Health implications of children in child care centres Part B: Injuries and infections and Well Beings Flashcards

1
Q

What is true regarding injuries in the child care centre?

A

Reduced risk of unintentional injury in childcare
Reduced risk of hospitalization due to inury
Majority of injuries are due to child factors

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2
Q

What should be done to prevent injuries in child care centres?

A
  1. Adequate staff-child supervision
  2. Play equipment should meet current Canadian Standards Association recommendations
  3. Well Beings: A Guide to Health in Child Care safety checklists should be utilized
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3
Q

What is the risk of respiratory illness in a child attending daycare?

A

for q9h of daycare per week there is a 12% increase in respiratory illness days

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4
Q

How can the risk of transmission of infectious diarrhea be reduced?

A
  1. Educate caregivers about proper hygiene
  2. Improve access to sinks
  3. Provide hand sanitizers
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5
Q

What is the recommendations regarding vaccinations in children attending daycare?

A

Vaccinated according to their provincial or territorial recommendations

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6
Q

What is the recommendations re: vaccinations of Canadian child care workers?

A
  1. Receive annual influenza vaccine
  2. Ensure tetanus and diphtheria vaccines are current
  3. Consider getting acellular pertussis vaccine with the tetanus and diphtheria booster
  4. Consider hepatitis A vaccination
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7
Q

What are the risks of transmission of hepatitis B, HIV, and hepatitis C in the childcare setting?

A

Extremely unlikely even with bites

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8
Q

What infections are transmitted in child care centres?

A
  1. Skin infections (impetigo, scabies)
  2. CMV
  3. H pylori
  4. Respiratory illnesses
  5. Infectious diarrhea
  6. Vaccine preventable illness incld. measles, mumps, varicella, and pertussis
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9
Q

What are the recommendations regarding exclusion of a sick child from daycare?

A
  1. Respiratory conditions: exclude if not well enough to participate fully in all activities
  2. Streptococcal pharyngitis or bacterial conjunctivitis: exclude until has 24h of antibiotics
  3. Diarrheal illness exclude if diarrhea cannot be contained in the diaper, cannot be controlled by a toilet-trained child or if there are signs of bacterial enteritis (fever, blood or mucus in stools)
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10
Q

What is the cost of illness for children 18-36mo in a six month period in daycare?

A

$260.96 per child

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11
Q

What are the recommendations re: child care centres and illness and injuries?

A
  1. All child care centres should have a written policy (in accordance with provincial or territorial health policies) on the management of a sick child, which is reviewed with all staff. The policy should contain information on recognizing an emergent illness or injury and when to call for an ambulance, proper use of antibiotics, characteristics of common paediatric infections and procedures on childcare exclusion. To help control outbreaks, the reason for exclusion should be documented. There should be enough child care staff to allow at least one adult to stay with a sick child until they return home or until medical help arrives. The policy should be shared with parents.
  2. All staff should be trained in basic first aid and CPR
  3. Handwashing, diapering and toileting instructions should include written and visual information, and should be reviewed with all staff. Ready access should be available to handwashing areas and/or hand sanitizer dispensers.
  4. Children and child care staff should receive all recommended immunizations as per their provincial or territorial area.
  5. Child care centres should be aware of the risk of injury and how to prevent the most serious and most common injuries. Compliance with supervision ratios and quality adult supervision are essential in preventing injuries.
  6. Child care centres should conduct routine safety audits on a weekly, monthly, seasonal and yearly basis, using the Well Beings recommendations as a point of safety reference.
  7. Play equipment and surfacing should comply with the Canadian Standards Association recommendations (www.csa.ca). Preschool-aged children should only use equipment that is designed for their age group.
  8. Employers should consider allowing their employees to take time off work, without penalty, to care for their sick children who need to be excluded from child care.
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12
Q

What are the Well Being recommendations re: exclusion of a child from daycare for viral respiratory illness?

A

Exclude if the child is unable to participate in all activities fully

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13
Q

What are the Well Being recommendations re: exclusion of a child from daycare for gastrointestinal illness?

A

For C diff, campylobacter, rotavirus, Yersinia: Exclude if the child’s diarrhea cannot be contained in the diaper or if a toilet trained child can’t control their bowel movements

For Ecoli O157 and Shigella: Exclude until diarrhea subsides AND 2 stool cultures are negative (while off antibiotics)

For Giardia: Exclude until diarrhea subsides

For Salmonella typhi: Exclude until diarrhea subsides AND 3 stool cultures are negative (while off antibiotics)

For Salmonella non-typhi: Exclude until well enough to participate in all activities

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14
Q

What are the Well Being recommendations re: exclusion of a child from daycare for varicella?

