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    Objectives
    • Describe the role of disposable gloves in preventing the spread of disease and promote glove-use among staff members.
    • Describe and promote the use of universal health precautions.
    • Identify and share resources related to health maintenance and common childhood illnesses.
    • Describe, apply, and communicate about your program’s exclusion and readmission policies.

    Learn

    Learn

    Teach

    All staff members who work with young children are required to complete training to learn how to help prevent the spread of infectious diseases. Often, a nurse or health care professional provides this training. You can also help support staff members' learning. Make sure you are familiar with the resources related to infectious disease available in this Healthy Environments course.

    You will also need to teach staff members how to model healthy habits related to infectious disease. For example, make sure staff members know how to cover their own coughs and how to use proper glove-wearing procedures. Provide ongoing training around universal precautions: glove-wearing, cleaning and disinfecting procedures, etc.

    You will also need to make sure staff members know how to perform and document daily health checks. This includes recognizing when a child experiences illness or a health concern. Make sure you train new staff members on your program's exclusion policy. You may be called to help a staff member make a decision about whether a child is ill and needs to be sent home. Therefore, you must be familiar with the signs and symptoms of common infectious diseases and your program's policies. You may also be responsible for communicating with families when certain infectious diseases occur in your program. Be prepared to make sure staff members follow exclusion and readmission policies themselves: sick staff members can spread illnesses, too.

    Model

    You should model practices that prevent the spread of infectious disease. Follow the Centers for Disease Control and Prevention's guidelines for covering your cough and handwashing. You can also model talking to children about healthy habits. For example, if a child sneezes while you are in a classroom, you can remind the child to go wash his or her hands. You can also help staff members remember to wash their own hands and the child's hands after wiping a child's nose. It's OK to remind staff members and administrators to take steps to prevent the spread of disease, too. This helps promote a culture of healthy habits in your program.

    You might be called when a staff member suspects a child is ill. Be prepared to conduct a health check and look for signs of illness. Follow your program's procedures for exclusion and readmission. In the event of an emergency or illness, model proper sanitation procedures in the presence of body fluids like blood, vomit, urine, or feces. Remain calm in these situations and help staff use their training. You might also need to supervise children while staff members respond to the emergency.

    Observe

    You may not see staff members respond to illness every time you observe in a classroom or program. However, when illness occurs, be prepared to make sure staff members follow your program's procedures for responding. You can observe and provide feedback on a staff member's calmness, appropriate response in caring for a child, and attention to health and sanitation protocols. Use the Infectious Diseases Best Practices Checklist resource in the Apply Activities section below to help document staff members' progress and knowledge of appropriate procedures. 

    Case Example: Responding to Illness

    It is important to think about how you support staff as they respond to illness. This case example shows an infant and toddler classroom. You will see responses that do not prevent the spread of disease. As you watch the video, think about the procedures the staff member should have taken and the health risks you see. Also take this opportunity to think about why your program has the health and cleanliness policies it does and how these policies help keep children healthy. Being able to articulate your policies to staff members is important, but it is also important to be prepared to talk about why and how those policies keep children and staff healthy.

    Case Example: Responding to Illness

    Think about how you might help staff members reflect on the best practices for responding to illness.

    Case Example Step 1: Make a Plan

    As a coach or trainer, it might be necessary to help the child development or school-age team develop a plan about providing a healthy environment for children. This requires a team effort. Here is a sample plan that you might develop based on what you saw in the video:

    Goal : Provide a healthy environment for all children by following program procedures when a child is ill.

    Steps :

    1. Meet individually with staff and as a team to go over the program procedures for responding to illnesses.
    2. Walk through the classroom and make sure cleaning supplies (soap and water mixture, bleach solution, disposable paper towels) are accessible at all times and were made accurately. Fix any problems immediately.
    3. Review handwashing policies for adults and children. Develop reminders that can be used by the team to reinforce handwashing.
      1. Remind staff members when someone forgets.
      2. Say "Thank you" as acknowledgement to each other when you see a team member wash their hands or a child's hands.
      3. Regularly use the Hand Hygiene Monitoring Tool (provided in Lesson Two) in classrooms and provide feedback (provided in Lesson Two).

