Infant and Toddler Care: Improving Quality Through Health and Safety Practices Danette Swanson...

Infant and Toddler Care: Improving Quality

Through Health and Safety Practices

Danette Swanson Glassy, MD, FAAPCA Head Start Association

2015 Health InstituteLos Angeles, CAApril 29, 2015

School readiness begins with health!

Danette Swanson Glassy, MD, FAAP

• Mercer Island Pediatrics• Advisory Committee, Head

Start National Center on Health

• Co-Editor, Caring For Our Children, National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition


Agenda• National Center on Health• Best-Practice/Standards/Regulations Oh My!• Infant/Toddler Care-a few highlights

– Medical Home– Infection Control– Immunizations: children and adults– Safe Sleep– Developmental Screening– Feeding solids (anemia/allergy issues)– Nutrition/Physical Activity– Others?

• Resources• Measure Your Quality


What is Health?

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

World Health Organization, 1948


•Program Management and Fiscal Operations

NCPMFO

•Quality Teaching and Learning

NCQTL

•Parent, Family, and Community Engagement

NCPFCE

•Cultural and Linguistic Responsiveness

NCCLR

•Early Head Start

EHSNRC

•HealthNCH

Office of Head Start National Centers


Head StartNational Center on Health

Our Goal: Fostering a culture of health and wellness for children, families, staff, and communities

Our Foundation: School readiness begins with health!

Sound Management Systems

Staff, Parent, and Community Engagement

Culturally & Linguistically Appropriate

Positively Associated with Improvement in

Learning

Applicable to Home Visits & Child Care

Settings

Safety & Injury Prevention

Oral Healt

h

Mental Health

Nutrition & Physi

cal Activi

ty

Health Literacy


• American Academy of Pediatrics• Education Development Center, Inc. • Center for Child and Human Development at

Georgetown University• National Maternal and Child Oral Health Resource

Center at Georgetown University• UCLA Health Care Institute at the UCLA Anderson

School of Management

National Center on Health Partners


NCH Resources

• Newsletters• Online courses• Webinars• Fact sheets• T/TA tools

http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/center


OHS Priority Health Issues

• Healthy active living • Mental health • Safety and injury prevention • Health literacy• Oral health and dental

homes• Asthma prevention with

special emphasis on tobacco exposure prevention


Emerging Issues• Emergency preparedness and

response• Connecting children with

medical and dental homes• Health manager networks• Health and home visiting• Toxic stress and trauma in

early childhood• Orientation for new health

managers• Staff wellness


Who’s Here Today?

• Health Managers?• Family Services

Managers?• Other Area Managers?• Classroom Staff, Home

Visiting Staff, or Family Child Care Providers?

• Parents or Family Members?

• Directors or Administrators?

• Governing Boards/Tribal Council/Policy Council?

• Community Partners?• TA Staff?• Federal Staff?• Other?• From California or

Other States?


Quality

• Evidence-based, expert informed *

• Head Start Program Performance Standards

• Accreditation Requirements• State Child Care Regulations• Evaluator Interpretation


Medical Home

Overall better health with true Medical Home

• accessible, • continuous, • comprehensive, • family-centered,• coordinated, • compassionate, and• culturally effective


Medical Home• Access-Use local outreach advocates:

– Covered California Outreach and Education Grant Partners – http://

www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/OE/OutreachandEducntygrantees.pdf

– Promote www.WellVisitPlanner.org

• Communication– Call, really, I mean it!

http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/OE/OutreachandEducntygrantees.pdf



http://www.wellvisitplanner.org/


Infection Control

• Infants and Toddlers more vulnerable

• Infants with fever hospitalized if under 2-3 months

• With flu hospitalized at the same rate as senior citizens

• Diarrheal illness significantly reduced with proper hand hygiene, sanitizing/disinfecting


Infection Control

Cleaning, Sanitizing, Disinfecting– Written policy– Which-for-What: CFOC Appendices J and K

