact the child’s parents/guardian/emergency contacts as soon as possible to have the child picked up. At this point parents are able to provide verbal authorisation to administer paracetamol if needed and must provide the child's accurate weight and dosage required which will be cross-checked with the information on the paracetamol bottle.
• Prior to any medication administration, educators will attempt to lower the child’s temperature by: 

1. Taking off their shoes and socks.
2. Applying a cool washer behind their neck and/or on their forehead. 
3. Removing extra clothing layers (jumpers etc.) 
4. Encouraging the child to drink water.

      In addition to:

• Place the child in a quiet area where they can rest, whilst being supervised.
• Continue to monitor and document any progressing symptoms. 
• Completing an illness record, ensuring the form has been completed correctly and signed by the parent/guardian/emergency contact upon collection.

 

Reporting Outbreaks to the Public Health Unit 

Outbreaks of communicable diseases represent a threat to public health. To prevent outbreaks it is important to monitor the number of people who contract certain infectious diseases and their characteristics and to work with patients and their doctors to help prevent spread to other people.

The NSW Public Health Act 2010 lawfully requires and authorises doctors, hospitals, laboratories, school principals and childcare centre directors to confidentially notify NSW Health of patients with certain conditions and to provide the information delineated on the notification forms. Specialist trained public health staff review this information and if necessary contact the patient’s doctor, and sometimes the patient, to provide advice about disease control and to complete the collection of information. 

All information is held confidentially in order to protect the patient’s privacy. Both the NSW and Commonwealth Privacy Acts contemplate the release/disclosure of patient information where it is lawfully required or authorised.

Management is required to notify the local public health unit (PHU) by phone (call 1300 066 055) as soon as possible after they are made aware that a child enrolled at the Service is suffering from one of the following vaccine-preventable diseases:

• Diphtheria
• Mumps
• Poliomyelitis
• Haemophilus influenza Type b (Hib)
• Meningococcal disease
• Rubella ("German measles")​
• Measles ​
• Pertussis ("whooping cough"​)
• Tetanus ​
• An outbreak of 2 or more people with gastrointestinal or respiratory illness 

  

Common Colds and Flu

Colds are the most common cause of sickness in both children and adults. Symptoms include a
runny or blocked nose, sneezing and coughing, watery eyes, headache, sore throat and a possible
slight fever.

Children in education and care services can have as many as 8 to 12 colds a year. However, by the
time they are 3 years old, children who attend a service have no more colds than those who are
cared for only at home.

Woodlands aims to support the family’s need for child care, however, families should understand that a child who is unwell will need one-on-one attention which places additional pressure on staff ratios and the needs of other children and our staff are not medically trained to support an unwell child as a medical practitioner would.

 

Excluding children from the Service 

• When a child has been diagnosed with an illness or infectious disease, Woodlands will refer to Staying Healthy in Childcare (6th Edition) to find the recommended exclusion period and also request a medical clearance from the GP stating that the child is cleared to return to the childcare setting. 
• When an infectious disease has been diagnosed, Woodlands will communicate the appropriate documentation and alerts for families including information on the illness/disease, symptoms, infectious period and the exclusion period. (This information can be obtained from Staying Healthy In Child Care 6thEdition) via a comms post.
• Children that have had diarrhoea and vomiting will be asked to stay away from Woodlands for 48 hours after symptoms have ceased to reduce infection transmission as symptoms can develop again after 24 hours in many instances. 

 

Notifying families and Emergency Contacts 

• It is a requirement of Woodlands that all emergency contacts listed are able to pick up an ill child within a 30-minute timeframe. 
• In the incident that the ill child is not collected in a timely manner or should parents refuse to collect the child a warning letter will be sent to the families outlining Woodlands policies and requirements. The letter of warning will specify that if there is a future breach of this nature, the child’s position may be terminated. 

 

Management and Educators will ensure 

• Effective hygiene policies and procedures are adhered to at all times 
•  Effective environmental cleaning policies and procedures adhere to all times 
• All families are given a copy of relevant policies upon enrolment which will be explained by management including; Control of Infectious Diseases Policy, Sick Children policy, Injury and Accident policy and Medical Emergency Policy.
• Any child who registers a temperature of 38°C or above will need to be collected from Woodlands and will be excluded for 24 hours since the last elevated temperature or until Woodlands receives a doctors clearance letter stating that the child is cleared of any infection and able to return to child care.  
• A child who has not been immunised will be excluded from Woodlands if; an infectious disease is reported within the Woodlands community and that child is deemed to be in danger of contracting the illness. Please refer to our Control of Infectious Diseases Policy.
• Families are notified to pick up their child if they have vomited or had diarrhoea whilst at Woodlands. 
• If the situation or event presents an imminent or severe risk to the health, safety and wellbeing of the child or if an ambulance was called in response to the emergency (not as a precaution) the regulatory authority will be notified within 24 hours of the incident.
• That parent is notified as soon as practicable but within 24 hours. Also, details of the condition/situation will be recorded on the Incident, Injury, Trauma and Illness Record.

 

Families Responsibility 

In order to prevent the spread of disease, families are required to monitor their child’s health, in particular when a child is presenting with any of the following symptoms which may require a medical practitioner to provide a clearance for a child to return to care:

•           Runny, green nose
•           High temperature 
•           Diarrhoea
•           Red, swollen or discharging eyes
•           Vomiting
•           Rashes (red/purple)
•           Irritability, unusually tired or lethargic
•           Drowsiness 
•           Lethargy or decreased activity 
•           Breathing difficulty 
•           Poor circulation 
•           Poor feeding 
•           Poor urine output 
•           A stiff neck or sensitivity to light 
•           Pain 

In addition to the above, families should keep up to date with their child’s immunisations, providing a copy of the updated immunisation schedule to Woodlands each time a new vaccination is administered. 

 

Returning to care after surgery 

• Children who have undergone any type of surgery will need to take advice from their doctor/surgeon as to when it is appropriate to return to care. 
• Children will require a medical clearance stating the child is fit and able to return to the Service and participate in daily activities. 
• Depending on the type of surgery, a medical clearance should include any limitations or precautions needed when returning to Woodlands.