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<Service name> Immunisation and Health Related Exclusion Policy When groups of children play and learn together, illness and disease can spread between children even when the service has implemented recommended hygiene and infection control practices. Services require a policy on immunisation because it is an important strategy in infection control. The policy should include the service’s guidelines for excluding children and adults with an infectious illness or disease. Services should regularly review policies in collaboration with educators, families, and if appropriate, children; and seek recommendations from recognised authorities. The date the policy is reviewed should be clearly documented on the policy. Policy Number <number> Link to CCQA Principles Family Day Care Quality Assurance (FDCQA) Quality Practices Guide (2004) – Principle 6.4 / Outside School Hours Care Quality Assurance (OSHCQA) Quality Practices Guide (2003) – Principle 6.3 / Quality Improvement and Accreditation System (QIAS) Quality Practices Guide (2005) – Principles 5.5, 6.6, 7.2 Policy statement <Service name> has a duty of care to ensure that all persons1 are provided with a high level of protection during the hours of the service’s operation. Protection can include: o notifying children, families and educators when an excludable illness or disease is present in the service; o maintaining a record of children’s and educators’ immunisation status; o complying to relevant health department2 exclusion guidelines; and o increasing educators’ awareness of cross infection through physical contact with others. The purpose of this policy is to manage and prevent the spread of infectious illnesses and diseases. The policy assists the service to: o notify families or emergency contact3 when a symptom of an excludable infectious illness or disease has been observed; o notify stakeholders when an excludable infectious illness or disease has been confirmed by a medical practitioner; o identify and comply with exclusion guidelines and timeframes; o identify when a child with an illness or disease is no longer excludable or infectious; and o maintain immunisation records of children and educators. Families, educators, students, volunteers and visitors can also display symptoms of an infectious illness or disease while in the service’s environment and as such, the service has an equal duty of care to all persons. The Immunisation and Health Related Exclusion Policy is applicable to children and adults. For the purpose of this policy, 'persons' include <children, families, educators, carers' family, management, coordination unit staff, ancillary staff (administrative staff, kitchen staff, cleaners, maintenance personnel), students, volunteers, visitors, local community, school community, licensee, sponsor and/or service owner>. 2 For the purpose of this policy, ‘health department’ is the state/territory health department relevant to the service’s location. 3 For the purpose of this policy, ‘emergency contact’ is the individual nominated on a child’s enrolment form or the person, educator, student or volunteer to be contacted in case of an emergency. 1 Current as at September 2010 Page 1 of 6 The service prevents the spread of illness and disease by implementing the following strategies which: o promote handwashing and other hygienic practices; o identify and exclude children and educators with symptoms of an excludable infectious illness or disease; o maintain clean and hygienic environments; and o encourage child and adult immunisation. Some of these strategies are detailed in the Hygiene and Infection Control Policy. Services can link this section by stating: Please refer to the service’s Hygiene and Infection Control Policy. It is understood by educators, children and families that there is a shared responsibility between the service and other stakeholders that the Immunisation and Health Related Exclusion Policy and procedures are accepted as a high priority. In meeting the service’s duty of care, it is a requirement under the Occupational Health & Safety Act4 that management and educators implement and endorse the service’s Immunisation and Health Related Exclusion Policy and procedures. Rationale The rationale represents a statement of reasons that detail why the policy and/or procedures have been developed and are important to the service. Please refer to: Department of Health and Ageing. (2007). Immunise Australia program. Retrieved 2 June, 2010, from http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/home National Health and Medical Research Council. (2005). Staying healthy in child care: Preventing infectious disease in child care (4th ed.). Canberra: Author. Strategies and practices These are examples. Services are encouraged to develop and adapt the following strategies and practices as required to meet their individual circumstances and daily best practices. Hygiene and infection control Services can state the importance of maintaining hygienic practices and procedures in all health and safety policies. For example, washing hands, concepts of Standard Precautions and the procedures for maintaining clean and hygienic environments. Immunisation If families are receiving Child Care Benefit (CCB), then it is a requirement that they inform services of their children’s immunisation status on enrolment. Children The service should have a record of each child’s current immunisation status. The service can describe how children’s immunisation records are maintained and monitored. Children who are not immunised The service should have a record of those children who are not immunised. There are legislative Acts and regulations for each state and territory that address the issue of occupational health and safety. Services are advised to seek information that is relevant to their jurisdiction. 4 Current as at September 2010 Page 2 of 6 For those families who decide not to immunise their children, there may be state or territory regulations that require the child to be excluded from the service until the disease outbreak is under control. This exclusion may occur even if the child is well. Services are encouraged to contact their health department for more information. Educators Educators are encouraged to maintain their immunisation status against immunisable diseases. The service should have a record of educators’ current immunisation status. The service can describe how educators immunisation records are maintained and monitored. Services should consider the following reflective questions: o How can the service support educators’ immunisation updates? For example, does the service finance staff/carer immunisation? o How does the service provide information to educators about immunisations against infectious diseases? Identifying symptoms of an excludable infectious illness or disease Services should ensure that educators are aware of symptoms which may indicate an excludable infectious illness or disease. The service can link this section by stating: Please refer to the service’s Illness Policy. Exclusion guidelines The service’s health related exclusion guidelines for infectious illnesses and diseases apply to both children and adults. Excluding children, educators, students or volunteers who have been diagnosed with an infectious illness or disease minimises cross infection. It is crucial that families are aware of the service’s exclusion guidelines at the time of enrolment and orientation. Services must state how they communicate with families during the exclusion period by offering clear and reliable information as to when a child can return to the service. Services should consider the following reflective questions: o How does the service determine the timeframe of