Illness Policy
Rationale:
Our service fosters an environment of good health and wellbeing for the children in our care. We have a duty of care to ensure a high level of protection during the hours of operation in this service. It is important that families maintain a focus not only on their own child(ren), but also upon the other children, the education and care professionals and visitors at the service. (Ed & Care Services National Regulations Oct., 2017, Staying Healthy, 5th ed. June 2013, Work Health & Safety Act 2011 6/2017)
This policy and related procedures apply to all children, educators, staff, parents/custodial parents/carers and visitors to the service. It must be understood by all who attend and use the service that the Illness Policy and related procedures are accepted as a high priority.
Aim:
- To promote an environment of good health and wellbeing
- To help stop the spread of infectious disease
- To meet the needs of children when they are unwell
- Identify symptoms of illness
- Monitor and document the progress of an illness (illness form)
- Notify parent, custodial parent or emergency contact persons when a symptom of an infectious illness/disease/medical condition has been observed (courtesy call and/or a call to pick the child up)
- Assess when an illness is an emergency (life threatening), requires medical attention, or medical advice (medical professional)
- Identify exclusion guidelines and timeframes (Time out poster and service policies)
- Identify when an illness is no longer infectious (child can return)
Procedure:
Our Service does not care for unwell children and therefore unwell children will not be allowed to attend the service until they are free of illness or are medically treated as required. A medical certificate must be supplied to the service if the Nominated Supervisor/Responsible person-in-charge asks for one. This needs to state that the child is free of illness/disease and is not contagious and can re-enter the service.
Please note: Fuji International Kindergarten’s exclusion times may override QLD health guidelines (time out poster) and the Nominated Supervisor/Responsible person-in-charge has the final say on whether a child is able to stay at the service. They also have the authority to override a doctor’s certificate permitting admittance to the service if the child is still unwell or not coping at the service.
Signs & symptoms that a young child may have an illness:
• High fever – (above 38°C) a high fever in a young child is a sign of infection and needs to be investigated to find the cause. If the child is less than 3 months old and has a fever above 38 °C, contact the child’s parent and ask them to take the child to a doctor, or ask permission to take the child to a doctor yourself. This is serious for babies to 12 months.
• Drowsiness - the child is less alert than normal, making less eye contact, or less interested in their surroundings.
• Lethargy & decreased activity - the child wants to lie down or be held rather than participate in any activity, even those activities that would normally be of interest.
• Breathing difficulty - this is an important sign. The child may be breathing very quickly or noisily, be pale or blue around the mouth. The child may be working hard at breathing, with the muscles between the ribs being drawn in with each breathe.
• Difficulty in swallowing – this can be a sore throat, infection or mouth ulcers. Fever can be present, or the child seems unwell. Children find it hard to eat or drink. Babies have a problem with feeding if their nose is blocked. They need to breathe through their nose when they are breastfeeding or drinking from a bottle.
• Poor circulation - the child looks very pale their hands and feet look cold or look blue.
• Poor feeding - the child has reduced appetite and drinks much less than usual. This is especially relevant for infants.
• Poor urine output - there is a lower frequency of urination, and in younger children there are fewer wet nappies than usual. This is especially relevant for infants.
• Red or purple rash - non-specific rashes are common in viral infections however red or purple spots that do not turn white if pressed with a finger require urgent medical referral because the child may have Meningococcal disease.
• A stiff neck or sensitivity to light – this may indicate meningitis
• Pain – a child may or may not be able to tell if he/she is in pain. Facial expressions are a good indicator of pain in small infants or children who do not talk. General irritability or reduced physical activity may also indicate pain in young children.
• Heat stroke/heat stress – this can be dangerous for both children and adults. The child can be suffering from headaches, chills, fatigue, vomiting and dizziness after families engage in outdoor activities with their children. Children must be kept at home.
• Bowel Motions – loose bowels, including diarrhoea, may also be accompanied with a sore stomach or cramping. Other bowel motions may indicate illness - grey in colour, pale or contain blood. Dehydration is a real danger to children.
