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CHCCN511A: Establish, manage and monitor the implementation of a safe and healthy environment

Promote appropriate practices to respond to illnesses

Contents

Regularly and clearly communicate infection control and medication guidelines to others 4

Reviewing infection control procedures 4

Communicating infection control guidelines 5

Reviewing medication procedures 6

Suggest specific practices to address situations as they arise 10

Signs of illness 10

Inform parents of infections 12

Communicating about the unwell child 12

Advising parents of illness in the centre 13

Develop procedures for responding to sick children 15

Unwell child policy 15

Report notifiable diseases/infections to the appropriate government organisation according to guidelines 18

Procedures for reporting notifiable disease 18

Explain and monitor policies for medication administration, storage and documentation 23

Explaining medication policies to staff 23

Monitor and reinforce the safe storage of hazardous materials with workers 25

Household cleaners 25

Safe storage of dangerous substances 25

Storing hazardous materials 27

Promoting the safe use and storage of hazardous materials 27

Demonstrate and effectively communicate guidelines for safe food handling and storage 29

Modelling and reinforcing safe food-handling practices 30

2 Diploma of Children’s Services: CHCCN511A: Reader LO 9299 © NSW DET 2010

Promote and demonstrate practices for managing children’s hygiene needs 32

Promoting children’s hygiene practices 32

Promoting staff’s personal hygiene 33

Strategies for developing hygiene and reducing spread of infection34

Diploma of Children’s Services: CHCCN511A: Reader LO 9299 3© NSW DET 2010

Regularly and clearly communicate infection control and medication guidelines to others

Just as children are at a higher risk of contracting an illness in the childcare environment, so too are staff. The costs of illness are high to both families and staff.

The childcare service faces the cost of replacing sick staff with casual staff and of course there are other costs less measurable in financial terms—costs such as disruption to the routine and extra stress placed on other staff in the team.

Families face the costs of possibly losing a day’s pay, paying for child care that they don’t use and associated medical costs of doctor’s bills and filling prescriptions for medication to treat their sick child.

Our aim should be to reduce the spread of infection in our services and reduce the negative impact disease and illness has on everyone in our service. As team leader, we have an important role to play in ensuring that everyone is familiar with infection control procedures and that they consistently follow these as they carry out their daily duties.

Reviewing infection control proceduresIt will be useful before we look at how to communicate infection control guidelines to our team to review what infection control entails.

Procedures to limit the spread of infection in the service include:

• effective hand washing• effective cleaning of toys and equipment• wearing disposable gloves when cleaning up body fluids or when cleaning

(remember that some people are allergic to latex, so use gloves that are made of other materials)

• appropriate disposal and handling of contaminated or infected waste products

• disinfecting infected objects, items or areas where it is appropriate• putting in place an exclusion policy as well as an immunisation policy.


Making sure information is up to dateIt is essential that we base our infection control procedures on up-to-date information. Ideas and knowledge about health changes regularly so knowing where to access current information is important.

The National Health and Medical Research Council (NHMRC) is a useful source of current information about the control of disease. You can download fact sheets on infectious diseases that would be useful for educating staff and families when disease presents itself in the childcare centre.

The NHMRC also publishes the Staying Healthy in Child Care (4th ed, 1966) which is downloadable from the following site: http://www.nhmrc.gov.au/publications/synopses/ch43syn.htm

This publication is another invaluable source of information about infection control and common childhood illnesses.

How then do we ensure all our staff understand these procedures and consistently implement them in the childcare service?

Communicating infection control guidelinesAn active hands-on approach to communicating infection control procedures is essential. We cannot rely on staff reading and absorbing written procedures from our policy and procedures handbook.

The strategies listed below will be useful.

Model best practiceJust as children learn appropriate practices from their role models, our staff will be encouraged to implement appropriate infection control procedures if we consistently model best practice for them. Role modelling is a powerful way of communicating what should be done and how it should be done.

Discuss as a team We can organise special team meetings to explain, discuss and promote ideas and procedures relating to infection control. This will be especially useful when information has changed that we need to update with all staff, or where we feel staff need to improve their practice.


http://www.nhmrc.gov.au/publications/synopses/ch43syn.htm

Collect resourcesBegin to collect and share current information and thinking about health. Cut relevant articles out of papers and copy articles in journals for staff to discuss.

Provide staff with feedback on performanceProvide staff with regular feedback on their performance. Remember to acknowledge those staff doing a wonderful job of infection control as well as sensitively reminding staff who need to develop their skills.

Develop proceduresDevelop clear procedure sheets or notices and place them near where tasks are carried out, eg in nappy-changing steps near the nappy-changing bench and steps in effective hand washing near the hand basins. There are posters you can download from the NHMRC website or you can create your own.

