Childminder's Club:Sickness policy??

[katymac]

I'm working on one to clarify the stuff we agree with parents - does anyone have time to read this for me (the nit bit is about a parent who openly admits she can't be bothered to wet comb more than once a week or so - even if the child has nits- sorry head lice)

As you will be aware, we have a responsibility, which we take very seriously to protect the children in our care from illness. With even the most stringent precautions all the risks of infection cannot be eliminated. We have looked at the relevant guidance and tried to apply a common sense approach to minimising the risks. This is set out below in a series of policies and procedures.

If there is anything in the list with which you disagree or believe to be unnecessary we would be happy to discuss the matter. Otherwise we would be grateful if you would sign to indicate your acceptance of these policies and return this form to us as soon as possible.

· When a child has had sickness (vomiting) or diarrhoea I will keep my child at home for a minimum of 24 hours after the last episode of illness, before returning him/her to Walnut Corner. The guidelines suggest a minimum period of 48 hours but we believe that 24 hours does not represent excessive risk.

· If my child is sick (vomits) or has diarrhoea whilst at Walnut Corner, I understand that I will be contacted for the child to be collected and I will have to keep my child at home for a minimum of 24 hours after the last episode of illness.

· If a child has a temperature of 38 degrees, whist at Walnut Corner, I understand that I will be telephoned and asked to remove them. This is because a temperature that high may cause infantile convulsions and therefore the child needs one to one care.

· Whilst accepting that head lice are part of a child?s life, we feel that to help prevent the spread of infection to other children we must be vigilant. From now on when anyone at Walnut Corner finds an infestation, we will wet comb the child?s hair with conditioner. If we find them twice within 7 days we will ring you to remove the child and we will not expect them to be returned until they are properly clear. However we do not advocate the use of chemicals, as the head lice are immune to them. Wet combing with conditioner is the only way to clear a child, and this should be done every other day for between 2 and 3 weeks.

· I understand that for conjunctivitis, I need to keep my child at home until either the eyes are clear or the doctor has agreed that it is not infectious.

· I understand that if another child has chickenpox Walnut Corner will not be excluding them once they are intrinsically well. This means my child will be at risk of infection.

Whatcha think?

If a child has a temperature of 38 degrees...... Think you need to put 38 degrees or above (just in case!)

the chickenpox thing... they're only infectious BEFORE spots appear and until the last ones have scabbed over.
would you have children there before spots have fully scabbed?

Thanks about the or over

I think I would have then before they were scabbed over unless they were "ill" as everyone would have already been exposed (iyswim)

Miss spell after '38 degrees',also, do the parents keep a copy of this as well as signing and returning, so they can look back at it for reference? Also there are other illnesses and or sickness that you could apply, for instance;
Measles- 5 days from onset.
Scabies- excluded until tratment has started.
Flu- excluded for 5 days.
Meningitis- Exclusion may not apply but Health Authority will be informed.
German Measles- excluded from 5 days from onset of rash.
Impetigo-excluded until lesions are completely crusted/healed.
Hepatitis-For under 5's exclusions will apply for 5 days.
I also say that this list is not exhaustive and I must be informed of all illnesses or accidents, no matter how insignificant. Exclusion may apply at my discretion, and illnesses may be generally discussed with other parents to decide if exclusion is warranted.

Flu as in Influenza rather than a bad cold?

Good points (I may work on it) I've only used the illness that have been a problem so far - I'll need to add in the others won't I

They will get a copy to keep and it will be part of the contract

A few points from a non CM!

I don't think above 38 degrees is a trigger for convulsions - I think it is likely to be higher than that! I don't disagree with the 38 degrees though! Just give the reason that the child is likely to be feeling unwell and require one to one care which you are unable to give!

The head lice is tricky. Children are not excluded from school for this problem. Even with a carefully tended outbreak, the problem can persist for quite some time - weeks!!! I think it is okay to say what you expect them to do, but the seeing them again within 7 days is not realistic. It is hard also to defend a policy which is stricter than the schools one - so find out what that is and copy it!

I think you need to be clear what intinscially well means as regards the chickenpox. That isn't a term that is medically defined and is hard to interpret. I think the norm with chickenpox is that the child can return to care when all of the pox have scabbed over. In actual fact the infection period for chicken pox is often before the pox appear, so there is a risk of infection any way!

For any other illnesses, I would take care to stick roughly to what school policy would be. E.g children with impetigo are not told to stay away from school, but may be told to keep the patch covered and take extra care with hygine!

Hope this helps!

Thanks Soapbox the 38 degrees was the temp mentioned on my first aid course and convulsions was the reason given - but I do see where you are coming from

As I say the headlice is directed at one parent refuses to wet comb regularily even when her child is infected (once a week is enough)

Chicken pox is a difficult one - I admit

I'm going to have to do research on impetigo tho' - I never considered it

Katymac i would check out the impetigo thing.A mindee i had last year was excluded from my setting and also school for about a week and a half.I am in Scotland so may be different where you are.In my infection control handbook it says the exclusion period is until lesions are crusted or healed.

hI kATYMAC, regarding quoting from a guideline do you think it would be good to put what guideline?

Hi Katymac, just quickly copied this from my own policies. Some are already mentioned.

Infectious diseases excluded for:

Chicken Pox
5 days from onset of rash

German Measles (rubella)
4 days from onset of rash

Impetigo
Until lesions are healed/crusted

Salmonella
6 days

Scarlet Fever
5 days from start of antibiotics

Diarrhoea / vomiting
24 hours or when well

Whooping Cough
5 days from start of antibiotics

Mumps
5-9 days or until swelling goes down

Jaundice
7 days from onset of illness

Conjunctivitis
Until eyes are clear

Head lice
Do not exclude but must be treated immediately

HTH

This is what my primary school & preschool use:

Although this says 24 hours for sickness/vomiting (s/v) the Health Protection Agency Guidance Booklet for North london nurseries says 48 hours. I have decided to have 24 hours for school children and 48 hours for under fives. As the HPA points out the school children are expected to have a higher standard when it comes to hand washing etc. Also as a colleague pointed out to me there can be a greater risk to babies than older children - her gp recommended 48 hours.

I've also added this to my policy:

• If your child is unable to participate in our normal daily routine, including playing outside and accompanying other children when I drop off/collect from school then your child MUST stay at home.
• If your child is irritable, continuously crying or requires more attention than I can provide without impeding the health, safety or well being of the other children in my care then your child MUST stay at home.
• If your child is not well enough to attend school or preschool then your child MUST NOT attend the child-care setting either.

NB Parents need to be aware that exclusion periods refer to the minimum time off - children should not return to childcare/school etc until fully recovered.

Childminders also need to consider the risk to the children's families and visitors to their home - eg people undergoing chemotherapy treatment, pregnant mothers etc.