• Vomiting – a child may or may not be in pain. May have a headache, feel unwell or have stomach cramping. Dehydration is a real danger for children.
• Discharge from eye/ear – (EYE) may be conjunctivitis (viral or bacterial) which is highly contagious. Eye may become red, swollen, itchy, irritated and may have a sticky discharge. (EAR) There may be clear or yellow fluid or blood. Earaches and burst ear drums are painful and may be accompanied with fever and/or vomiting. (Children may have grommets, which allow fluid to drain from the ear.)
• Skin – skin may be affected and can be a symptom of an illness. This can be rashes, blisters, spots, crusty or weeping sores. This is an important sign.
• Headaches – the child could be irritable, lethargic, have fever, vomiting and may not want to eat or participate in activities.
Illness in infants and young children can progress very quickly.
Educators/staff:
Staff are NOT health care professionals and are unable to diagnose an illness. This is primarily the responsibility of medical practitioners.
Staff are not responsible for decisions about the primary health care of sick children. Sick children need to be in the care of their parents so that the parents can make these important decisions. (medical advice, medications, etc)
The service will ensure that educators are trained to be aware of symptoms which may indicate a possible infection/serious illness/condition. Symptoms of illness can occur in isolation (on its own) or in conjunction with others (as well as along with others). Parents should seek medical advice to minimise the spread of infection to ensure that symptoms are not contagious.
Assessing an infectious Illness:
Educators will assess whether the symptoms fit an illness with an exclusion period. (QLD health Time out poster/Staying Healthy, 5th ed. June 2013 Appendix A)
Assessing when an Illness is an Emergency:
An illness is considered an emergency when the child is exhibiting respiratory or circulatory (shock) failure and/or is unconscious (e.g. of emergency – anaphylaxis, convulsions, febrile convulsions, temperatures of 40°C)
1. Educators will commence first aid.
2. An Ambulance will be called immediately.
3. Parents/custodial parents and/or nominated emergency contacts will be notified.
Assessing when an Illness requires immediate Medical Intervention:
“Immediate medical intervention” in this policy is when the symptoms may indicate an illness is potentially serious. (e.g. child complains/displays intense abdominal pain, temperatures of 38°C-40°C, continuous vomiting/diarrhoea, displays abnormal signs/symptoms that raise concern)
1. Educators will commence first aid.
2. Parents/emergency contact persons will be notified and requested to take their child to a hospital or doctor immediately.
3. If parents and/or emergency contact persons cannot be reached an ambulance will be called.
Assessing when an Illness requires Medical Advice:
“Medical advice” in this policy is defined as when symptoms may indicate that the illness is potentially infectious. (e.g. continuous sticky discharge from eyes, rashes)
1. Educators will provide first aid where necessary.
2. Parents and/or emergency contact persons will be notified for them to pick up the child immediately.
3. Depending on the illness, the child will be able to return to the service if a medical certificate is given to the Nominated Supervisor /Responsible person-in-charge, clearing the child and deeming the child well enough to return. (as set out in Staying Healthy Appendix A)
If a child appears to be unwell or complains that he/she is unwell:
(Including teething, requiring antibiotics and immunisation)
• Separate the ill child from the other children.
• Check the temperature in °C. (degrees Celsius)
• If below 38°C, then constantly check and observe the child. (give parents a courtesy call)
• If above 38°C and/or the child is not well enough to participate in activities, contact the parent as soon as possible and send the child home.
• If 40°C or over, and if the service cannot contact the parents/custodial parent and/or nominated emergency contacts, an ambulance will be called.
• If the child has vomited, clean the child and affected area thoroughly following the correct procedures. Educators/staff will assess the child and either make a courtesy call or ask the parents to pick up the child as soon as possible, depending on the severity.
