ILLNESS, INFECTION CONTROL AND CLEANING · ILLNESS, INFECTION CONTROL AND CLEANING REGULATORY...

Illness, Infection Control & Cleaning Policy Page 1 of 20

Approved: May 06 Last Review: Aug 12 Review Date: Dec 14

ILLNESS, INFECTION CONTROL AND CLEANING REGULATORY Alpine Children’s Services Committee of Management SOURCES & PROCEDURAL REFERENCES:

Education and Care Services National regulations

Relevant ACS policies

Infection control standards

OHS Act 2004 (Victoria)

Food Safety Act 1988 (Victoria)

Public Health and well being regulations 2009

Australia and New Zealand Food standards Code

Health Act 1958 (Victoria)

Department of Human Services Exclusion Table

A Guide for the management and control of Gastroenteritis Outbreaks in Children’s Centres, Department of Health 2010

Royal Children’s Hospital (Melbourne) Model Medications Policy, 2007 SCOPE This policy applies to Alpine Children’s Services (ACS) staff, ACS Committee of Management, Family Day Care Educators, parents/guardians, children, volunteers, students and contractors involved with the service. POLICY STATEMENT: Alpine Children's Services (ACS) recognises the right of educators and young children grouped together in early childhood settings to work and be cared for in healthy, safe environments. ACS acknowledges that effective control and prevention of transmission of infection is based on standard and additional precautions. These assume that anyone could have an infectious condition at any time. A person can:

be infectious and show signs and symptoms of an infectious disease, be infectious but show no signs and symptoms , appear unwell with an infectious disease but no longer be infectious.



ACS is committed to: As far as practicable, providing a safe and healthy environment for all children,

educators, and any other persons during the hours of the centre’s operation. Responding to the needs of the child if the child becomes ill whilst attending the

service. Providing up-to-date information for parents/guardians and educators regarding

immunisation and the protection of all children from infectious diseases. Complying with the exclusion requirements for infectious diseases set out in Staying

Healthy in Childcare. ACS ensures the health and safety of the family day care educator and will attempt to

provide alternate care for children usually cared for by an educator with an illness. OBJECTIVES/PRINCIPLES: 1. Physical Facilities Physical facilities must meet Education and Care Services National Regulations 2011. 2. Education and Training During orientation on commencement of work in the program, all staff and educators working with young children, including staff not involved in the direct provision of services and volunteers should have training in infection control and first aid. In addition, staff and educators should be familiar with common signs and symptoms of infectious diseases and be familiar with the appropriate care for identified sick children until they are able to be taken home. 3. Minimising Risk All staff/educators should comply with standard precautions for the control and spread of infection as prescribed by health authorities, such as thorough washing and drying of hands, protection of injuries of the skin, immunisations and periods of exclusion.

4. Exclusion Criteria Exclusion criteria relating to infectious diseases should apply to both children and staff/ educators and should be based on information available from health authorities. If there is some concern about exclusion, a doctor's opinion should be sought. Children or staff/educators with transmissible infections should be excluded from early childhood programs until deemed non-infectious by a physician, as per Health Department Regulations, and the centre/ service's illness policy. Exclusion requirements set by health authorities (Public Health and well being regulations 2009) are based on minimising risk of transmission to others and on the time a child or staff member are infectious to others. Alpine Children's Services might also advise that a child/staff member stay away from the site for a longer period of time, not because they are still infectious but because they remain unwell and need time to recuperate. Decisions about excluding contacts of infectious diseases are based on regulations. There are circumstances where a child is too ill to attend an early childhood service and needs to stay home for treatment and recovery. There are a number of diseases that are notifiable under the Public Health Act 1991 to the local Public Health Unit. Exclude children, educators, volunteers or visitors who have infectious diseases other than listed above in accordance with the Public health and well being regulations 2009 Recommended Minimum Periods of Exclusion. Also seek advice from the local Public Health Unit in other cases of infectious disease, or if a child or staff member has a serious



infectious illness such as meningitis, food poisoning, streptococcal infection, tuberculosis, hepatitis A. Exclude children, educators, volunteers or visitors who have symptoms of or a confirmed case of gastroenteritis. All persons coming into the centre (including families, children and staff) must be clear of symptoms for 48 hours. Staff must have a medical certificate prior to returning to work. In the case of a gastro outbreak (defined as two or more cases of vomiting and/or diarrhoea occurring among children and/or staff within 48 hours of each other, when the symptoms cannot be explained by medication and or other medical conditions) the Department of Health must be notified on 1300 651 160 within 24 hours and the Environmental Health Officer at the Alpine Shire on (03) 5755 0555. The department officer will collect information on the number of cases, symptoms, duration of illnesses and other details and can discuss any issues and provide advice if necessary. Refer to ‘A guide for the management and control of gastroenteritis outbreaks in children’s centres’ for assistance on the management and control of a gastro outbreak

Under the Food Act (VIC) 1988 exclude educators from food handling duties that have pustular infections (such as boils) of the skin that cannot be covered or who are ill from gastroenteritis, sore throat with fever or hepatitis A.