Involve staff in research and mentoringGet your staff involved in writing and researching newsletter articles about procedures within the service aimed at minimising or eliminating infections. Someone with a keen interest in health and safety may be happy to take on this task or you can rotate the responsibility around the team.

Ask your staff if they would be prepared to present short in-service sessions to each other promoting an aspect of best practice in relation to hygiene practices. This would be particularly useful when new staff come into your service. You could set up a mentor system where the more experienced staff present information on service procedure to the newer recruits.

Reviewing medication proceduresThere will be many times when a child in your service will require the administration of a prescribed medication as part of their care plan.

Staff must be clear about how to do this safely.

All childcare service medication policies should include the following guidelines that must be adhered to at all times.


Parents’ consentParental consent must be obtained before medication can be administered to a child. This is usually obtained on a medication authorisation form that must include the following details: the child’s name, the date, the name of the medication and dosage required, the time that the dosage is required, the prescribing doctor’s name and any allergies the child may have.

Note: Paracetamol should not be given as it masks the signs of the child’s unwellness.

Storing medicationAll medications must be stored out of reach of children in a locked, childproof cupboard in an area which children do not access.

Administering medicationBefore any medication is administered staff must:

• wash their hands• check the medication authority form for the current date and the parent’s

signature• check the medication bottle to ensure it is in its original bottle and read

the label carefully, check the expiry date, the child’s name, the dose amount and frequency of dose, method of administration and storage instructions

• make sure the medication has not been administered already (it will have been signed for on the medication authorisation form if it has)

• collect any equipment you might need and then find the child requiring the medication; explain what is going to happen to the child

• measure the dose accurately with a medication measuring device only• check the dose with another staff member.

Once they are confident these steps have been followed and it is safe to do so:

• administer the dose ensuring the child takes the whole dose• sign the medication authority form after the whole dose has been given• have another staff member counter-sign the form• return medication to its appropriate storage place• observe the child for any negative side effects and report these to the

child’s family.

Each childcare service needs to have a medicines policy. This policy will include their guidelines on in-service training on medicine use and safety for staff. It will also include the centre’s position on whether homeopathic (or herbal)


medications will be administered by staff. If the service does support the administration of homeopathic medications they will require a letter from a qualified practitioner stating what the medication is for. Also the container must have the same information required of any medication. Homeopathic medications must be treated with the same caution as any other medication.

Note: a parent may come into the service to administer any medication to their child if the staff can’t legally do so.

Communicate procedures to staff and familiesHaving reviewed these procedures, how is it best to communicate them to staff and families?

As with all aspects of health and safety, it is best to promote the desired practice in the following ways:

• Role model appropriate behaviours.• Discuss and explain procedures at team and parent meetings.• Post visual reminders about procedures in relevant areas, eg signs on

locked medication cupboards and above where the sign-on sheets are kept.

• Include copies of the policy in the centre newsletter when it is peak sickness time. Winter is usually a timely occasion for reminders about medications when all those winter colds and flu viruses make their way around the service.

Activity 1

A number of staff have expressed to you their confusion about when to use chemical disinfectants in the service and another staff member was overheard having difficulty explaining to a family member why they needed to provide a letter from their doctor to support the administration of an over-the-counter cough suppressant medication.

How will you clarify service policy and procedure with your staff? What methods of communication will be most effective?

Feedback

Did you identify strategies such as these?

• Hold a cleaning procedures workshop for all staff. You or perhaps another experienced member of your staff might do this.

• Invite a guest speaker like your local infection control nurse from the public health unit in your area to discuss current practice.


• Encourage staff to research what is current cleaning best practice. Also, as a team, review your service policies and procedures to ensure they are up to date.

• Verbally explain the medication policy to staff and encourage the unsure staff member to write an article for the centre newsletter explaining the policy.

• Organise a staff–parent meeting to review and discuss the medication policy and procedures.

The safe administration of medications and a strong commitment to a working environment where infection control is valued are vital to a quality program.

You can achieve this with consistent role modelling, effective leadership and communication skills and a commitment to best practice for health and safety in your workplace.


Suggest specific practices to address situations as they arise

Even the most carefully developed policies and procedures will not be able to tell us what to do for each and every child who presents as unwell.

There are many diseases and many symptoms and we are not trained to be qualified in medical diagnosis.

More important than being able to guess what illness a child may be suffering is to consistently implement safe and hygienic practices to minimise the risk of further infection in the service. Each situation involving an unwell child will be managed appropriately as it occurs if you remember to implement good infection control practices.

Signs of illnessOf course the best place to begin when faced with a child who we think may be unwell is to look carefully at how they present to us. What we are looking for are signs and symptoms that may indicate illness.