exclusion? o Does the child require clearance from a medical practitioner before returning to care? Exclusion guidelines for immunisable diseases This section relates to those infectious diseases that are immunisable. The service can list the infectious diseases that can be immunised against, as detailed by their health department. For example, measles, mumps, chicken pox. All other illnesses and diseases, and possible exclusion guidelines, are addressed in the Exclusion guidelines for infectious illnesses or diseases section of this policy. The service can refer to their health department’s exclusion guidelines and attach a copy to the policy. Exclusion guidelines for infectious illnesses and diseases The exclusion guidelines outlined in this section do not include the exclusion timeframes for those infectious diseases that can be immunised against. The service can describe the need for exclusion by referring to their health department’s exclusion guidelines and attach a copy to the policy. Exclusion procedures The service’s health related exclusion procedures for infectious illnesses and diseases apply to both children and adults. Services should consider the following reflective questions: o How is an infectious illness or disease identified, observed and documented by educators? Current as at September 2010 Page 3 of 6 o o o o o o When and how does the service contact the child’s family? How are children who are displaying symptoms of an infectious illness or disease, cared for before being collected by their families? Are they separated from the main group of children? How are observations documented? For example, child’s temperature, colour, size and texture of rash. How will the family day care service manage the outbreak of an infectious illness or disease in a carer’s home? For example, if a carer’s family member contracts measles and is recuperating at home. How will the outside school hours care service respond to an outbreak of an infectious illness or disease in the school which it is located? How will the outside school hours care service response to an infectious illness or disease while on an overnight camp? Notifying families or emergency contacts Services should consider the following reflective questions: o What is the procedure for notifying families and emergency contacts when an individual displays symptoms of an excludable infectious illness or disease? o How do educators determine when a child needs to be excluded from the service? o How is an excludable infectious illness or disease confirmed? o What is the service’s action plan when families, guardians and emergency contacts cannot be notified? o Are families made aware of the action plans at enrolment and orientation? o How does the service ensure that up to date contact details for families and emergency contacts are maintained and documented? Communication with different stakeholders Children It is important for the service to discuss how it will meet the individual needs of children. Services can link this section by stating: Please refer to the service’s Supporting Children’s Individual Needs Policy. Families It is important for the service to discuss how it will meet the individual needs of families. Services should consider the following reflective questions: o How does the service inform families about the service’s exclusion guidelines? o How are families informed when an infectious illness or disease has been confirmed in the service? o Does the service have information on infectious illnesses and diseases and can families access them? o How are families informed about health initiatives in the community or state/territory? For example, notifying families about children’s health nurse visits. o Does the service have factsheets for infectious illnesses or diseases such as measles and chicken pox, to distribute to families? o How are families informed about immunisation updates or requirements? Educators Services can state how educators support one another when a child is unwell. For example, one person may be nominated to be the primary carer until the child is collected. This strategy can often minimise the number of people caring for an unwell child and reduce the risk of cross infection. Services should consider the following reflective questions: o How do services support educators to minimise the risk of cross infection? Current as at September 2010 Page 4 of 6 o o o o o o o o o o How are educators supported when they have an excludable infectious illness or disease? How do educators support one another during an outbreak of an excludable infectious illness or disease? If there is only one person able to care for all children, such as in a family day care home, how can the person access support and guidance from colleagues or management? How does the service provide information to educators about excludable infectious illnesses and diseases? How does the service promote the awareness of excludable infectious illnesses and diseases? For example, the service may arrange for health care professionals to visit the service to discuss about safe effective hygiene practices or display written and visual information for children, families and educators. What are the management strategies when an excludable infectious illness or disease is confirmed? What is the contingency plan when a large number of regular educators are excluded from employment due to an infectious illness or disease? How does the service communicate to their health department when there is an infectious illness or disease? Are there other external agencies that need to be informed? How does the service plan for relief staff when an infectious illness or disease excludes educators from employment? How are relief staff utilised when educators are excluded due to an infectious illness or disease? Privacy and confidentiality The right for children, families and educators to be afforded a level of privacy and confidentiality in regards to their immunisation status is paramount. Educators, students and volunteers should be aware of the service’s commitment to maintaining and respecting privacy and confidentiality. Services can link this section by stating: Please refer to the service’s Privacy and Confidentiality Policy. Links to other policies The following are a list of examples: Child protection Employment of educators First aid Hygiene and infection control Illness Medication Occupational health and safety Privacy and confidentiality Supporting children’s individual needs Sources Childcare and Children’s Health. (2005). Infection control and some common infections in young children. Childcare and Children’s Health, 8 (3), 1-4. Department of Health and Ageing. (2007). Immunise Australia program. Retrieved 2 June, 2010, from http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/home NSW Multicultural Health Communication Service – www.mhcs.health.nsw.gov.au Current as at September 2010 Page 5 of 6 Further reading Matthews, C. (2004). Healthy children: A guide for child care (2nd ed.). NSW: Elsevier. National Health and Medical Research Council. (2005). Staying healthy in child care: Preventing infectious disease in child care (4th ed.). Canberra: Author. Oberklaid, F. (2004). Health in early childhood settings. NSW: Pademelon Press. Useful websites Centre for Community Child Health – www.rch.org.au/ccch/index.cfm?doc_id=427 Immunise Australia Program – www.immunise.health.gov.au National Health and Medical Research Council – www.nhmrc.gov.au Useful NCAC resources FDCQA Factsheet #23 – Managing illness in child care. QIAS Factsheet #17 – Supporting children hygiene skills. QIAS Factsheet #18 – Managing illness in child care. Policy created date <date> Policy review date <date> Signatures <signatures> Current as at September 2010 Page 6 of 6