Exclude children and educators who:

- are acutely ill and may need to see a doctor,

- are too ill to participate in normal activities at any early childhood service

- may require extra supervision to the detriment of the care and safety of the child or other children,

- are ill from gastroenteritis or hepatitis A,

- have symptoms or signs of a possible infectious illness.

Advise families that when children have commenced treatment with a medication, the child should not attend any early childhood service for at least 48 hours to ensure the child is recovering and is not having side effects from the medication.

Ensure all educators and persons visiting or normally residing in the home conform to all infectious disease policies.

Request from the Public Health Unit a clearance to attend for children and educators who have had diphtheria, hepatitis A, polio, tuberculosis, typhoid or paratyphoid infection.

Educators shall monitor the health and wellbeing of each child; and in the event a

child becomes unwell, the parent, guardian or emergency carer, shall be contacted and requested to collect the child as soon as possible.

In the event a child’s parent, guardian or emergency contact being unable to be contacted, and the child’s condition warrants, an ambulance may be called to transport the child to hospital. This shall be at the parents or guardian’s expense.

In the event a child is infectious, they may be relocated to the office until they can be collected. (This will occur only if office staff are available).



If a child or educator has been unable to attend an early childhood service because he/she has been diagnosed with an infectious illness, when the child or educator has fully recovered ask the family or educator to obtain a certificate from their doctor which specifically states the child or educator is not infectious and is able to attend an early childhood service or return to work.

5. Child to Child Transmission of Infection All children from a very early age should participate in activities such as handwashing, particularly in relationship to toileting/ nappy changing and eating.

6. Confidentiality Families, volunteers and staff/educators have the right to confidentiality and freedom from discrimination. 7. Carriers of HIV/Hepatitis B and C Children known to be infected with Human lmmunodeficiency Virus (HIV) or Hepatitis B/C viruses (carriers) are not to be excluded from early childhood programs and their infection status is not to be disclosed. A person's infection status is private and confidential information and should not be disclosed except by an authorised health officer acting under public health legislation. 8. Special Risk Children Some children are immune suppressed and therefore at greater risk than others for both contracting an infectious disease and for experiencing a more severe episode of the illness. Such children include those who are receiving treatment for cancer or some other major disease, and children with late stage HIV infection (i.e. AIDS). To ensure minimum exposure of these children to illness, please refer to exclusions of contacts in Staying Healthy: Preventing infectious diseases in early childhood education and care services (2012) as recommended by the NHMRC and the ACS exclusion policy. 9. Immunisation Alpine Children's Services fully supports age appropriate childhood immunisation and acknowledges immunisation as a priority health issue. Due to the high risk of spreading communicable diseases in an early childhood program, staff/educators and children should be immunised. Please refer to ACS Immunisation Policy. Immunisation schedules recommended by NHMRC for both children and staff is promoted and supported. Please refer to the following website for the current immunisation schedule: http://www.immunise.health.gov.au/ 10. Guidelines for Services/Programs

Alpine Children's Services has made available to staff/educators and parents, easily understood written guidelines for maintaining hygiene and infection control which relate to that setting. These include:

health care plans and plans for staff providing health support

toileting/ nappy changing guidelines

Policy for attending to injuries

Procedure for use of disinfectants and their appropriate storage.

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



guides to first aid and easy access to first aid kits

handwashing procedures

Policy on the management and cleaning of blood and body fluid spills

Guidelines for use of protective barriers including gloves and masks

Procedure for safe handling and disposal of sharp objects, including syringes, broken glass etc

Procedure for cleaning of surfaces and toys and use of disinfectants

laundry procedures

Procedure for disposal of waste in appropriate infectious and general waste bins

Guidelines for environmental cleaning of sandpits and secure covering when not in use

food preparation and safety policy

pet handling, cleaning and safety policy/procedure

Practices: To minimise the spread and risks of infectious disease in early childhood services by using standard infection control precautions, educators should:

Be aware that transmission of infectious disease, especially respiratory and diarrhoeal infections, occurs more frequently in early childhood service environments because of the close contact between a large number of children and staff, and that using standard infection control precautions and these procedures will reduce transmission and risks.

Be aware that Aboriginal and Torres Strait Islander children are more at risk of some infectious diseases, especially respiratory, diarrhoeal and ear infections and their complications. It is important to ensure infection control precautions are followed to reduce risks in Aboriginal and Torres Strait Islander children and other children at special risk.

Ensure children, staff, volunteers and visitors wash hands correctly with soap and running water. Dry hands with paper towels, individual towels or automatic hand-dryer upon arriving and leaving the home and other situations where appropriate.