The following are common symptoms of illness:

• vomiting• feverish appearance• a higher than normal temperature• loss of appetite• diarrhoea and/or a change in the consistency of faeces• headaches• stomach aches• sore throats• difficulty swallowing• difficulty breathing• constant or severe coughing• changes in normal skin tones• eyes that are bloodshot or discharging pus• regular discharge of mucous from the nose• darker than normal urine


• constant itchiness of the head or skin• any change to a child’s usual behaviour, eg a child who is normally active

and involved with other children might show a reluctance to play and may not tolerate having other children nearby.

If you are able to recognise these symptoms you will be able to respond to them appropriately and quickly. Your response will need to meet their physical and emotional needs while limiting the spread of infection to others in the service.

Activity 2

Read through the following scenario. You may find it useful to refer to the NHMRC Staying Healthy in Child Care.

Kyle, two years, comes over to you with a book and asks you to read to him. He climbs up on your lap and you begin to read. You notice that he repeatedly scratches at his face and it looks like he has a rash. When you look closer you see it is a rash of pink, isolated spots. It is also on his neck and the upper parts of his body. He appears warm to the touch.

What do you think might be wrong with Kyle? How would you manage the situation?

Feedback

Did you think that Kyle might have an infectious disease, eg measles? You would need to separate Kyle from the other children. You would notify his parents, describing what you have observed (ie, the rash and being warm to the touch) and suggesting the need for Kyle to see a doctor. If a diagnosis of measles is confirmed, exclusion periods apply. Kyle must be excluded from care for a minimum of five to seven days after the onset of the rash. That is just the minimum period for exclusion—he may need to stay away from care even longer, depending on when he is fully recovered.


Inform parents of infections

Communicating about the unwell childParents have the right to know when their child may be showing signs of potential illness or an infectious disease and also need to know when their child may have been in contact with another child in the service who has developed an infectious disease.

How is this best communicated?Probably the most effective technique is a combination of a personal one-on-one verbal exchange of information with a factual letter or pamphlet to families in the service.

Any written communication needs to be sensitively and professionally stated.

Parents will want to know that if their child develops an infection in the service:

• the staff can competently provide care for their child• the service will openly exchange information with families• they will not be blamed for poor hygiene habits within the home.

What will parents want to know about their sick child?Parents may find it useful to have some written information on what you have noticed and how you have managed the child’s condition.

Each childcare service will pass on this information in a different way. Some services may record signs of illness on a report form.

The report form will include the following information:

• the symptoms observed (including the time of the observation)• whether there had been a similar illness in the centre previously• what the child’s temperature was (including the time temperature was

taken)• what actions have been taken to lower the child’s temperature • what the child has eaten and drunk


• whether the child has passed urine and at what time• when the parent was contacted.

This report form can be given to the parent to take to their doctor.

Once an illness has been diagnosed, parents will want to know when their child can return to the centre. You will use your exclusion policy to guide your decision here.

The exclusion period is the minimum period of time for the child to be away from the service. The recommended exclusion periods are based on the time that a person with a specific illness or condition might be infectious to others.

Advising parents of illness in the centreYou will also need to advise parents about cases of illness in the service so they can be alert to signs of illness in their child.

Again a written pamphlet, flyer or fact sheet that parents can take home with them to refer to is a useful method of sharing this information. What would be really effective but easy to do would be a big sign posted at the front door of the centre.

You would need to advise parents of the following:

• what the condition is• how it is passed to a person• what symptoms we need to be alert to• what treatment is necessary• what measures can be taken to limit the spread of the disease within the

family• what the exclusion periods are.

Information must be factual and calmly and professionally stated.

Activity 3

One of the staff members in your team has just been to the doctor and has had a diagnosis of chicken pox confirmed. If you can, refer to a children’s health textbook (eg Staying Healthy in Child Care) or http://www.health.nsw.gov.au

Who would you need to inform? What information would you need to share and how will you pass on this information?

Feedback

Hopefully you noted the need to inform all families in the service as well as the rest of the work team about the case of chicken pox.


http://www.health.nsw.gov.au/

Pregnant women, especially in their first trimester, should be advised to avoid contact with chicken pox. If either a pregnant staff member or pregnant family member has had contact with this worker, they should be advised to see their doctor.

General information to provide to families would include:

• what the disease is

• the incubation and infectious period

• how to control the spread of infection

• the suggested treatment.

You probably suggested you would produce a fact sheet or flyer for families to take home. You might also write up a message on a blackboard or whiteboard at the entry to the service.


Develop procedures for responding to sick children

Most childcare services will have already developed clear policies and procedures to guide the response of staff when a child is unwell. However, as new centres open or undergo staffing changes, there will be opportunities for you to be involved in developing policies and procedures.

When developing any policy it is important that all stakeholders are involved in a collaborative and consultative approach. This is particularly so when discussing care of the sick child.

Working closely with families, staff and medical professionals will ensure that the procedure developed will focus on what is best for all children and staff. If people feel a policy is reflective of their needs and interest, the more likely they are to understand and comply with the policy and procedures.