    Case Example Step 2: Provide Feedback

    As a coach or trainer, it might be overwhelming to think about what you might say to staff members about maintaining healthy habits. There are often many things you could talk about following any observation of a classroom or program. It is important to focus your feedback-in this case on responding to illness. You might say:

    "You guys had your hands full today when your little guy got sick at the table. I know that's a non-contagious health concern for him and that you are working with his family. I want to talk, though, about the steps we need to take when children get sick or sneeze. Even if the child does not have a contagious illness, we need to treat all body fluids as if they could possibly spread illness. This is just good practice and a good habit to have. Let's talk about the steps to take the next time this child gets sick or sneezes…"

    "Teachers often think about the children first and themselves last; I know how much you care about the kids! But washing your own hands is an important step to keep the kids healthy…"

    Case Example Step 3: Provide Resources

    As a coach or trainer, it is up to you to identify resources that might support a team. For the team in this case example, it might be important to do a team health and safety check in the morning to make sure all cleaning supplies are ready and accessible. You might help them make a simple flowchart that they can hang in a discrete location to remind them what to do when a child is ill. You might provide copies of the Hand Hygiene Monitoring Tool (in Lesson Two) and ask the team to check themselves regularly.

    Additional Examples of Responding to Illness

    Now look at additional examples of ways infant and toddler, preschool, and school-age staff members respond to illness. You and all staff members must be vigilant about responding to illness. The same principles apply across age ranges. As children age they become more independent: they may be able to make it to the restroom if they are ill, or they may blow their noses independently. Regardless of how independent children are, all staff members must follow the same universal health precautions.

    Responding to Illness: Infants and Toddlers

    This video shows a range of of ways staff members respond to illness with infants and toddlers.

    Responding to Illness Scenarios

     

    Scenario

    You saw:

    • Children and teacher engaged in conversation at child's eye level.
    • Teacher notices runny nose.
    • Teacher uses bare hand and tissue to wipe child's nose.
    • No mention of handwashing for adult or child.

    You Say

    What you might say:

    • "You really built a connection between the kids while I was observing; you helped them communicate. I know it's hard to break up the flow of a conversation, but it's equally important to model healthy habits…"
    • "How does this group of kids compare to other groups you have had? What are your priorities with this group?"
    • "How well do you think the kids understand handwashing and germs?"

    You Do

    What you might do:

    • Observe with the Hand Hygiene Monitoring Tool (in Lesson Two) and provide feedback; encourage the staff members to monitor themselves.
    • Provide tissues within children's reach, so they can begin practicing self-care.

    Scenario

    You saw:

    • Two children and adult at table. No food has been served yet.
    • Adult notices a child's runny nose.
    • Adult gets glove and tissue and wipes child's nose.
    • Adult washes her hands right away.

    You Say

    What you might say:

    • "You were very thoughtful and intentional today when you helped the children at the table. You made sure not to leave children alone with food, and you found the right opportunity to clean a runny nose."

    You Do

    What you might do:

    • Continue regularly observing the team and providing feedback; open lines of communication between team members.

    Scenario

    You saw:

    • Mother and child arrive at the infant room.
    • Both are greeted warmly.
    • Teacher asks mother about the infant's night, about shots, and general health questions.
    • Maintains friendly interaction and takes child to wash her hands.

    You Say

    What you might say:

    • "I could tell you and the mom have built a strong relationship. You got a lot of important information and started the day with a healthy foundation."
    • "What are your goals when a parent drops a child off? What's the most important information you need to get?"

    You Do

    What you might do:

    • Ask the staff member to share ideas for greeting parents and daily health checks with other staff members.

    Responding to Illness: Preschool

    This video shows a range of of ways staff members respond to illness with preschoolers.

    Responding to Illness Scenarios

     

    Scenario

    You saw:

    • Child sitting alone in quiet area with dolls.
    • Child pulls tissue out of his pocket and blows his nose.
    • Puts tissue back in pocket.
    • Continues playing with dolls.

    You Say

    What you might say:

    • "Tell me more about your little guy who was relaxing in the corner. It looked like he had a cold…"
    • "It's such a fine balance with preschoolers when we're teaching independence; but we've also got to teach healthy habits like handwashing. How could we help that little guy remember to go wash his hands?"
    • "What do you think would happen if you had gone over just then and asked him to wash his hands?"

    You Do

    What you might do:

    • Offer to observe and help out in the classroom if individual children need extra attention around self-care and handwashing.
    • Help the team brainstorm visual reminders they could put in the room to help the child remember to wash his hands.

    Scenario

    You saw:

    • Classroom transition.
    • Adult notices child has runny nose.
    • Adult uses bare hand and tissue to help child clean nose.
    • Adult and child both go wash hands.