ASSESSING SERIOUS OR POTENTIALLY INFECTIOUS DISEASES Practices:

To minimise the spread of potential infectious disease between children, other healthy children and educators and to minimise the detrimental impact on a sick child and the ability of the educator to safely supervise other children, educators should:

Advise families to always inform you when their child has been sick at home prior to bringing their child to care so you can assess whether or not they are well enough to attend. Use this guide to assess whether the child is too ill to attend or needs to see a doctor, inform the family that the child cannot attend until they have recovered or have a certificate from their doctor. (See Staying Healthy: Preventing infectious diseases in early childhood education and care services, 2012).

If you are having difficulty assessing whether a child is ill or not fit enough to attend care, discuss with the family and contact the child’s doctor if they consent.



If you are unable to contact the child’s doctor, contact:

- The Team Leader or General Manager - another local doctor, - the local hospital or emergency department, - the local Public Health Unit.

Refer difficult or unresolved situations in relation to infectious diseases to the local Public Health Unit or Children’s Services Advisor.

Advise families to take a child with any of the illnesses or symptoms listed below or a child you believe to be acutely ill or infectious to their doctor.

Write a report and include any actions and decisions taken regarding excluding a child from care or advising families to take their child to a doctor.

Exclude a child and advise the family to take the child to a doctor if you consider:

- the child has fever which has not yet been assessed by a doctor, or

- the child has fever accompanied by abnormal behaviour or symptoms or signs that indicate a possible severe illness (such as lethargy, drowsiness, severe or prolonged coughing, wheezing, difficulty breathing, unusual irritability or crying), or

- the child will be unable to participate in normal activities without possible

detriment to their care and safety, or

- the child will require extra supervision which may compromise the adequate supervision, care and safety of other children, or

- the child needs to see a doctor for any reason.

Exclude a child or staff member with any of the following symptoms which might indicate they have a potentially serious illness, and advise the family to take the child to, or advise the staff member to go to, a doctor or hospital:

- vomiting, - rash, especially if purplish or haemorrhaging spots (possibly meningococcal) or

blistering (possibly staphylococcal), - headache, - stiffness of the neck, - aversion to light (photophobia), - severe pain anywhere (including toothache), - swelling of the lips, mouth, tongue, throat, neck or airways, - hives (urticaria), - asthma, wheezing, or any difficulty breathing, - drowsiness or any unusual state of consciousness or behaviour, - convulsion or epileptic seizure.

Exclude a child or staff member with any of the following symptoms which might indicate they have an infectious illness, and advise the family to take the child to, or advise the staff member to go to, a doctor or hospital: - diarrhoea,



- generalised rash, - enlarged or tender lymph glands, - severe cough with fever, - sore throat with fever - scabies, tinea ('ringworm'), impetigo ('school sores'), or mouth ulcers not yet

treated, - mouth ulcers due to herpes simplex virus or coxsackie virus, - infection or yellow or green discharge of the eyes or ears, - if any other infectious disease is suspected. -

Refer to Exclusion table at the end of this policy for full details:

Consider a child may be ill or is developing an illness, and seek advice from a doctor and the child’s family, if you notice a child has the any of following symptoms:

- a fever. The definition of a fever is an oral (mouth) temperature or forehead

(using a forehead thermomotor) temperature greater than 37.5C or an auxiliary

(armpit) temperature greater than 37C. - irritable, agitated, fretful, crying, not able to be comforted, behaving abnormally, - listless, quiet, inactive, has no interest in normal play activities, - not wanting to eat or drink, - an excess number of wet or soiled nappies, - is not having the usual number of wet nappies (usual is 4-6 a day),

- an unusual colour or smell to the urine or faeces.

Ensure that staff who have symptoms which may indicate a potential illness are not caring for children and advise them to seek medical advice.

Ensure that staff who have symptoms which may indicate a potential illness are replaced to provide appropriate supervision for children.

FEBRILE CONVULSIONS Staff are not expected to diagnose childhood illnesses or to make judgements in relation to the administration of medication. This is the responsibility of the health professional in conjunction with the child’s parents. Febrile Convulsion Definition A febrile convulsion is a common condition where a child has a convulsion or fit that is brought on by a high temperature (fever). Fever is when the temperature of the body rises

to above 37.5C (using a forehead thermomotor) or an auxiliary (armpit) temperature

greater than 37C. Fever is a sign of infection in the body and is often caused by a virus and sometimes by bacteria. A high fever does not necessarily mean your child has a serious illness. Fever itself is not harmful until it reaches 42.0°. Most children with fever suffer only minor discomfort. However 1 in 25 children will have a febrile convulsion at one time or another. This usually happens between the ages of 6 months and 4 years.



Febrile convulsions are not harmful to the child and do not cause brain damage. They are, however, quite upsetting to parents. Most children with febrile convulsions only ever have one; occasionally some have another during future illnesses with fever. There is no increased risk of epilepsy in children who have febrile convulsions. Signs and symptoms During a febrile convulsion:

The child usually loses consciousness.

Their muscles may stiffen or jerk.

The child may go red or blue in the face.

The convulsion may last for several minutes.

Then the movements stop, and the child regains consciousness but remains sleepy afterwards.