Unwell child policy The unwell child policy will need to balance carefully the goals of effective infection control procedures, supporting the physical and emotional needs of the child and supporting families in the workplace.

Basically, the policy needs to clearly state what to do when a child appears to be unwell or sick.

Actions to be taken:

• Separate the uwell child from other children in the room to reduce the risk of cross-infection. Ensure the sick child can be closely supervised.

• Provide the unwell child with one-to-one support. Reassure the child.• Take the child’s temperature and try to reduce it if it is above the normal

36 to 37 degrees Celsius. Note: Having a temperature is the body’s way of destroying viruses and bacteria. If the temperature is rising seek medical attention.


Policy for communicating with families or emergency contacts The policy and procedure will need to clearly identify:

• who is responsible for communicating with families and emergency contacts

• when the phone call will be made (ie, as soon as you notice symptoms, etc)

• when and why parents should be asked to collect their child.

Why should parents collect the child?Usually this will be because the service is unable to safely meet the individual needs of the child without jeopardising the health and safety of other children in the service.

Collection of the child would also be necessary when symptoms such as diarrhoea and vomiting require the sick child to be separated from other children to reduce the likelihood of further spread of disease.

Some final points about developing policyOur policy must be realistic to be successful. It is no good developing a sick-child policy that will be impossible for our staff to carry out or that will increase their workloads and stress levels. For instance, our policy could not state that the service would provide care for any ill child no matter what, when your current staffing levels will be unable to provide the level of care each sick child would require.

Our policy must balance the needs of the sick child with the needs of the other children in our care. We cannot keep a sick child in the service indefinitely even if they are happy laying on a lounge with some books, if the other children are at an increased risk of contracting a disease or illness.

We must actively promote our policy and ‘talk the policy up’ whenever we can, in our service newsletter and at parent–staff meetings. Our goal should be to help families understand the reasons behind our decisions and actions.

Collaborating effectively with families and staff to develop a sick-child policy that is fair and then implementing this consistently will hopefully help to reduce some of the tension that can develop between staff and families when a child is unwell.

Activity 4


You have received a number of complaints from families that your service’s sick-child policy is outdated and unfair. You agree that the policy needs to be revamped.

How would you go about developing a sick-child policy that is fair and meets the needs of both families and sick children as well as staff?

Feedback

Did you remember the importance of a collaborative approach to ensure the success of the policy? Did you say that it is important to obtain as many families’ ideas as possible on how best to manage sick children? Of course staff would be involved and perhaps an objective, knowledgeable health professional would be a useful resource to your planning.


Report notifiable diseases/infections to the appropriate government organisation according to guidelines

You will be well aware by now of the importance of communicating information about the child who is unwell to families and other staff. Sometimes it will also be necessary to communicate this information to your local public health unit.

Procedures for reporting notifiable diseaseUnder the NSW Public Health Act 1991, you have a responsibility to the community to report outbreaks of particular diseases or viruses in NSW. The aim of this Act is to improve infectious disease control in NSW through improved disease notification procedures.

Collection of information about disease ensures that action can be taken to:

• identify the cause of the infection• implement the appropriate procedures required to treat the infection• educate members of the public and our service about the illness or

disease and specific practices or behaviours we should adopt to reduce the spread of the disease

• contain or minimise the impact of the disease on the public.

What do you need to know about notifiable diseases?In order to meet your legal obligations and duties you will need to know answers to the questions listed below.

What are the notifiable diseases or illnesses? Under the Public Health Act 1991, directors of childcare facilities need to report the following diseases:

• diphtheria


• measles• mumps• pertussis (whooping cough)• poliomyelitis• rubella (German measles) • tetanus.

What information are you required to report? The centre staff and director need to collaborate with families and medical staff on this question. Remember, we do not diagnose—we leave that to the doctor.

The information you need to report usually includes:

• the number of children infected with the disease • when the illness was first diagnosed.

What is the time frame for reporting the disease?Once a diagnosis of one of these diseases has been confirmed, it is essential that we contact the health authorities immediately (within 24 hours of diagnosis).

How do you make a notification?Remember that we do not make a diagnosis—the doctor or hospital does this.

In most organisations the director, manager or coordinator will collect and present the required information to the public health unit.

Are there any other diseases we need to report?There are other times when we will need to contact health authorities, ie if an outbreak (more than one case) of disease or illness occurs, eg in the instance of giardiasis or cryptosporidiosis.

Reporting infectious diseases presented by staffIt is important to remember that our responsibilities in this matter extend to reporting infectious diseases our staff may present with too. In this instance an additional requirement to report the illness or disease to WorkCover is required.

