Most children, whether in care or not, sport a runny nose at this time of year and most educators spend the whole day with a tissue in hand ready to catch the never ending drips.

While child care services may never be able to eradicate colds and 'flu completely there are a number of steps which can reduce their spread. This article will hopefully serve as a reminder of the best ways to keep the dreaded lurgy at bay.

CONTROLLING INFECTION

Infection control requires child care services to break the four step cycle of infection spread as described below:

1. A person with an infection spreads the germs into their environment for example by coughing or wiping a runny nose with the back of a hand and then touching a toy.
2. The germ survives in its new environment which could be in food or water or on toys and/or surfaces.
3. Another person comes into contact with the germ.
4. This person then becomes infected and can spread the germ.

The most effective ways of breaking this cycle of infection are to encourage regular hand washing by staff and children, to exclude staff and children from the service when they are sick and to promote immunisation.

If these measures aren't followed then many of the other processes which support infection control, such as cleaning and food safety procedures will not work so well.

HAND WASHING

The best way to control the spread of infection in a child care service is to encourage regular and effective hand washing and drying by staff and children.

The best way to promote hand washing is to ensure hand basins are readily accessible and located where they are most needed, for example near toilets, nappy change areas, food preparation areas and outdoors.

Hand basins the right size and height for staff and children need to be available and providing soap dispensers, hands free taps and paper towels should help promote regular washing. Babies also need their hands washed just as regularly and thoroughly as older children.

The National Health and Medical Research Council (NHMRC) recommends the following method for hand washing in child care services.

How to Wash Hands

The process of thoroughly washing and rinsing your hands should take 10-15 seconds. This is about as long as it takes to sing 'Happy Birthday' twice.

• Wet hands with running water
• Use liquid soap and spread it over both hands.
• Rub hands vigorously.
• Wash hands all over paying attention to the palms, backs of hands, between fingers, fingernails and wrists.
• Rinse hands thoroughly and remove all the suds.
• Turn off the tap using a paper towel.
• Dry your hands with a new paper towel.

Download a free NHMRC poster to remind staff and children how to wash their hands properly here.

When staff should wash their hands:

• On arrival at the service, this reduces the introduction of germs.
• Before handling food, including baby bottles
• Before eating
• After changing a nappy
• After removing gloves
• After going to the toilet
• After cleaning up blood, faeces or vomit
• After wiping a nose, either a child's or their own
• Before giving medication
• After handling rubbish
• After coming in from outside play
• Before going home, this prevents staff from taking germs home.

When children should wash their hands

• When they arrive at the service. This reduces the introduction of germs and parents can assist
• Before handling food, including baby bottles
• Before and after eating and handling food
• After nappy changes as their hands will become contaminated while they are on the change mat
• After going to the toilet
• After coming in from outside play
• After touching nose secretions
• After coming in contact with blood, faeces or vomit;
• Before joining the mixed age group
• Before going home. This prevents them from taking germs home and parents can assist.

EXCLUSION POLICIES

Excluding sick staff and children from the service plays a very important role in controlling the spread of infection. Most parents will appreciate a service's efforts to prevent and control the spread of infection. However exclusion policies can be difficult to enforce when parents put a lot of pressure on staff to allow the children to attend child care even when they are sick.

The best way to avoid conflict is to have a written policy that clearly states the service's exclusion criteria. A copy of this policy should be on public display and given to all parents as they enrol their child in the service.

The need for exclusion should depend on; the ease with which the infection can be spread, the ability of the infected person to follow hygiene procedures and the severity of the disease.

Refer to the NHMRC's guidelines provided at the end of this article for advice on recommended exclusion periods.

IMMUNISATION

Universal childhood immunisation is the third prong in the battle against infection and Is the most effective way of preventing certain common infections.

Parents should be asked to provide a copy of their child's immunisation records on enrolment at the service and the parents of children who are not immunised should be advised that their children may be excluded from care during outbreaks of certain infectious diseases such as measles and whooping cough even if the child is well.

The NHMRC recommends vaccination for all children and suggests that child care providers play an active role in encouraging parents to have their children vaccinated. Ways to encourage parents to vaccinate and keep their vaccinations up-to-date include:

• Put up reminder posters around the service about key vaccination ages
• Send children home with first birthday immunisation reminder cards
• Send children home with fourth birthday immunisation reminder cards
• Regularly review children's vaccination records and send reminder cards to parents
• Include a reminder message at the bottom of receipts or in newsletters

Infection control relies on the consistent application of the above range of fairly straightforward measures. By working to ensure staff and children at your service are informed about your policies and procedures you'll hopefully keep this year's ‘flu season a short one!

FURTHER READING

Staying Healthy in Child Care 5th Edition