Treatment during a convulsion

A second staff member should contact a parent/guardian, or other emergency contact as noted in their enrolment document.

There is nothing you can do to make the convulsion stop.

The most important thing is to stay calm - don't panic.

Place the child on a soft surface, lying on his or her side or abdomen.

Do not restrain the child.

Do not put anything in their mouth including your fingers. The child will not choke or swallow their tongue.

Try to watch exactly what happens, so that you can describe it later.

Time how long the convulsion lasts.

Do not put a child who is having a convulsion in the bath. Call an ambulance on 000 if:

The convulsion lasts more than 5 minutes,

The child does not wake up when the convulsion stops,

The child looks very sick when the convulsion stops, or

The child’s parent/guardian or emergency contact cannot come within five minutes The parent/guardian or emergency contact should be advised to take the child to see their doctor, particularly if the child was unwell prior to the febrile convulsion. Fever care Since a fever is the body's natural response to infection it is not always necessary to reduce a fever. Treatment of a fever with paracetamol or ibuprofen does not prevent a febrile convulsion. NOTIFICATION OF INFECTIOUS DISEASES Practices: When a child is acutely ill from an infectious disease or the educator or staff or a person normally residing in the home is suspected as having an infectious disease as listed by the Scheduled Medical Conditions, the NHMRC exclusion guidelines, or Recommended Notifiable Disease, the General Manager or Team Leader should:



Under the Health Act 1958 (VIC) notify the local Public Health Unit and the Scheme Team Leader or General Manager, provide details, and seek advice in relation to exclusion from care or work in the home, of any known or suspected person (child, educator, staff, or person normally residing in the home) with any of the following vaccine preventable diseases- measles, mumps, rubella, diphtheria, tetanus, polio, pertussis (whooping cough).

Report to and seek advice from the local Public Health Unit if two or more persons (children or staff) have gastroenteritis.

Seek advice from the Local Public Health Unit if any person has a serious illness such as meningitis, food poisoning, gastroenteritis, streptococcal infection, tuberculosis, hepatitis A or a disease as listed by the recommended notifiable diseases.

When a child is acutely ill from an infectious disease or the educator or staff or a person normally residing in the home is suspected as having an infectious disease as listed by the Scheduled Medical Conditions, the NHMRC exclusion guidelines, or Recommended Notifiable Disease, an educator should:

Notify the family as soon as practically possible, request they or a responsible person nominated by the parent or guardian, pick up and take charge of the child and take to the doctor

If practicable and if supervision is available, isolate the child from other children until the child can be picked up their family or nominated responsible person.

If adequate supervision for children is available, isolate the staff member from other children and staff and ensure they are replaced for appropriate supervision of children.

Assess the child for any need for first aid or emergency treatment, make them comfortable and reassure them. Keep the child under adult supervision until the child’s family or some other responsible person who has consent takes charge of the child except as required by law under the Health Act 1958 (VIC).

Inform all families as soon as possible of the presence of the infectious disease in an early childhood service, an educator or staff, or a person normally residing in the home. In providing such information, ensure confidentiality of any personal identifying or health information of any person or child with an infectious disease.

When a confirmed outbreak of an infectious disease has occurred, discuss the situation with the local Public Health Unit, and request the Public Health Unit to provide written advice and information about identification, prevention and management of possible infection or serious illness. The WorkCover Authority may also need to be notified.

Ensure all bedding, towels, clothing, toys, equipment and utensils used by the child or staff member are washed and dried in the sun, or give the child’s clothes to the family to wash.



If the educator or a person normally residing in the home has the infectious disease, ask advice from the Public Health Unit and Team Leader whether to close your service until the person has recovered and received a medical certificate that they are not infectious.

Be vigilant for the same disease occurring in any other child or person that has been in contact with the child (most incubation periods for common infectious diseases are around 1 to 2 weeks).

Ensure confidentiality of any personal or health related information obtained by children’s centre staff in relation to any children, children’s parents and families.

Be aware that infection with HIV, AIDS, Hepatitis B, or Hepatitis C, are not grounds for exclusion (unless the person is acutely infectious or has an infectious secondary infection).

Be aware that if an educator or other staff member is informed that a child or any person associated with the service has HIV, AIDS, Hepatitis B, or Hepatitis C, this information must remain confidential unless the person or parent has given explicit consent to inform others.

Record all immunisable and infectious diseases, with the exception of the common cold (on the child’s Accident, Illness, Injury and Trauma record).

Hand Washing Information

Infections can be spread by a person who shows no signs of symptoms of illness. Hand washing is one of the most effective ways of preventing the spread of infection.

The best way to prevent the transmission of disease is to wash and dry your hands thoroughly. Educating staff to wash and dry their hands effectively decreases the amount of disease in infants and toddlers. Hand washing is effective because it loosens, dilutes and flushes off germs and contaminated matter. To promote and enable effective hand washing basins are to be:

readily accessible and located where they will be needed (including nappy changing areas, toilets, food preparation areas and outdoors); and

at an appropriate size and height, for staff and children. Hands-free taps and liquid soap dispensers will reduce the opportunities for cross contamination.