As a responsible, informed children’s service employee with management and supervisory responsibilities, it is important that you know how to access up-to-date information about diseases and illness. The NSW Health website is an extremely useful source of information: http://www.health.nsw.gov.au/publichealth/infectious/index.asp


http://www.health.nsw.gov.au/publichealth/infectious/index.asp

Activity 5

You will need to access information at the NSW Health website to complete the following activity. Go to http://www.health.nsw.gov.au/publichealth/infectious/index.asp

Follow the links in the list of infectious diseases table to access the fact sheet for pertussis (whooping cough). Look for answers to the following questions:

• What is pertussis? • What are the symptoms?• How is it spread?• Who is at risk?• How is it prevented?• How is it diagnosed?• How is it treated?• What is the public health response?

Summarise what you now know about pertussis.

Feedback

What did you find out?

• Did you say pertussis or whooping cough is a disease caused by an infection of the throat?

• It usually begins like a cold with a runny nose, tiredness and mild fever and then progresses to coughing bouts. Pertussis is spread to other people by droplets from coughing or sneezing. Anyone is at risk of getting pertussis.

• Immunisation greatly reduces the risk of infection. Keep babies away from people with coughing illnesses. Get immunised if you are an adult in close contact with small children. Watch out for symptoms if you are in close contact with someone with pertussis and get treatment early.

• Swabs from the back of the nose or blood test will confirm a diagnosis. Pertussis is treated with a course of a special antibiotic. Cases of pertussis must be reported to your local public health unit. Infectious children are restricted from going to preschool and school.

Activity 6

Read through the case study presented below and answer the question. You may find it useful to refer to a child health textbook to assist your response. Healthy


http://www.health.nsw.gov.au/publichealth/infectious/index.asp

Children: A Guide for Child Care by Coralie Mathews or Health in Early Childhood Settings by Frank Oberklaid have relevant information on diabetes that would be helpful.

Rani is a four-year-old girl in your service who has Type 1 diabetes. She requires insulin injections daily. She has attended your service for a few weeks now and you are feeling pleased with how the service is managing to meet Rani’s care needs.

You have spent a lot of time talking through Rani’s condition with Rani’s family and medical practitioner to develop a care plan that will meet Rani’s needs. Staff have been briefed about the importance of providing Rani with the correct diet at the correct time and noting if she seems unwell. Staff have been trained in the measurement of Rani’s blood sugar levels and assist with her insulin injections. Rani will eventually be able to do these by herself.

How will you ensure that infection control procedures and medication guidelines are being consistently practised by staff? What would you want to monitor?

Feedback

Did you identify that you would need to monitor hand washing, glove use, and safe medication administration procedures? Monitoring can be through the following ways:

• direct observation• visual reminders of procedures displayed in relevant places, eg near the

medication storage area and where the blood sugar level testing equipment is stored

• verbal discussions and reminders about safe practices with all staff, including casual staff. Staff training is also important.

Activity 7

Rani’s case study … continued

It has been a busy morning and the routine in Rani’s room is running behind. While a staff member is organising the progressive morning tea another worker alerts you to her concern about Rani. She is lying on the floor in the playroom and appears pale and sweaty. You are aware that these are signs that she may be hypoglycaemic, or have low blood sugar levels.


You know the concern with Rani is that she can quickly become unconscious and go into a hypoglycaemic coma. It is important that you respond quickly and appropriately to ensure Rani’s health and wellbeing.

Rani’s playmates are looking on with horror and your co-workers are looking to you for guidance.

What will you do? How will you respond to this emergency situation? How will you support the emotional needs of staff and children? What will need to be done once the medical emergency has passed?

Feedback

Rani will need her blood sugar levels raised immediately and this can be done by giving some fast-acting sugar such as a sweet drink of lemonade or some jelly beans. Her parents will need to be notified. Her blood sugar levels will need to be closely monitored and her condition closely observed to see if there is any improvement. Urgent medical assistance would be required if there was a worsening of Rani’s condition.

Staff need to take the children to an area where they can be comfortable. Staff would need to explain what is happening to Rani and why. Families would need to be advised that there had been an incident and what the children had been told so parents could follow up any questions or concerns with their child later on.

Staff would need to be debriefed after the incident and policy and procedures reviewed. It is essential that Rani eats regularly after her insulin injections so the routines need to be reviewed. The staff would need to identify why the morning tea late. Was this avoidable? If yes, then procedures need to be put in place to ensure that this wouldn’t happen again. Staff need to be commended for noticing Rani’s symptoms quickly.


Explain and monitor policies for medication administration, storage and documentation

Administering medication in the centre is an important aspect of childcare health practices that requires careful attention to detail.

Small children can easily be harmed by the failure to develop and follow proper procedures.

While some centres do refuse to give medications of any type and require parents to come to the centre to administer medications to their child, this practice does not seem very supportive of working parents.

Clear policies and procedures relating to the handling of medications will ensure that we can administer medication safely to children and support working families.

