©2012 Cengage Learning. All Rights Reserved. Chapter 5 The Infectious Process and Environmental...

©2012 Cengage Learning.All Rights Reserved.

Chapter 5The Infectious Process and

Environmental Control


What Makes an Illness Communicable?

• Three components are required for an illness to be communicable:– Pathogen– Susceptible host or individual– Method of transmission


What Makes an Illness Communicable?

PathogenMethod of

Transmission

SusceptibleHost


How are Illnesses Transmitted?

• Pathogens or organisms (e.g., viruses, parasites, bacteria, fungi) can be transmitted in several ways:– Airborne – Fecal-oral – Direct contact– Indirect contact

• Give an example of an illness that is transmitted by each of these methods.


Stages of an Infectious Illness

Describe what typically occurs during each of these stages:– Incubation– Prodromal– Acute– Convalescence


Controlling Infectious Illness…..

• Understanding the communicable process provides the most effective means for limiting the spread of infectious illnesses.

• Teachers have an ethical and professional responsibility to protect the wellness of all children in a group setting.


Infection Control Measures

• Ongoing teacher observations provide early clues about a child’s changing state of health.

• Policies should be in place and address a variety of protective measures such as exclusion guidelines, cleaning procedures, diapering procedures, food preparation, hand washing, and sanitation.

Exclusion Guidelines10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES

(a) Centers may provide care for a mildly ill child who has a Fahrenheit temperature of less than 100 degrees axillary, 101 degrees orally, or 102 degrees rectally and who remains capable of participating in routine group activities; provided the child does not:

(1) have the sudden onset of diarrhea characterized by an increased number of bowel movements compared to the child's normal pattern and with increased stool water; or

(2) have two or more episodes of vomiting within a 12 hour period; or

(3) have a red eye with white or yellow eye discharge until 24 hours after treatment; or

(4) have scabies or lice; or©2012 Cengage Learning.

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(5) have known chicken pox or a rash suggestive of chicken pox; or

(6) have tuberculosis, until a health professional states that the child is not infectious; or

(7) have strep throat, until 24 hours after treatment has started; or

(8) have pertussis, until five days after appropriate antibiotic treatment; or

(9) have hepatitis A virus infection, until one week after onset of illness or jaundice; or

(10) have impetigo, until 24 hours after treatment; or

(11) have a physician's or other health professional's written order that the child be separated from other children.


Exclusion Guidelines10A NCAC 09 .0804 INFECTIOUS AND CONTAGIOUS DISEASES


Infection Control Measures (continued)

• Immunizations should be current and required for children and teachers.

Immunizations


• All children in North Carolina must be vaccinated against certain diseases.

• Immunization records are checked when a child enters a child care center.

Required vs. Recommended in North Carolina

All children in North Carolina are

required to be vaccinated against:• Diphtheria• Hepatitis B• Hib Disease• Measles• Meningococcal• Mumps• Pertussis (whooping cough)• Pneumococcal • Polio• Rubella• Tetanus• Varicella (chickenpox)

The CDC also recommends

Children be vaccinated against

the following diseases, although

Immunization against these

diseases is not required for

children in North Carolina: • Hepatitis A

• Influenza

• Rotavirus

• Human Papillomavirus

http://www.immunize.nc.gov/family/vaccines/diphtheria.htm

http://www.immunize.nc.gov/family/vaccines/hepatitis_b.htm

http://www.immunize.nc.gov/family/vaccines/hib.htm

http://www.immunize.nc.gov/family/vaccines/measles.htm

http://www.immunize.nc.gov/family/vaccines/meningococcald.htm

http://www.immunize.nc.gov/family/vaccines/mumps.htm

http://www.immunize.nc.gov/family/vaccines/pertussis.htm

3 months 1 DTaP 1 Polio 1 Hib 1 Hep B 1 PCV***

5 months 2 DTaP 2 Polio 2 Hib 2 Hep B 2 PCV***

7 months 3 DTaP 2 Polio 2-3 Hib 2 Hep B 3 PCV***

12-16 months 3 DTaP 2 Polio 3-4 Hib 1 MMR 2 Hep B 1 Var+ 4 PCV***

19 months 4 DTaP 3 Polio 3-4 Hib 1 MMR 3 Hep B 1 Var+ 4 PCV***

4 years or older (in daycare only)

4 DTaP 3 Polio 3-4 Hib 1 MMR 3 Hep B 1 Var+ 4 PCV***

4 years and older (and in kindergarten)

5 DTaP 4 Polio 3-4 Hib 2 MMR* 3 Hep B 2 Var+ 4 PCV***

By this age:

Children Need These Shots:

Child Care Operator's Responsibility

• The child care facility maintains on file immunization records for all children attending the child care facility, which contains the information required for a certificate of immunization.

• When a child transfers to another child care facility, the facility where the child previously attended must, upon request, send a copy of the child’s immunization record, at no charge, to the child care facility or school to which the child has transferred.