How to wash hands:

Use the following method to make sure your hands and the children’s hands are as germfree as possible. The process of thoroughly washing and rinsing your hands should take 10 – 15 seconds. This can be achieved by slowly counting to 10 when

you wash and then slowly counting to 10 when you rinse. This is about as long as it takes to sing ‘Happy Birthday’ twice.

• Wet hands with running water. • Use liquid soap and spread over hands. • Rub your hands vigorously as you wash them. • Wash your hands all over. Pay particular attention to wash the palms and backs of

hands, in between fingers, under finger nails and around wrists.



• Rinse your hands thoroughly to remove all suds and germs. Thorough rinsing will help prevent dermatitis from suds.

• Turn off the tap using paper towel. • Pat dry your hands with a new paper towel

Soaps, towels and lotion Liquid soap dispensers and disposable paper towels are the preferred option for hand washing. Liquid soap is advocated rather than solid bar soap because it is less likely to become contaminated and is more likely to be used. If reusable containers are used for liquid soap, they must be cleaned and dried before refilling with fresh soap. Antibacterial hand washes should not be used routinely in children’s centres as they are unnecessary and may encourage the development of resistant bacteria. Alcohol-based hand cleaners can have a role if proper hand washing facilities are not available (e.g. on excursions). Alcohol based cleaners may be used in the following situations:

• On excursions, where washing hands with soap and water is not available. When possible gloves should be used during these occasions to ensure effective infection control. Alcohol based cleaners should be used a last resort. When liquid soap and running water becomes available, educators/staff must use these facilities e.g. upon return to the centre.

• When supervision is an issue if a staff member leaves an area to access liquid soap and running water e.g. a staff member is outside on their own. When possible gloves should be used during these occasions to ensure effective infection control. Alcohol based cleaners should be used a last resort. When liquid soap and running water becomes available, educators/staff must use these facilities e.g. when going inside or a second staff member come outside or when going on a break.

After several uses of an alcohol-based hand cleaner, you will need to wash your hands properly with liquid soap and water. Effective hand drying is just as important as thorough hand washing because wet surfaces transfer germs more effectively than dry ones. Disposable paper towel is the preferred option. Cloth towels should not be used as they allow re-contamination of the hands. Warm air dryers are also not recommended as they take longer to dry hands than with paper towel, can only serve one person at a time and often people do not spend long enough using the dryer. Hand care Some infections are spread when blood from an infected person comes into direct contact through broken or abraded skin, therefore healthy intact skin can be a very effective barrier to disease and infection. Wash hands with mild soap and water and make sure that they are thoroughly dry. Soaps and detergents remove oils from the skin causing dryness and possible cracking. Some staff and children may find that frequent hand washing may lead to dry skin, which may be prone to cracking and dermatitis. Cracked or inflamed skin is harder to clean properly and may become infected. Application of a hand cream may help to prevent skin cracking and dermatitis. Prolonged contact with water softens the skin and makes it more susceptible to irritation. Reducing the dryness and irritation of the skin is very important. Application of a hand cream and powder-free gloves may be used to reduce drying of skin. Sorbolene cream and water may be used instead of soap and water, and hands patted dry, rather than rubbed vigorously. Apply more sorbolene cream as a hand cream if needed.



Use barrier cream to protect skin that will be wet for long periods. Do not use barrier cream on damaged skin. Treat minor cuts and abrasions promptly. Children with eczema have a type of skin that is dry, itchy and sensitive. Their skin is easily inflamed, gets itchy and is made worse by rubbing and scratching. Reducing the dryness and irritation of the skin is very important. These children may find that frequent use of soap and water may irritate their skin. They can use sorbolene cream instead of soap. They can put the cream on and then gently rub off under running water. They should pat their hands dry rather than rub and apply more sorbolene cream if needed. Hand washing takes time In the steps for good hand washing you need to slowly count to 10 while soaping and rubbing your hands and then slowly count to 10 while rinsing your hands. This may seem like a long time. It is a challenge to allow enough time in your daily program for children to wash and dry their hands well. But it can be done. Wearing jewellery will make it harder to clean your hands effectively and will require extra attention. When to wash your own hands • When you arrive at the centre. This reduces the introduction of germs; • Before handling food, including babies’ bottles; • Before eating; • After changing a nappy; • After removing gloves; • After going to the toilet; • After cleaning up blood, faeces or vomit; • After wiping a nose, either a child’s or your own; • Before giving medication; • After handling garbage; • After coming in from outside play; and • Before going home. This prevents taking germs home. When to wash the children’s hands • Before and after eating and handling food; • After having their nappy changed. Their hands will become contaminated while they