Explaining medication policies to staffIs it enough, though, to believe that if there are clear medication policies and procedures in place that they will always be followed? Not really.

Our job as team leaders will be to ensure that all staff know exactly how they should respond in different situations and why it’s important that they should act in a certain way.

How will we do this?

We can implement strategies such as the following:

• Discuss the medication policy with all staff—in team meetings, on a one-to-one basis and on their arrival at the service as part of induction.

• Display clear, concise instructions about safe storage of medications on the fridge or storage cupboard where medications are kept.

• Address sensitively any concerns or inconsistencies of practice as they arise with individual staff.

• Regularly check the medication book and immediately follow up any mistakes in documentation or inconsistencies.


• Talk to families about the service’s medication policy and the reasons for its existence. Send copies of the policy to the families—attaching them to the monthly newsletter is a good idea. Summarise key points in relation to prescribed and non-prescribed medications in the service newsletter.

• Organise a brief staff meeting at specific times during the year, eg at the beginning of winter when many children will be unwell, to remind staff of safe practices regarding the handling, administration, storage and documentation of medications in the service.

Of course, the strategies we will use will depend on our preferred communication style, the needs of our staff and families we are working with and the particular situation with which we are dealing.

Activity 1


Monitor and reinforce the safe storage of hazardous materials with workers

Which of the following do you think could be considered a hazardous material?

• disinfectant• scissors• knives• fly spray• soap• medicine• carpet cleaner.

If you thought all of them were, you are right! Anything in the childcare service that has the potential to cause accidents, injury or illness is a hazardous material and needs to be securely stored.

Household cleanersIt is important for us to be aware of what ingredients there are in the household cleaners that we use every day—as some of these are harmful to us and our environment. It would be an excellent idea to look for alternative recipes to make the same household products yourself. The use of safer ingredients is especially important for children (and adults) who have asthma as commercial cleaning products can contain irritants that can trigger an episode of asthma. There are many websites with recipes. Try this one to begin with:

http://www.metrokc.gov/health/asthma/facts/greencleaning.htm

Activity 2

Safe storage of dangerous substancesDangerous substances should be stored in a child-resistant container that is labelled with a description of its contents and directions for their use.


http://www.metrokc.gov/health/asthma/facts/greencleaning.htm

Dangerous substances that pose a hazard to children are all required to be stored securely in an area that is inaccessible to children. These include cleaning materials, disinfectants, poisonous and other dangerous substances, dangerous tools and equipment, toiletries, medications, first aid equipment and sharp or jagged objects.

Medications that need to be refrigerated should be kept in a child-resistant container in the fridge.

Is safe storage always enough to ensure staff and children’s safety? Not really! How will we know how to store a material or substance safely if we aren’t familiar with it? Take the example of chemicals. We really need to know a little about what we are using or storing to ensure our own safety and that of others in our workplace.

We can find information about the chemicals we might be using in the service in a resource called material safety data sheets (MSDS).

Material safety data sheetsThese fact sheets must be available to all staff under the Children’s Services Regulation 2004 and can be obtained by contacting the manufacturer of the chemical. Material safety data sheets contain information on:

• what chemicals are in the container• what the potential health effects are if the chemical is inhaled, ingested or

comes in contact with skin or eyes• where it should be stored and at what temperature• how the chemicals should be used• what precautions we need to take (eg wear gloves when using it, use in a

well-ventilated room, etc)• what first aid actions are recommended in case of accidents involving the

chemical• what the use-by date is.

This information needs to be recorded and stored in a place accessible to all staff. A hazardous materials register stored with the chemicals or where chemicals are prepared is ideal.

NOTE: By carrying out a ‘risk assessment’ on the use and needs for these chemicals, it is a good time to see if you actually need this product. It may be totally eliminated, or replaced by a safer/greener product.


Storing hazardous materialsThe storage of hazardous materials must be up high and away from where children can access the products. You will need to consider the age and skill level of the children in your care when choosing a storage location. You will need to ask yourself if the children will be able to reach the shelves or cupboard where the hazardous materials will be stored and if they will be able to access the storage area.

Some other strategies to reduce the risk of potential injury or illness caused by exposure to hazardous materials include:

• Install child-proof locks and trying to only purchase chemicals with child-proof caps.

• Regularly clean out storage cupboards and dispose of old or empty containers appropriately.

• Try to reduce the numbers of chemicals in the service. Warm soapy water is sufficient for most cleaning purposes in the childcare service (NSW Infection Control Policy 2001). ‘Green’ cleaners that are environmentally friendly can be used instead of chemicals. Did you know vinegar mixed with water can be used to clean most bathroom surfaces?

Promoting the safe use and storage of hazardous materialsOnce you have ensured the safe storage of hazardous materials in the service, you need to promote the safe use and storage of hazardous materials with all staff.