• If the child has diarrhoea, clean the child and affected area thoroughly following the correct procedures. Educators/staff will assess the child and either make a courtesy call or ask the parents to pick up the child as soon as possible, depending on the severity. (Bowel motion may be quite severe - child has accompanying pains and is uncomfortable, watery consistency, explosive loose bowel motion)
• Office staff are to record all illnesses at the Service using the “Fuji Record of Illness” book. Educators are to fill out the “Illness Form” and keep this in the “Illness Register” in their room. A copy may be given to the parent/custodial parent/ nominated emergency contact persons. Keeping records can help prevent the spread of infection. Records can show when infection control is working. They are invaluable in helping the Service and public health workers to identify the cause of any outbreak and how to control it.
Custodial parent or a nominated emergency contact (as on the child’s enrolment form or through Xplor) will be contacted if the parent is unavailable or unable to pick the child up.
While waiting for the parent/custodial parent/nominated emergency contact to arrive, make the child feel comfortable and move them away from the other children. If the child is uncomfortable due to fever, place a wet compress on their forehead or back of their neck to lower the temperature. Strip off any heavy clothing and encourage the child to sip water intermittently.
The “Illness Form” will be filled out by the educator and signed by the parent/custodial parent/nominated emergency contact before the child leaves the premises of the Service.
In case of illnesses suspected/diagnosed as infections, refer to “Infectious Disease Policy” and “Exclusion Policy.”
Exclusion period: (24 hours AFTER THE LAST temperature, vomit or diarrhoea – e.g. the last temperature, vomit or diarrhoea was at 3pm, and then 24 hrs. after this would be 3pm the next day. If it is an infectious illness, then they may require further exclusion. In the event of an outbreak this will be increased to 48 hours)
A child who is unwell needs to be with a person who can care for them and their needs.
Parents:
Parents are asked to inform the service if their child is absent due to illness and the specifics of the illness.
If a child is deemed not well or is not coping well at the service, parents/custodial parent/ nominated emergency contact persons will be notified to collect the child within 1 hour from the time person–to-person contact is made. (e.g., fever over 38°C, diarrhoea, vomiting, is lethargic, not eating, not participating, including teething, requiring antibiotics and immunisation)
Parents are not contactable at times; however Fuji International Kindergarten MUST be able to contact a parent/custodial parent or a nominated emergency contact. Parents are always to supply reliable emergency contact numbers on their child’s enrolment form for educators to contact in the absence of a parent.
The Nominated Supervisor /Responsible person-in-charge has the final say on whether a child is not well or is not coping at the service. The nominated Supervisor/Responsible person-in-charge can override a doctor’s certificate allowing the child to return to the service. (A second opinion may be needed if the child has been cleared and is still unwell to staff).
It is the responsibility of parents to advise educators through the “Medication Book” if they have administered any over the counter medication such as cold/flu remedies or decongestants to their child before their arrival to the service. The “Medication Book is located outside on the lockers of each room. This assists educators if symptoms of an infectious illness/ disease/medical condition have been observed. (This information may be needed if an emergency arises)
Children are not to attend the service until 24 hours after the last vomit, diarrhoea, fever.
If an outbreak of Gastro occurs, we will be imposing an exclusion period of at least 48 hours.
Children will be excluded if live head lice are detected until effective treatment has commenced.
The service must be notified immediately if a child has contracted an infectious illness. There are specific quarantine periods for infectious illnesses which are listed in Staying Healthy 5th ed. June 2013 Appendix A (Exclusion of Sick Children) and the ‘Time Out’ poster Qld Health Guidelines.
The Nominated Supervisor/Responsible person-in-charge will notify QLD Health where necessary of an outbreak of an infectious disease and notices will be displayed.
Any child needing Panadol, Nurofen, etc. for a fever, pain, and other symptoms, SHOULD NOT attend kindy.
If it persists, they should be examined by a medical practitioner carefully to exclude serious infections. (Infections can include meningitis, urinary tract infection or pneumonia)
Link to NQF: Quality Area 2 Children’s health and safety
Standard 2.1 Each child’s health and physical activity is supported and promoted.
Element 2.1.2 Effective illness and injury management and hygiene practices are promoted and implemented.
Source: Ed & Care Services National Regulations, Staying Healthy, 5th ed., QLD Health Guidelines, National Health Medical Research Council (NHMRC)
Form Reviewed: December 2020