• http://cfoc.nrckids.org

– Alameda County Green Child Care:• http://acgov.org/ece/green_childcare.htm

– Coalition for Safety and Health in Early Learning:• http://cshelwa.org/downloads/13_Disinfect_E15L.pdf

http://cfoc.nrckids.org/

http://acgov.org/ece/green_childcare.htm

http://acgov.org/ece/green_childcare.htm

http://cshelwa.org/downloads/13_Disinfect_E15L.pdf

http://cshelwa.org/downloads/13_Disinfect_E15L.pdf


Infection Control

Hand Hygienehttp://www.cdc.gov/CDCTV/handstogether

/

http://www.cdc.gov/CDCTV/WashYourHands/

http://www.cdc.gov/CDCTV/handstogether/

http://www.cdc.gov/CDCTV/handstogether/




Infection Control

• Diapering– Use posters:

• http://www.ecels-healthychildcarepa.org/• http://here.doh.wa.gov/materials/how-to-change-a-dia

per/12_DiaperCCsm_E12L.pdf

• Policy for parents using the diapering area• Hand washing nowhere near food and bottle

prep sink/area

http://www.ecels-healthychildcarepa.org/

http://here.doh.wa.gov/materials/how-to-change-a-diaper/12_DiaperCCsm_E12L.pdf

http://here.doh.wa.gov/materials/how-to-change-a-diaper/12_DiaperCCsm_E12L.pdf


Infection Control

• Inclusion/Exclusion• Written policy shared with

parents-Plan B• Help from health professional-

– Child Care Health Consultant– Health Services Advisory

Member (Weaving Connections)– Specific child’s Health Care

Provider (call, really)


Immunizations• Timing critical for Infants and

Toddlers• Trusted Advisor• Parent Friendly resources• Staff Immunizations a must• Parent Immunizations• http://www.cdph.ca.gov/

programs/immunize/Pages/Schools-and-Childcare-Centers.aspx


Immunizations

Resources• CA DOH:

http://www.cdph.ca.gov/programs/immunize/Pages/Schools-and-Childcare-Centers.aspx

• AAP: https://www2.aap.org/immunization/index.html

Measles Simulation:http://fred.publichealth.pitt.edu/measles/results.php


Developmental Screening

Critical Elements-• Evidenced based tool• Easy to understand

and use• Practice

communicating results• Know how to refer• Always share results

with health care provider


Developmental Screening

• EHS tip sheet No. 6• Learn the Signs, Act Early

– Home page- http://www.cdc.gov/ncbddd/actearly/index.html

– Free online training for Early Education and Child Care Providers- http://www.cdc.gov/ncbddd/watchmetraining/index.html


Safe Sleep

• More than SIDS, think SUIDS—Sudden Unexplained Infant Deaths

• Positioning AND Environment-cribs, blankets, temperature, cords, bumpers

• Resources and Free online training-

http://www.healthychildcare.org/sids.html





Safe Sleephttp://www.healthychildcare.org/sids.html

• A Parents' Guide to Safe Sleep ( Also available in Spanish)This brochure includes information for parents about infant sleep positioning and practices as well as describes how parents can work with child care providers to ensure that safe sleep practices are used in all child care settings as well as at home. (Updated April 2012)

• A Child Care Provider's Guide to Safe Sleep (Also available in Spanish)This easy-to-read brochure provides child care providers with information about ways to promote safe sleep practices and reduce the risk of SIDS. (Updated April 2012)

• Tummy Time This brochure provides information about the importance of supervised tummy time and how it promotes healthy development. (Revised 2011)

http://www.healthychildcare.org/PDF/SIDSparentsafesleep.pdf



http://www.healthychildcare.org/PDF/SIDSchildcaresafesleep.pdf

http://www.healthychildcare.org/pdf/SIDStummytime.pdf


Safe Sleep

•More information about the new play yard standards. Links to keeping babies safe in their sleeping environments is at the Crib Information Center on CPSC’s website.

Safe Sleep Practices and SIDS/Suffocation Risk Reduction

This spinoff includes safe sleep practice standards from Caring for Our Children, 3rd Edition.