This is best done in an ongoing way, monitoring and reinforcing positive practices and discussing any inappropriate or incorrect use, storage or handling of chemicals or materials with the individuals concerned as soon as possible.

Strategies to use with staff• Spend adequate time discussing the safe storage of chemicals with the

group at induction or orientation.• Display clear notices and posters to reinforce the procedures and

practices near storage areas for hazardous materials.• Make sure there are adequate supplies of gloves, aprons and safety

glasses (personal protective equipment) for staff to wear when necessary.• Observe staff and recognise positive behaviours verbally to reinforce

appropriate practices.


• Sensitively remind staff when inappropriate practices are observed. Choose the time and place for these reminders carefully. Nobody wants to be corrected in front of co-workers or family members.

• Provide training opportunities for these staff either to attend outside of the service or you might even present some in-house training.

Remember:Never use soft drink bottles or other food or drink containers to store or dispense chemicals. This is an extremely dangerous practice as children and adults alike can unknowingly drink from these and be poisoned.

All chemicals are potential poisons. All of them can cause injury or death if someone is exposed to them in a dangerous way.


Demonstrate and effectively communicate guidelines for safe food handling and storage

Proper food-handling and storage techniques are critical if the children and staff in the childcare service are to be safe and healthy. A number of diseases can be easily transmitted while preparing food because of poor food-handling and storage practices.

It is essential that these are maintained in the childcare service:

• strict hygiene procedures• effective food storage • ongoing monitoring of staff workplace practices.

What are safe food-handling practices?

You may already know quite a bit about safe food-handling and storage practices. Can you identify at least 10 hazards in the picture below?

A dirty kitchen and unsafe food handling practices

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Whether you are preparing food at home for family and friends or preparing meals for children in the childcare setting you need to be aware of the following strategies to ensure you don’t spread disease and make others sick.

Remember:

• Wash your hands before handling raw food.• Prevent cross-contamination between raw and cooked foods by keeping

raw and cooked foods separate as well as using separate utensils for them.

• Keep food hot (over 60 degrees Celsius) or keep food cold (under 4 degrees Celsius).

• Discard food that has been partially used or heated once already.• Reheat meals thoroughly (above 60 degrees Celsius) and them let them

cool down.• Heat milk for infant bottles once only and then discard leftovers.• Pin back hair to lessen the likelihood of it falling into the food or using

fingers to push it out of the way.• Wear disposable gloves on hands if you have cuts or sores on your hands.• Ensure food-handling and nappy-changing duties are carried out by

different caregivers. As this is often difficult to enforce, we need to keep the two areas separate and reinforce and practise effective hand washing.

• Clean up any spills immediately with warm soapy water.• Ensure food is not stored on the floor.

All of these factors are probably familiar to you but are you as comfortable with knowing how to encourage these behaviours in the other members of your work team? The following discussion highlights some strategies you might find helpful.

Modelling and reinforcing safe food-handling practicesWhen you see unsafe or inappropriate work practices happening in the service it is important to realise that the worker may not know what they have done wrong. As coordinators, it is important that we model and consistently reinforce service guidelines in a clear fashion.

Our response must be sensitive and timely. It is much more effective (and safe!) to give feedback immediately than wait for a more appropriate moment that may never happen. However, correcting someone in front of other staff or a family member is not likely to make them feel very good about themselves or to change their workplace practices!

Some other ways we can help staff to know the right thing to do when preparing food include:


• recording and displaying procedures for bottle and food preparation near the areas where these tasks will be carried out

• organising regular reviews of the service policy and procedures in team meetings and using the opportunity to discuss issues that may have come up in the service

• offering immediate feedback and gentle, sensitive reminders when you notice inappropriate practices and remember it is just as important to provide feedback to staff when you notice staff modelling appropriate practices to other staff and children, eg ‘Quan, I heard you telling the children how important it was to wash their hands before they made the fruit kebabs today. You’ll be pleased to know I heard Elvie and Soumitra talking to their parents just a little while ago, telling them they wanted to help make dinner tonight but they all had to wash their hands first to stop the germs from getting into the food.’

• collecting professional journal articles and media clippings that focus on health and hygiene in children’s services and then developing a system for storing and displaying these as a trigger for staff discussion and ongoing professional development.

Essentially we need to use every opportunity we can to promote a culture of safety where all staff are committed to providing safe food-handing and storing practices.

Activity 3

Children learn so much from cooking experiences and learning how to safely prepare food can and should be part of this learning experience too.


Promote and demonstrate practices for managing children’s hygiene needs

Another important aspect of maintaining wellness in the childcare service and also in developing knowledge and skills that foster independence is promoting and modelling the importance of good personal hygiene with the children in our care.

You will be aware that children in full day care are exposed to more people and are at greater risk of illness and accidents because of their age and stages of development. (National Health and Medical Research Council, Staying Healthy in Child Care 2001)

Young children have a tendency to explore their world by ‘mouthing’ materials and equipment in their environment. While this is a normal stage of play it is also unfortunately a means of contracting and spreading illnesses.