    You Say

    What you might say:

    • "You stuck with it when your little guy needed to wash his hands. That was an important way to model healthy habits."
    • "How do you promote independence and healthy habits in the room?"

    You Do

    What you might do:

    • Provide or help brainstorm visual supports that could be used to help the child wash his hands independently.

    Responding to Illness: School-Age

    This video shows staff members responding to illness in a school-age program.

    Responding to Illness Scenarios

     

    Scenario

    You saw:

    • Staff member takes a child's temperature.
    • Child is laying on the couch while other children dance.
    • Staff member comforts child throughout.
    • Another child (the ill child's brother) lays on him on the couch.

    You Say

    What you might say:

    • "It looked like Sam wasn't feeling well today. Tell me about how you handled that…"
    • "What do you usually do when children aren't feeling well?"
    • "When a child has a fever, we need to make sure we keep it as contained as possible. Let's think about ways we could separate Sam (or any sick child) from the group."

    You Do

    What you might do:

    • Make sure the staff knows where the sick room is located and how to use it.
    • Work with the supervisor or manager to make sure a sick room is accessible and available for isolating ill children.

    After completing their Healthy Environments course, staff members should understand and follow procedures for responding to illness whenever it occurs. Remember to observe, provide feedback, and offer resources as needed throughout an employee’s career. Needs will change, but your role always serves a critical mission. 

    Explore

    Explore

    Even in the best programs, serious illness can occur. Use the Sick and Tired activity to read the scenarios and describe how you would respond. Then compare your answers to the suggested responses.

    Apply

    Apply

    Use the Infectious Diseases Best Practices Checklist tool to focus your observation in each classroom or program. Provide feedback to a staff member about what you saw, then save the completed checklist in the staff member’s training file as documentation of their competence and progress with their practices in encouraging and maintaining healthy environments.

    Glossary

    TermDescription
    ExclusionWhen a child is sent home from child care due to illness. Children are excluded from child care based on each program’s exclusion policy. Readmission, also based on a program’s policy, can vary due to the reason for exclusion
    Infectious diseaseA disorder “caused by organisms — such as bacteria, viruses, fungi or parasites…. Some infectious diseases can be passed from person to person. Some are transmitted by bites from insects or animals. And others are acquired by ingesting contaminated food or water or being exposed to organisms in the environment.” (Mayo Clinic, n.d.)
    Reportable illnessesConsidered serious public health concerns. Doctors and hospitals have to report these illnesses to public health officials when they are diagnosed. This helps with tracking and controlling outbreaks

    Demonstrate

    Demonstrate
    Assessment

    Q1

    You overhear a staff member in the school-age program discussing an illness with a parent. The staff member says, “Yeah, Natalie has whooping cough. She was here before she knew she had it, but they say that’s when it’s most contagious. I guess school-age kids like Natalie get it because the vaccine wears off ….” What did the staff member do wrong?

    Q2

    As you step into the office, you hear a family member asking to see you. She is very angry that she has been called to pick up her preschooler, Ty, because he is sick. She says she gave him fever medication in the morning and it should be fine for him to stay at school. What do you say?

    Q3

    Carolyn, a staff member in the school-age program, comes to you and says she is not feeling well. She has never called in sick before. When she says she thinks she should go home, you know she is seriously ill. Unfortunately, you do not have enough staff to cover. What should you do?

    References & Resources

    American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. (2015). Caring for Our Children: National health and safety performance standards; Guidelines for early care and education programs, 3rd ed. Elk Grove Village, IL: American Academy of Pediatrics; Washington, DC: American Public Health Association. Also available at http://nrckids.org

    Aronson, S. S., Bradley, S., Louchheim, S., & Mancuso, D. (2002). Model Child Care Health Policies, 4th Ed. Washington, DC: National Association for the Education of Young Children.

    Aronson, S. S., & Spahr, P. M. (Eds., 2002). Healthy Young Children: A Manual for Programs. Washington, DC: National Association for the Education of Young Children.

    Keeping Healthy: Families, Teachers, and Children. (2007). [Brochure]. Washington, DC: National Association for the Education of Young Children.

    North Carolina Child Care Health and Safety Resource Center, (May 2009). Information available by contacting 800-367-2229.

    Ritchie, S. & Willer B. (2008). Health: A Guide to the NAEYC Early Childhood Program Standard and Related Accreditation Criteria. Washington, DC: National Association for the Education of Young Children.