are on the change mat; • After going to the toilet; • After coming in from outside play; • After touching nose secretions; • After coming in contact with blood, faeces or vomit; • Before joining the mixed age group (if applicable); and • Before going home. This prevents taking germs home. Parents can help with this. Education of Infection Control Teach the children under your care to wash and dry their hands in this way. Staff need to supervise and observe children so that they develop hand washing as a good habit and do it properly. Encourage the children not to touch the tap after they have washed and dried their hands. The tap will have lots of germs on it. Babies need their hands washed as often and as thoroughly as older children. If the baby is able to stand at an appropriate sized hand basin, you need to wash and dry their hands just as you would for yourself. If the baby is unable to stand at a hand basin, wash



their hands with either pre-moistened towelettes or wet disposable cloths, and then pat dry with paper towel. Gloves Wearing gloves does not replace the need for hand washing as gloves may have very small holes or be torn during use. Hands may also become contaminated during removal of gloves. New gloves should be used for each child. CLEANING PROCEDURE: Alpine Children's Services is committed to providing a healthy environment for all children, staff and other stakeholders. An essential component of this is having proper cleaning procedures and ensuring these are carried out. Washing Germs Away Washing germs down the drain is better than trying to kill the germs with disinfectant. Ordinary detergents help to loosen the germs so that they can be washed away. Colour coded cloths are used in each area to keep them separate. Enjo products are also colour coded for use in specific areas. Disinfectants Disinfectants cannot kill germs if the surface is not clean. It is more important to make sure that all surfaces have been cleaned with detergent and warm water than to use disinfectant. To kill germs, any disinfectant needs:

- A clean surface to be able to get to the germ - To be able to act against those particular germs - To be of the right concentration - Enough time to kill the germs. This takes at least 10 minutes.

Detergents Effective cleaning with detergent and warm water, followed by rinsing and drying removes the bulk of germs from surfaces; Germs are unable to multiply on clean, dry surfaces. Ensure that cleaning equipment is cleaned and stored so it can dry between uses. It should be well maintained, and designed to reduce dust during use. Enjo Enjo products can also be used to clean effectively. The appropriate coloured enjo fibre must be used for each specific cleaning requirement. Only water is to be used with these fibres. There is no need for chemicals or cleaning products. The Enjo fibre consists of microscopic fibres that reach into the finest cervices that are present on all surfaces. Enjo fibres clean in a mechanical rather than a chemical way. The fibres attract and hold the dirt and bacteria effectively like a magnet, without the use of toxic chemicals. Linen Wash linen in hot water. Do not carry used linen against your own clothing or coverall. Instead take it to the laundry in a basket. Treat soiled linen as you would a dirty nappy. Soiled linen should be:

- Soaked to remove the bulk of contamination - Washed separately in hot water, and - Dried in the sun or on a hot cycle in the clothes dryer.

Wear gloves when handling soiled linen.



Toys Washing toys effectively is very important to reduce spread of disease. Toys, especially those in rooms with younger children, need to be washed at the end of each day. Warm water and detergent help to loosen the germs so that they can be washed away. Remove toys for washing during the day. Place toys in the ‘Toys to Wash’ box and place toys in it during the day if you see a child sneeze on a toy, if it has been mouthed, or if the toy has been discarded after play by a child who is unwell.

Buy only washable toys. Wash toys daily in warm water and detergent, rinse them well and dry them. Many

toys can be cleaned in the dishwasher. All toys, including cloth toys and books, can be dried by sunlight.

Cots If a child soils a crib or cot:

- Put on gloves - Clean the child - Remove your gloves - Dress the child - Wash and dry the child’s hands - Wash and dry your hands - Put on gloves - Clean the cot - place soiled linen in a lined, lidded laundry bin - Remove bulk of soiling/spill with absorbent paper towels. - Remove any visible soiling by cleaning thoroughly with detergent and water - Remove gloves - Wash and dry your hands - Provide clean linen.

Dummies Dummies must never be shared by children. When not in use, dummies should be stored in individual plastic containers. Each container should have the child’s name on it. Do not store dummies where they may come in contact with another dummy or toy. Store dummies out of children’s reach Clothing Staff clothing, or over clothing, should be washed daily. Staff may wear overclothes, such as aprons to cover clothing that cannot be washed daily. Another option is for staff to have a changes of clothing available for ‘accidents’ or after dealing with potentially infectious situations. These measures also help to protect the families of child care staff when they return home. The children’s dress-up clothes should be washed regularly. It is recommended that these are washed once a week in hot water and detergent.



Wash daily

plus when visibly soiled

Wash weekly plus when visibly soiled

Bathrooms. Wash tap handles, toilet seats, toilet handles and door knobs. Check the bathroom during the day and clean if obviously soiled.

Toys and objects put in mouth

Surfaces the children have frequent contact with, for example, bench tops, taps, cots and tables

Mattress covers and linen, if each child does not use the same mattress cover each day

Door knobs

Floors

Low shelves

Other surfaces often touched by children

Enjo microfiber solutions are great if you have family members with asthma or allergies. The products remove up to 100% of all bacteria on the surface you are cleaning. We have yet to find another cloth that can do that.