• The child care operator must complete and submit annually to the N.C. Immunization Branch the Annual Child Care Immunization Report.– This report is due to the N.C. Immunization Branch on December 1st of

each year.



Infection Control Measures (continued)

• Environmental measures must be implemented and include:– Universal infection control precautions for handling

body fluids (e.g. blood, feces, vomited matter) and disinfection (Table 5-2)

– Using proper hand washing technique and washing at appropriate times (Tables 5-3)

• Click on link and watch the CDC’s “Hands Together” video on hand washing: http://www.cdc.gov/CDCTV/HandsTogether/index.html


Environmental measures (continued)

– Cleaning and disinfecting eating and food preparation areas, bathrooms, diapering areas, toys, and equipment (Table 5-4).

– Arranging rooms to minimize extended periods of close contact.


Environmental measures (continued)

– Maintaining comfortable room temperatures; opening doors and windows for fresh air.

– Taking special precautions with sandboxes, pools, and water tables.

• Teaching children, teachers, and families about infectious illness and effective control measures.

• Informing families of exposure

Administering Medication• When parents request that

medicine be given to their child, you will need to make sure you have all the documentation and materials required to legally and safely give the medication.

• If medication is brought into the center for a child riding a van or bus, the medication must be transferred between responsible adults.


Permission to Administer Medication:

• Check to see if parents have completely filled out the required information on the Permission to Administer Medication form.

• Parents must provide written permission for prescribed medication and for over-the-counter medication.

• This meets the requirement for written permission from the parent to give the child a medication.


Permission to Administer Medication:

The written permission slip must include:Name of the child Any special instructions, like give with food or milkName of the medicationDosage Any possible reactions to watch forDates to be givenTimes to be given Parent’s signature


For prescribed medications:

Check to see that the medication is in its original container.

Be sure the container is properly labeled with the:

• Name of the child who will be given the medication

• Name of the medication or prescription number

• Directions for giving the medication: dose, time, number of days, and the route. (Route refers to the way the medication is given: for instance, by mouth, by eye drops or eardrops, or applied topically to the skin.)

• Name of the prescribing physician or other health professional

• Date the prescription was filled

• Date the medication expires


For over-the-counter medications:

Cough syrup, decongestants, and acetaminophen

are examples of over-the-counter medicines.

• Check to see that the medication is in its original container, has the child’s name written on it and that the directions are visible and understandable.

• Caregivers can only give the recommended dosage included in the instructions found on the packaging, unless the medication is accompanied by written instructions signed by a physician.


Administering Medication

Before giving medication:• Wash your hands before giving or applying

medication to each child.

• Check that the parent has signed and provided all the required information on the Permission to Administer Medication form.


Administering Medication

• Take the medication out of the locked storage area or container.

• Relock.

• Prepare the dose.

– Avoid touching the medication with your hands.

• Use an appropriately labeled medicine dropper, cup, or spoon

for accurate measuring of liquid medications.

– Do not use tableware such as spoons for measuring, as they are not accurate.

• Double check the time, the amount of the dose and the route

of administration on the container label and on the permission

slip.


Remember:• Never give a medication you do not have

written permission from the parent to give.

• Never give a medication that has expired.

• Never give a medication someone else prepares.

• Never give medication by a route you are not comfortable with or for which have not received enough training.


Administer medication:• Give the exact dose to the child, by the route specified.• Follow any special instructions, such as giving the

medication with food or on an “empty stomach”.• Wash your hands.• Return the medication to the locked storage area or

container.• Relock.• Document that you have given the medication by

completing the required information on the “Permission to Administer Medication” form (date, time, dose, route, signature).


After medication is given:

• If an error is made administering the medication, be sure to document what was given and inform the parents and director of the error. – Additional documentation may be needed.

• Observe the child’s response to the medication and report any side effects or reactions to the parent, the child care health consultant or physician if necessary. ©2012 Cengage Learning.

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After medication is given:

• If an allergic reaction occurs, the parent should be notified immediately.

• If a life threatening reaction occurs, dial 911 immediately and: - Follow the emergency action plan for your facility.

- If the child has special health needs, follow the instructions on the child’s individual health plan.

• Complete the required incident report. – Keep a copy in the child’s folder, send a copy to DCD, and

give the parents a copy.

– Record the incident in the incident log.


• Return unused medication to the parents after the last authorized dose has been given to the child.

• Return expired medications to parents or dispose of them if the parents do not want the expired medications



Caring for Mildly Ill Children

• Factors to consider– Is the illness highly contagious?– Will other children be placed at risk?– Does the child feel well enough to participate?– Does the child’s illness place them at greater

risk of catching something else?– Can teachers meet the child’s needs as well

as those of the other children in attendance?

©2012 Cengage Learning. All Rights Reserved. Chapter 5 The Infectious Process and Environmental...

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