Online learning module:

www.healthychildcare.org/sids

http://www.cpsc.gov/Safety-Education/Safety-Education-Centers/cribs/

http://nrckids.org/SPINOFF/SAFESLEEP/SafeSleep.pdf

http://nrckids.org/SPINOFF/SAFESLEEP/SafeSleep.pdf

http://www.healthychildcare.org/sids


Feeding Solids

• “Cue feed”, just like feeding bottles

• New recommendations:– Promote iron-rich foods

early on– Introduce allergy-prone

foods before 12 months


Nutrition/Physical Activity

Remember NCH website: • http://

eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/nutrition/nutrition.html

• http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/healthy-active-living/healthy-active-living.html

http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/nutrition/nutrition.html



http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/healthy-active-living/healthy-active-living.html





Little Voices for Healthy Choices

https://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/healthy-active-living/little-voices


Nutrition/Physical ActivityContainers Resources to keep infants and toddlers moving:• Motion Moments-http

://nrckids.org/index.cfm/products/videos/motion-moments1/

• Bright Futures-http://www.brightfutures.org/physicalactivity/pdf/Infancy.pdf

http://nrckids.org/index.cfm/products/videos/motion-moments1/






Others


Resources

• Caring For Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education, 3rd Edition

• http://cfoc.nrckids.org• Available in print or online

http://cfoc.nrckids.org/


ResourcesCFOC Spinoffs:• Caring for Infants and Toddlers in Early Care

and Education• Stepping Stones*• Preventing Childhood Obesity in ECE

Programs*• Safe Sleep Practices and SIDS/Suffocation

Risk Reduction• Oral Health in Child Care and Early Education• Environmental Health in ECE• Coming Soon: Caring for Children with

Special Health Care Needs in ECE


Resources

• Healthy Child Care America

– www.healthychildcare.org– AAP– Information, resources,

trainings– Sign up for newsletter

http://www.healthychildcare.org/


Resources

National Resource Center for Health and Safety in Child Care and Early Education• www.nrckids.org• Houses CFOC and Spin Offs• Search state child care regulations• Child Care Health and Policy

information• Sign up for E-Resources Newsletters

http://www.nrckids.org/


ResourcesAAP books• Managing Infectious

Diseases in Child Care and Schools, 3rd Edition

• Easy to use guide with specific diseases and conditions

• Easy to copy information about inclusion and exclusion


ResourcesAAP Books• Managing Chronic Health

Conditions in Child Care and Schools

• Easy to use format, specific conditions addressed, easy to reproduce forms and handouts


Resources

AAP Books• Model Child Care Health Policies, 5th

edition• Also available online at http://

www.ecels-healthychildcarepa.org/publications/manuals-pamphlets-policies/item/248-model-child-care-health-policies

http://www.ecels-healthychildcarepa.org/publications/manuals-pamphlets-policies/item/248-model-child-care-health-policies






Resources

AAP Books• PedFACTs-Pediatric First Aid

for Caregivers and Teachers, 2nd edition

• Manual and a training program

• www.pedfactsonline.com


Resources

Health Consultation Websites• California Child Care Health:

http://www.ucsfchildcarehealth.org/• Disinfecting/Sanitizing Worksheets• Integrated Pest Management Toolkit• Health and Safety Checklist

http://www.ucsfchildcarehealth.org/

http://www.ucsfchildcarehealth.org/


ResourcesHealth Consultation Websites• Early Childhood Education Linkage System

– http://www.ecels-healthychildcarepa.org/ – Professional Development, Training, Tools

• Public Health Seattle King County Child Care Health Program– http://

www.kingcounty.gov/healthservices/health/child/childcare.aspx

– Trainings, Tools, Model Policy recently updated

http://www.ecels-healthychildcarepa.org/

http://www.kingcounty.gov/healthservices/health/child/childcare.aspx





Measure Your Quality

• Head Start Health and Safety Checklist• Stepping Stones to Caring for Our Children,

3rd Edition Compliance/Comparison Checklisthttp://nrckids.org/index.cfm/products/stepping-stones-to-caring-for-our-children-3rd-edition-ss3/

• CCCH Health and Safety Checklisthttp://www.ucsfchildcarehealth.org/pdfs/Checklists/HS_Checklist.pdf

http://nrckids.org/index.cfm/products/stepping-stones-to-caring-for-our-children-3rd-edition-ss3/



http://www.ucsfchildcarehealth.org/pdfs/Checklists/HS_Checklist.pdf




National Center on Health Contact Information

Toll-free: 888-227-5125E-mail: [email protected]: http://eclkc.ohs.acf.hhs.gov/hslc/tta-

system/health/center

Infant and Toddler Care: Improving Quality Through Health and Safety Practices Danette Swanson...

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