A

No exclusion

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15
Q

What are the Well Being recommendations re: exclusion of a child from daycare for HSV?

A

No exclusion for simple cold sores, exclude a child with mouth ulcers who is drooling until well enough to eat and participate in all activities

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16
Q

What are the Well Being recommendations re: exclusion of a child from daycare for conjunctivitis?

A

Exclude until seen by a doctor, if bacterial return after 24h of antibiotics, if viral can return with doctor’s approval, can return if no eye discharge

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17
Q

What are the Well Being recommendations re: exclusion of a child from daycare for CMV?

A

No exclusion

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18
Q

What are the Well Being recommendations re: exclusion of a child from daycare for GAS?

A

Exclude until received at least 24h of appropriate antibiotics and a doctor has determined recovery

19
Q

What are the Well Being recommendations re: exclusion of a child from daycare for Hib?

A

Exclude until has received at least 24h of appropriate antibiotics and a doctor has determined recovery

20
Q

What are the Well Being recommendations re: exclusion of a child from daycare for hand-foot-and-mouth disease?

A

No exclusion

21
Q

What are the Well Being recommendations re: exclusion of a child from daycare for head lice?

A

No exclusion

22
Q

What are the Well Being recommendations re: exclusion of a child from daycare for hepatitis A

A

Exclude for 1 week after onset of illness unless all other children and staff are vaccinated

23
Q

What are the Well Being recommendations re: exclusion of a child from daycare for hepatitis B?

A

No exclusion

24
Q

What are the Well Being recommendations re: exclusion of a child from daycare for hepatitis C?

A

No exclusion

25
Q

What are the Well Being recommendations re: exclusion of a child from daycare for HIV?

A

No exclusion

26
Q

What are the Well Being recommendations re: exclusion of a child from daycare for impetigo?

A

Exclude if there are draining lesions that cannot be kept covered and if GAS until 24h of appropriate antibiotics

27
Q

What are the Well Being recommendations re: exclusion of a child from daycare measles?

A

Exclusion for at least 4d after onset of the rash.

Non-immune children and staff must be excluded for 2 weeks after onset of rash in child diagnosed with measles unless they have been vaccinated within 72h of first exposure

28
Q

What are the Well Being recommendations re: exclusion of a child from daycare for meningitis?

A

Exclude until has received at least 24h of appropriate antibiotics and a doctor has determined recovery

29
Q

What are the Well Being recommendations re: exclusion of a child from daycare for meningococcal disease?

A

Exclude until has received at least 24h of appropriate antibiotics and a doctor has determined recovery

30
Q

What are the Well Being recommendations re: exclusion of a child from daycare for molluscum contagiosum?

A

No exclusion

31
Q

What are the Well Being recommendations re: exclusion of a child from daycare for mumps?

A

Exclude for 9d after onset of swelling

32
Q

What are the Well Being recommendations re: exclusion of a child from daycare for otitis media?

A

No exclusion unless child is too ill to participate

33
Q

What are the Well Being recommendations re: exclusion of a child from daycare for parvovirus B19?

A

No exclusion, once a rash appears the child is no longer contagious

34
Q

What are the Well Being recommendations re: exclusion of a child from daycare for pertussis?

A

Not routine but exclusion may be mandated by pubic health if at risk persons are present. Exclude until 5d of appropriate antibiotic therapy or for 3wks from onset of illness if not treated.

35
Q

What are the Well Being recommendations re: exclusion of a child from daycare for pinworms?

A

No exclusion

36
Q

What are the Well Being recommendations re: exclusion of a child from daycare for pneumococcal disease?

A

No exclusion for minor illnesses

A child with serious illness can return once a doctor has determined recovery

37
Q

What are the Well Being recommendations re: exclusion of a child from daycare for ringworm?

A

Exclude until the first treatment has been applied

38
Q

What are the Well Being recommendations re: exclusion of a child from daycare for roseola?

A

No exclusion

39
Q

What are the Well Being recommendations re: exclusion of a child from daycare for rubella?

A

Exclude for 7d after the rash is first noticed

40
Q

What are the Well Being recommendations re: exclusion of a child from daycare for scabies?

A

Exclude until the first treatment is applied

41
Q

What are the Well Being recommendations re: exclusion of a child from daycare for streptococcal pharyngitis and scarlet fever?

A

Exclude until has received 24h of antibiotics

42
Q

What are the Well Being recommendations re: exclusion of a child from daycare for thrush and candida diaper rash?

A

No exclusion

43
Q

What are the Well Being recommendations re: exclusion of a child from daycare for tuberculosis?

A

Exclude for at least 2 weeks after starting appropriate antibiotic treatment and until the treating physician and local public health unit states that the child is no longer infectious