Promoting children’s hygiene practicesYou have an important role to play, therefore, in promoting children’s hygiene practices from an early age to manage the spread of infection in the service. Remember children are great imitators so if we role model best practice then the children are more likely to copy our ‘healthy’ behaviours.

Below are some strategies:

• Encourage effective hand washing at regular times during the day, ie after going to the toilet, after having their nappy changed, before meal times, after blowing or touching their noses, after touching animals, after playing outside, when they first arrive at the service and before they go home.

• Encourage children to use toilet paper and flush the toilet after use.• Encourage children to use tissues to wipe their noses and then put their

used tissue in the rubbish bin immediately.• Encourage children to rinse their mouths well with water after meals.• Encourage children to cover their mouths when coughing, sneezing or

yawning (and then washing their hands of course!).


• Talk to children throughout the day about the importance of good personal hygiene. Make sure you use language that is clear and easily understood by them.

• Encourage children not to share food and to put any dropped food immediately into the bin.

All of these practices not only help children develop a sense of what good personal hygiene is but also helps to slow the spread of disease in the service.

Encourage children to wash their hands

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Promoting staff’s personal hygieneHow do we make sure that the staff in our work team do role model appropriate personal hygiene behaviours?

Just as we role model best practice for the children, we need to role model best practice for our co-workers too. We need to do this every day, not just when we might feel we need to make a point to another staff member about their inappropriate hygiene practices.

We can organise staff meetings to explain, discuss and promote ideas and procedures about aspects of personal hygiene.

We can collect and share current information and thinking about health. Start saving clippings you see in papers and magazines with relation to personal hygiene and use them to trigger discussions about what should and shouldn’t be done!

Foster that sense of shared responsibility for workplace safety by encouraging co-workers to give each other feedback on their hygiene practices. Remind staff to acknowledge the positive behaviours as well as giving gentle encouragement when they don’t practise good hygiene.

Create clear procedure sheets or notices and place them near to where tasks are carried out, ie put the steps for an effective nappy change near the nappy-changing bench and the steps to effective hand washing near the wash basins, etc.


Ask staff to develop a short newsletter article to share with families about procedures within the service aimed at minimising or eliminating infections.

You could also ask staff to put together and present a brief workshop session about an aspect of hygiene. They could then present this best practice workshop to each other at a team meeting focuses on professional development.

Ask staff to put together a resource folder on diseases and health care. This needs to be updated regularly.

Activity 4

Strategies for developing hygiene and reducing spread of infection

• Organise a workshop for all staff on current hygiene principles or ask some of the staff to research and present a hygiene workshop to each other.

• Focus on the accreditation principles your team needs to develop over a series of team meetings.

• Source and purchase resources that can be used to educate staff and children about effective personal hygiene. The Germ Busters Kit produced by Queensland Department of Health is a wonderful resource that would be useful here, also Eceen, the NSW Early Childhood Environmental Education Network, at www. eceen .org.au .

• Encourage staff to research and suggest strategies for how their work practices and work environment could improve. Re-training of staff may be required. You might discover that the reason why staff often aren’t wearing gloves is that there is no storage space in the nappy-change area for a supply of gloves.

• Encourage staff to share some fun programming ideas to develop the children’s self-help skill of hand washing. Staff might share some great stories or songs with each other that they can use with the children. Re-training of staff may be necessary.

• Ask a creative staff member to develop some attractive posters or signs on hand washing and glove use to be displayed in a prominent place. These will act as reminders to staff throughout the day.

• Spend time in each room observing staff and children. Give them positive feedback on the improvements you have noticed in their personal hygiene.

• Continue to monitor and review the hygiene practices of staff and children and the incidence of illness in the service over time to ensure that all staff continue to maintain a safe and healthy environment.


Remember that the hygiene practices of children and staff are vital to a quality programme. We can achieve this with consistent role modelling, effective leadership and communication skills and a commitment to best practice for health and safety in our workplace.

Activity 5

Strategies to promote safe workplace practices both in the short term and over a longer period could include:

• spending adequate time discussing the safe storage of chemicals with the work team.

• displaying clear notices and posters to reinforce the service procedures and practices near storage areas for hazardous materials.

• observing staff and verbally commenting on positive behaviours to reinforce appropriate practices.

• sensitively reminding staff when inappropriate practices are observed. Remember to choose the time and place for these reminders carefully. Nobody wants to be corrected in front of co-workers or family members.

• providing training opportunities on the storage of hazardous substances for all staff. This training could be accessed through a reputable training organisation or you might even present some in-house training.

• reviewing the action plan. Check that the new location is working, ie children are unable to access areas where chemicals are stored and that all staff are complying with procedures consistently.


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