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Draft 5th edition of Staying Healthy in early childhood education and care submission

ID: 
4
Personal Details
Organisation Name: 
Rainbow Childrens Centre
C. Additional Information
Please identify the best term to describe the Organisation: 
Educational institution – Preschool or Primary
E. Submission
Submission methods: 
Online Submission (specific questions)
Online Submission (specific questions)
3. Please comment on the new format , are there aspects that can be improved?: 

The new format is quite good in some ways. Plkease note

  • I like the section about hand washing and using lotions – it is clear and thorough and an improvement on the previous edition
  • I like the clear table re exclusion periods. I also like the logo clarifying when we have to contact the regional Public Health Unit
  • I like the section at the end re the role of the Public Health Unit
  • The section on immunisation follows the formula where authorities refuse to acknowledge that staff and families will refuse to get immunised. It is all very well to tell people and advise people and work with people but we have to have recognition that many families refuse to have a child immunised. That should be discussed in a document like this. (e.g. our centre has about 5% of children deliberately not immunised and I believe at a Byron Bay child care centre near here  about 30% of children are not immunised.) As well the scenario about a non-immunised staff member is very similar to what happened at ourcentre three years ago. However the staff member did not forget or neglect to get immunised. They refused to be immunised. Again the documentshould have addressed this dilemma. We think the current info re immunistaion is unrealistic for this reason.
  • Section re wearing gloves is good and clear
  • Section re cleaning and disinfection is interesting. A centre following these National Medical Health & Research Council recommendations would not have passed the old NCAC Child Care Accreditation as it stood up to the end of 2011. This explanation re cleaning, sanitising, non-use of disinfectant in  most circumstances, use of warm soapy water etc is clear. It is how we operated until our last Accreditation visit when we were found unsatisfactory for cleaning as we followed a routine almost exactly as set out by this document. We were told we were missing a sanitising step and NCAC recommended regular use of disinfectant. Who is right ??
  • Recommendations re use of sunlight as sanitiser are good and swapping over of nappy change mats
  • Monitoring illness in children section is brilliant – very clear and moves us away from measuring a high temperature type approach to lets look at children and decide if they are ill. Very good.
  • However the advice to separate a sick child  from other children is not well thought out. We do not havea  sick room. We do not have separate spaces with observation windows. We do not always have staff to monitor a sick child in a separate area. Few child care centres would have such facilities Children can become more distressed if moved away from the home room where they are secure. This is an example for usof people looking at “best practice” in isolation from the reality of what space and resources and staffing a children’s service has at its disposal. We have a lot of things to take into account and balance in any decision re a sick child and any advice or best practice from NHMRC should be tempered by an acknowledgement of our everyday reality. Isolation of a child may result in  a greatr deal of distres to that child - is that really appropriate ?
  • Section on fever and the need to reduce fever or otherwise is great
  • Record keeping re illnesses is a bit unrealistic. We have to keep such records for 25 years and have them associated with individual children. The sample record of illness as set out would require a centre to copy that onto another format to allow the record to be kept as required. Double handling should be avoided.
  • Hand hygiene section is good
  • Hygienic nappy change section is good but again not in line with current NCAC standards.
  • Pleased to see advice against us of potties(p47). I find them the most disgusting things and don’t see any reason why a children’s service with toilets designed for young children would need to have potties.
  • Advice on wiping noses is interesting (p53) and it not being necessary to use a glove to wipe a child’s nose. Again this is contrary to current NCAC requirements.
  • Decision tree re cleaning of various items (door knobs, handles etc) is interesting and will help services to develop a cleaning policy
4. Are there topics that you would like more information/guidance on infection prevention and control? If yes, please specify.: 
  • Discussion re children’s cooking is interesting but is so brief it perhaps it should not be bothered with at all. There are so many issues re children’s cooking experiences and appropriate hygiene and safety these couple of short paragraphs I don’t imagine will be of much help to anyone.
  • The section re “other considerations” is perhaps well meaning but again written clearly from the viewpoint of people who have never worked in a centre. I ask one simple question – Is children’s health so important that it should override any other factor ( educational, social, child development, staff rights etc) ? Should  every decision be based solely on health criteria and not on educational criteria ? If so then no child should ever be let anywhere near a child care centre. Research suggests                                                                                                                                                                                                                                                          child care centres are a hot bed of disease and cross infection. Any service with more than 3 or 4 children together increases significnatly the possibility of cross infection among children regaless of policies followed. If however there are other factors to be taken into account ( e.g. the socia,l communication and developmental learning that occurs in a centre)   then this type of health advice must be structured in such a way that the qualified educator can balance educational, social, family and health issues together.
  • THis last issue leads to further thought about whether exposing young children to infection is actually such a bad thing. We are disappointed in a general sense that there is no recognition nor discussion about growing evidence that thecurrent obsession with health and hygiene has coincided with higher levels of many diseases in the community – and certainly more evidence among children of asthma and anaphylaxis. There are significant voices saying that our obsession with cleanliness in home, child care centres etc has not been in the best interests of children. Children who are not exposed to various bacteria/ germs /dirt as young children are possibly not as healthy or resilient as those who have been exposed. We believe asthma and anaphylaxis are virtually unknown in third world countries – where all our super hygiene practices are unknown. It makes usthink we are not on the right track. This issue should at least have been addressed in this document.
General Comments
Comments: 
  • Heating bottles in microwaves. Why oh why does this nonsense keep coming up. As quickly as it is dispatched it rears its ugly head again. We challenge NMHRC to come up with any evidence that children are at gerater  risk of scalding in a child care centre that heats bottles in a microwave.  A bottle can be overheated no matter what heating method you use. There is best practice in using baby bottles and that includes shaking bottles to even out temperature after heating, standing it to rest and testing the liquid  before giving it to any child. Any responsible adult does that. If you do so properly, then it does not matter what heating method you use, it will be OK. The idea that a group of experienced qualified early childhood educators cant follow simple procedures like that is an insult to us – it is OK for parents in a home to use a microwave to heat bottlkes but not us halfwits who work childrens services!! RUBBISH!!
  • As well there is no discussion about what alternative heating methods might be used and what are the health and OH&S risks of those heating methods. Staff having a different heating apparatus in a chld care room raises other OH&S issues about such heaters being knocked or pulled over. Staff having to leave  a child care room to go to a kitchen to heat a bottle leaves child :staff rations compromised. Bottles can still be overheated no matter what other heating method is used if the person involbed does not act with care.
  • Sensible professional use of a microwave to heat bottles and procedures to ensure those bottles are not overheated is our job - and we are good at that job.

Page reviewed: 3 September, 2013