The dust cleaning products (floor fibers and dust mitts) produce 13 times less airborne particles than traditional cleaning. Enjo fibers trap dust and hang onto it, so dust doesn’t float and land back on floor or furniture.

Enjo is chemical free cleaning at its best. With this green cleaner you are avoiding the harmful effects of chemical sprays, chemical cleaners and manufactured fragrances that have been linked to cancer, asthma, tissue damage and skin irritations! Who would argue with that?

How does Enjo cleaning work?

Enjo cleaning is a mechanical process rather than a chemical one. Traditional cleaning cloths superficially clean the surface leaving dirt and chemical residue. The thick fibers the cleaning products are made from get into all crevices of the surface you are cleaning.

Since these green cleaning products are made of microscopic fibers, they attract and trap dirt, bacteria and grease in the tiny fibers (instead of moving it to other parts of the surface you’re cleaning). While traditional chemical cleaners claim to kill bacteria and germs, unless you remove the chemical residue they leave behind, chemical products don't give you a true clean.

How can you clean with only water?

Water acts as a solvent, loosening, dissolving or weakening dirt particles. The dirt, grime and germs then stick to the Enjo microfibers and remain trapped until loosened in your washing machine (with a gentle detergent). Enjo cloths and mitts are so effective at trapping dirt, grime and germs that you can wipe a greasy surface clean and then use the same fiber on glass without making it greasy!



Appendix 1: Step by Step Procedure for Infection Control Relating to Blood-Borne Viruses (STAFF ONLY)

Blood spills

Equipment and procedures for managing blood spills and providing first aid for patients who are bleeding are detailed below:

Anyone working with children, who may need to respond to an incident involving blood, needs to cover cuts, sores or abrasions they may have on their hands and arms with waterproof dressings, while at the service.

Cleaning and removal of blood spills

Equipment

Disposable gloves

Disposable plastic bags

Warm water and detergent

Disposable towels

Bleach. Strength should be 10,000 parts per million, approximately to one quarter of a cup of household bleach to one cup of water. Ensure that bleach has not passed its use by date and that it is mixed fresh on each occasion.

Procedure

Put on disposable gloves.

Saturate disposable towel in bleach solution.

Cover the spill with the towel.

Leave the towel in place for 10 minutes.

Place towel in disposable plastic bag.

Wash area with warm water and detergent.

Place gloves into disposable plastic bag.

Seal bag and dispose of it appropriately taking into consideration health and safety issues.

Wash hands in warm soapy water.

Soak any utensils used in bleach solution for 30 minutes, then wash in warm to hot soapy water and rinse.

Care needs to be taken to ensure that children do not have access to the bleach saturated towel.

Providing first aid for children who are bleeding

Equipment

Antiseptic

Disposable plastic bags

Disposable gloves

Waterproof dressings

Disposable towels

Warm water and detergent



Procedure

Adult treating child to cover any uncovered cuts, sores or abrasions on arms and hands with waterproof dressings.


Wash wound under warm running water and apply antiseptic to wound.

Apply waterproof dressing to the wound if necessary.

Remove gloves and place in disposable plastic bag, tie securely.

Seal bag and dispose of it appropriately taking into consideration health and safety issues.

Wash hands in warm soapy water.

Contaminated clothing or sick room linen should be removed and stored in leak-proof disposable plastic bags until they can be washed as follows using gloves:

Rinse in cold water.

Soak in 1:10 bleach solution (1 Part bleach 10 parts water) for 30 minutes, then rinse off bleach.

After soaking, wash clothes and sick room linen separately from other laundry, at a high temperature on a long cycle.

Safe disposal of discarded needles/syringes

Equipment and procedures for the safe disposal of discarded needles and syringes are detailed below:

Equipment

Disposable gloves.

Long handled tongs.

Disposable plastic bags.

‘Sharps’ syringe disposal container or plastic container with a screw-top lid.

Procedure:


Do not try to recap the needle.

Place the disposal container on the ground next to the syringe.

Pick up the syringe as far from the needle end as possible, using tongs if not easily accessible.

Place the syringe, needle point down, in the disposal container and screw the lid back on firmly.

Repeat this procedure to pick up all syringes and/or unattached needles.

Remove gloves and place in disposable plastic bag.

Seal and dispose of the plastic bag.



If tongs are used, soak in bleach solution for 30 minutes, then wash in hot soapy water and rinse.

Wash hands in warm, soapy water.

Under no circumstances should work experience students or children be asked or encouraged to pick up needles/syringes.

Syringe disposal containers or syringes must not be put in normal waste disposal bins.

Syringe disposal containers may be disposed of by:

Telephoning the Disposal Help Line on 1800 552355 for the location of the nearest needle exchange outlet or public disposal bin.

Contacting the Alpine Shire (03) 5755 0555

Contacting the local hospital.

Contacting the Risk Reduction Unit at the Department of Human Services on 03 9637 4000.

Contacting the environmental officer (health surveyor) at the local municipal/council offices; also for any further concerns about syringe disposal.

