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Chapter Ten: Infection Control in Child Care Health Policies for Infection Control Prevention Protection Promoting Good Health Health Policies should include Mechanisms of disease spread Immunizations Sanitation Environmental quality control Caregiver methods and practices for minimum risk and maximum health protection Mechanisms of Infectious Disease Spread Via germs and bacteria—organisms that cause diseases Specific child care practices that contribute (Table 10-1) Four Methods of Transmission Respiratory tract Fecal-oral Direct contact Blood Respiratory Tract Transmission Most common Tiny droplets from eyes, mouth, and nose are in air When child sneezes, coughs, drools, or talks Transmitted through air when another person breathes it in They can multiply and cause illness Handwashing is major deterrent to spread Fecal-Oral Transmission Germs from one person’s feces find their way into another person’s mouth, are swallowed and get into the digestive system Most common way is when hands are not washed after toileting, before eating or food preparation Water tables are another method Handwashing is major deterrent to spread Direct Contact Transmission Occurs when one person has contact with secretions from an infected person Secretions can be left on doorknobs, toys, and other objects Also occurs with parasites, such as lice infestation occurs with contact Good hygiene including handwashing and sanitizing are deterrents to spread Blood Contact Transmission Occurs when infected blood of one person enters bloodstream of another person Spread occurs when an infected person has a cut, scraped skin or bloody nose, and interacts with a person with open sores, chapped hands, etc. Can also occur when mucous membranes come into contact with infected blood Disposable gloves should be worn when treated in presence of blood Child-biting becomes a serious issue Five Fabulous Forestallers of Disease Transmission Keep immunization records up to date Use proper handwashing Use universal sanitation procedure for diapering Sanitize and disinfect bathrooms and food preparation areas Carry out daily health check Immunizations for Disease Prevention Keep with recommended immunization schedule for all children Make sure all present in childcare are immunized properly If a child has not followed the normal immunization schedule, make sure he or she gets all immunizations needed Review records periodically to assess that everyone is in compliance Universal Sanitary Practices Handwashing Outline procedure Diapering Outline procedure Toileting Outline procedure Cleaning, Sanitizing, and Disinfecting Define the difference What constitutes contamination? Environmental Quality Control Water table guidelines Outline procedure How often should they be cleaned? Play Dough guidelines Outline procedure Air quality guidelines What are guidelines? Contamination guidelines Outline procedure Implications for Caregivers Education Role modeling Handwashing especially important Cultural competence Immunization Provide resources for connection to source for immunization Supervision Prevent spread Require and monitor immunizations Report some illnesses Exclude some children Be prepared Reality Check: The Issue of Head Lice in Child Care Direct contact Historical connotation More children in care, happens more frequently No-Nits Policy Is it realistic? Is the expertise for it present everywhere it is used? Larger number of children who build up immunity to regular treatment Can be a frustrating experience if everything appears to have been done and problem persists Consider policy carefully Review as guideline for exclusion Develop a policy that everyone can live with