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Preparing for infectious disease outbreaks or pandemic influenza
Having a practiced emergency action plan in place will increase your success in managing a potential crisis or communicable disease outbreak within your program. The American Academy of Pediatrics provides the following preparedness recommendations.
Steps for improving preparedness:
Managing communicable disease and sick child exposures
Caring for Our Children: National Health and Safety Performance Standards, Standard 126.96.36.199: Prevention of Exposure to Blood and Body Fluids states:
Child care facilities should adopt the use of Standard Precautions developed for use in hospitals by The Centers for Disease Control and Prevention (CDC). Standard Precautions should be used to handle potential exposure to blood, including blood-containing body fluids and tissue discharges, and to handle other potentially infectious fluids.
In child care settings:
1. Use of disposable gloves is optional unless blood or blood containing body fluids may contact hands. Gloves are not required for feeding human milk, cleaning up of spills of human milk, or for diapering;
2. Gowns and masks are not required;
3. Barriers to prevent contact with body fluids include moisture-resistant disposable diaper table paper, disposable gloves, and eye protection.
Caregivers/teachers are required to be educated regarding Standard Precautions to prevent transmission of bloodborne pathogens before beginning to work in the facility and at least annually thereafter. Training must comply with requirements of the Occupational Safety and Health Administration (OSHA).
Procedures for Standard Precautions should include:
Prior to using a disinfectant, clean the surface with a detergent and rinse well with water. Facilities should follow the manufacturer’s instruction for preparation and use of disinfectant.
If blood or bodily fluids enter a mucous membrane (eyes, nose, mouth) the following procedure should occur. Flush the exposed area thoroughly with water. The goal of washing or flushing is to reduce the amount of the pathogen to which an exposed individual has contact. The optimal length of time for washing or flushing an exposed area is not known. Standard practice for managing mucous membrane(s) exposures to toxic substances is to flush the affected area for at least fifteen to twenty minutes. In the absence of data to support the effectiveness of shorter periods of flushing it seems prudent to use the same fifteen to twenty minute standard following exposure to bloodborne pathogens.
Recognizing communicable diseases
Recognizing the signs of other communicable diseases can allow you to react in a timely manner to help prevent a potential outbreak at your center and school. A quick reference chart developed by the Virginia Department of Health - Communicable Disease Reference Chart for School Personnel provides insight on incubation period, transmission, common symptoms and recommendations for controlling the spread of nineteen communicable diseases frequent to school-aged children.
While the recommendations section of this chart applies only to school-aged children, programs that service preschool and early education can use this guide to quickly identify symptoms and reference how these common diseases are also transmitted.
Healthychildren.org offers parents insight on what they can do to possibly control the spread of communicable diseases in their child’s school or child care programs. You can direct parents or guardians to this site for help with a variety of concerns, such as: Questions to Ask Your Child’s School or Child Care Program, Reducing Disease Transmission, When to Keep Your Child Home and Measures Promoting Good Hygiene.
Providing parents and guardians with information will help you maintain a higher level of accountability for taking appropriate actions to reduce the spread of communicable disease at your program. The CDC’s data base of information provides great resources to use for educating staff and to use with children. Because these resources are multilingual, they can serve as a great resource to educate non-English speaking cliental.
Cleaning and sanitizing to prevent the spread of communicable diseases
Keeping your facility germ free helps to fight any potential communicable disease transmissions at the front-line. According to Caring for Our Children: National Health and Safety Performance Standards - one of the most important steps in reducing the spread of infectious diseases in child care settings is cleaning, sanitizing or disinfecting surfaces that could possibly pose a risk to children or staff. Routine cleaning with detergent and water is the most common method for removing some germs from surfaces in the child care setting. However, most items and surfaces in a child care setting require sanitizing or disinfecting after cleaning to further reduce the number of germs on a surface to a level that is unlikely to transmit disease.
There are numerous products available to help you clean and sanitize such as “green cleaning products,” commercial cleaning/disinfecting products and diluted bleach solutions. Always confirm the solution you are using is appropriate for use in an environment that services children and meets state and local licensing agencies regulations. Additionally, refer to the guidelines provided by the manufacturer to ensure proper contact time for cleaning surfaces.
If you are considering using a low cost alternative such as bleach, the following recommendations from the California Childcare Health Program – Health and Safety Notes, Sanitize Safely and Effectively: Bleach and Alternatives in Child Care Programs can serve as a useful reference.
To safely prepare bleach dilutions:
To safely use bleach solutions:
Recommended bleach dilutions
For food contact surface sanitizing (refrigerators, freezers, plastic cutting boards, stainless cutlery, dishes, glassware, countertops, pots and pans, stainless utensils, toys that have been mouthed, high chair trays)
For nonporous surface sanitizing and disinfecting
If you have an event, Caring for Our Children: National Health and Safety Performance Standards outlines the following:
Treat urine, stool, vomit, blood, and body fluids, except for human milk, as potentially infectious. Spills of body fluid should be cleaned up and surfaces disinfected immediately.
For larger spills on floors, or any spills on rugs or carpets:
Having a plan should also include managing a crisis. A Guide to Crisis Management is a supportive Markel Safety 1st Guide designed to help you plan an effective crisis response. You can get a copy of this guide by visiting Markel’s Risk Management Library, then clicking on “Safety guides.”
The information provided in this article is intended for general informational purposes only and should not be considered as all encompassing, or suitable for all situations, conditions, and environments. Please contact us or your attorney if you have any questions.