Needle stick injuries

The Department of Human Services has indicated that the risk of infection from needle stick injury is low and should not cause alarm.

The following procedures should be observed in case of needle stick injury:

Flush the affected part with running water and detergent.

Wash in warm, soapy water.

Dry area, apply antiseptic to the wound and cover with a waterproof dressing if necessary.

Report the injury to the ACS General Manager.

See a doctor as soon as possible and report the circumstances of the injury.

This procedure is based on advice provided by the Department of Education, Employment and Training and the Department of Human Services.





ACS Period of Exclusion

In this Schedule, medical certificate means a certificate of a registered medical practitioner.

Condition Exclusion of Cases Exclusion of Contacts

Amoebiasis(Entamoeba histolytica) Exclude until there has not been a loose bowel motion for 48

hours. Not excluded.

Campylobacter Exclude until there has not been a loose bowel motion for 48


Chickenpox

Exclude until all blisters have dried. This is usually at least 5

days after the rash appears in unimmunised children, but may

be less in previously immunised children.

Any child with an immune deficiency (for example, leukaemia) or receiving chemotherapy should be excluded

for their own protection. Otherwise not excluded.

Conjunctivitis Exclude until discharge from eyes has ceased. Not excluded.

Diarrhoea Exclude until there has not been a loose bowel motion for 48


Diphtheria

Exclude until medical certificate of recovery is received

following at least two negative throat swabs, the first not less

than 24 hours after finishing a course of antibiotics and the

other 48 hours later.

Exclude family/household contacts until cleared to return by the Secretary.

Hand, Foot and Mouth disease Exclude until all blisters have dried. Not excluded.

Haemophilus influenzae type b (Hib) Exclude until at least 4 days of appropriate antibiotic

treatment has been completed. Not excluded.

Hepatitis A Exclude until a medical certificate of recovery is received,

but not before 7 days after the onset of jaundice or illness. Not excluded.

Hepatitis B Exclusion is not necessary. Not excluded.

Hepatitis C Exclusion is not necessary. Not excluded.

Herpes ("cold sores")

Young children unable to comply with good hygiene practices

should be excluded while the lesion is weeping. Lesions to be

covered by dressing, where possible.

Not excluded.

Human immuno-deficiency virus infection

(HIV/AIDS) Exclusion is not necessary. Not excluded.

Impetigo Exclude until appropriate treatment has commenced. Sores on

exposed surfaces must be covered with a watertight dressing. Not excluded.

Influenza and influenza like illnesses Exclude until well. Not excluded unless considered necessary by the Secretary.

Leprosy Exclude until approval to return has been given by the

Secretary. Not excluded.

Measles* Exclude for at least 4 days after onset of rash.

Immunised contacts not excluded. Unimmunised contacts should be excluded until 14 days after the first day

of appearance of rash in the last case. If unimmunised contacts are vaccinated within 72 hours of their first

contact with the first case, or received NHIG within 144 hours of exposure, they may return to the facility.

Meningitis (bacteria - other than

meningococcal meningitis) Exclude until well. Not excluded.

Meningococcal infection* Exclude until adequate carrier eradication therapy has been

completed. Not excluded if receiving carrier eradication therapy.

Mumps* Exclude for 9 days or until swelling goes down (whichever is

sooner). Not excluded.

Pertussis* (whooping cough)

Exclude the child for 21 days after the onset of cough or until

they have completed 5 days of a course of antibiotic

treatment.

Contacts aged less than 7 years in the same room as the case who have not received three effective doses of

pertussis vaccine should be excluded for 14 days after the last exposure to the infectious case, or until they

have taken 5 days of a course of effective antibiotic treatment.

Poliomyelitis* Exclude for at least 14 days from onset. Re-admit after

receiving medical certificate of recovery. Not excluded.

Ringworm, scabies, pediculosis (head lice) Exclude until the day after appropriate treatment has

commenced. Not excluded.

Rubella (german measles) Exclude until fully recovered or for at least four days after the

onset of rash. Not excluded.

Salmonella, Shigella Exclude until there has not been a loose bowel motion for 48


Severe Acute Respiratory Syndrome (SARS) Exclude until medical certificate of recovery is produced. Not excluded unless considered necessary by the Secretary.

Streptococcal infection (including scarlet

fever)

Exclude until the child has received antibiotic treatment for

at least 24 hours and the child feels well. Not excluded.

Tuberculosis

Exclude until receipt of a medical certificate from the

treating physician stating that the child is not considered to

be infectious.

Not excluded.

Typhoid fever (including paratyphoid fever) Exclude until approval to return has been given by the

Secretary. Not excluded unless considered necessary by the Secretary.

Verotoxin producingEscherichia coli(VTEC) Exclude if required by the Secretary and only for the period Not excluded.



Condition Exclusion of Cases Exclusion of Contacts

specified by the Secretary.

Worms (Intestinal) Exclude until there has not been a loose bowel motion for 48


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