MANAGING CHILDREN WHO ARE SICK, INFECTIOUS OR HAVE ALLERGIES

Policy statement

We provide care for healthy children through preventing cross infection of viruses and bacterial infection. We promote health through identifying allergies and preventing contact with the allergenic substance.



Procedures for children who are sick or infectious

·        If children appear unwell during the day – have a temperature, sickness, diarrhoea or pains, particularly in the head or stomach – the manager or Key Person calls the parents and asks them to collect the child, or send a known carer to collect the child on their behalf.

·        If a child has a temperature, they are kept cool, by removing top clothing and sponging their heads with cool water, but kept away from draughts.

·        The child’s temperature is taken using a forehead thermometer strip, kept in the first aid box.

·        In extreme cases of emergency, the child should be taken to the nearest hospital and the parent informed.

·        Parents are asked to take their child to the doctor before they return to nursery. The nursery can refuse admittance to a child who has a temperature, sickness, diarrhoea or a contagious infection or disease.

·        Where children have had sickness or diarrhoea parents are asked to keep them away from nursery for at least 48hours after the last symptoms.

·        Where children have been prescribed antibiotics, parents are asked to keep the child at home for the first 48 hours of taking the medication.

·        The setting has a list of excludable diseases and current exclusion times.

Reporting notifiable diseases

·        If a child or adult is diagnosed as suffering from a notifiable disease under the Health Protection Regulations 2010, the GP will report this to the Health Protection Agency (HPA).

·        When the setting becomes aware, or is formally informed of the notifiable disease, the manager informs OFSTED and acts on any advice given by the HPA.

HIV/AIDS/hepatitis procedure

·        HIV virus, like other viruses such as Hepatitis A, B or C, are spread through body fluids. Hygiene precautions for dealing with body fluids are the same for all children and adults.

·        Single use vinyl gloves and aprons are worn when changing children’s

nappies, pants and clothing that are soiled with blood, urine, faeces or vomit.

·        Protective rubber gloves are used for changing/sluicing clothing after changing.

·        Soiled clothing is rinsed and bagged for parents to collect in the setting.

·        Spills of blood, urine, faeces or vomit are cleared using mild disinfectant solution and mops, any cloths used are disposed of with the clinical waste.

·        Tables and other furniture, furnishings or toys affected by blood, urine, faeces or vomit are cleaned using a disinfectant.

·        Children do not share tooth brushes, which are soaked weekly in sterilising solution (when used).

Nits and head lice

·        Nits and head lice are not an excludable condition, although in exceptional cases a parent can be asked to keep a child away until the infestation has cleared.

·        On identifying cases of head lice, all parents are informed and asked to treat their child and the family if they are found to have head lice.

Procedure for children with allergies

·        When parents start their children at the nursery they are asked if their child suffers from any known allergies. This is recorded on the registration form.

·        If a child has an allergy, a risk assessment form is completed to detail the following:

o   The allergen (i,e, the substance, material or living creature the child is allergic to)

o   The nature of the allergic reactions e.g. anaphylactic shock reaction, including rash, reddening of skin, swelling, breathing problems etc.

o   What to do in case of allergic reactions, any medication used and how it is to be used (e.g. Jext pen).

o   Control measures – such as how the child can be prevented from contact with the allergen.

o   Review

·        This form is kept in the child’s personal file and a copy is displayed where staff can see it.

·        Nurse educators train staff in how to administer special medication and devices in the event of an allergic reaction.

·        Generally, no nuts or nut products are used within the setting.

·        Parents are made aware so that no nuts or nut products are accidentally brought in, for example to a party.

Insurance requirements for children with allergies and disabilities

·        The insurance will automatically include children with any disability or allergy, but the procedures set out below must be adhered to at all times. For children suffering life threatening condition, or requiring invasive treatments, written confirmation from the insurer will be required before the child can begin attending the nursery.

Oral medication

·        Asthma inhalers are regarded as ‘oral medication’ by insurers.

·        Oral medications must usually be prescribed by a GP or other health professional.

·        Parents must provide the nursery with clear, written instructions on how to administer such medication.

·        All risk assessment procedures need to be adhered to for the correct storage and administration of the medication.

·        The setting must have the parents’ prior written consent. This consent must be kept on file.

·        In exceptional circumstances, and entirely at the discretion of the nursery manager, we may be prepared to administer certain non prescription medication, e.g. Calpol. Written permission and details of the medicine to be given will always be required.

Life-saving medication and invasive treatments

Adrenaline injections (epipen, jext) for anaphylactic shock reactions (caused by allergies to nuts, eggs etc.) or invasive treatments such as rectal administration of Diazepam (for epilepsy).

·        The nursery must have:

o   A letter from the child’s GP/consultant stating the child’s condition and what medication if any is to be administered.

o   Written consent from the parent allowing staff to administer medication; and

o   Proof of training in the administration of such medication by the child’s GP, a District Nurse, children’s Nurse Specialist, Community Paediatric Nurse or Nurse Educator.

Key person for children with special needs – children requiring assistance with tubes to help them with every-day living, e.g. breathing apparatus, to take nourishment, colostomy bags etc.

·        Prior written consent must be obtained from the child’s parent to give treatment and/or medication prescribed by the child’s GP.

·        The Key Person must have the relevant medical training/experience, which may include those who have received appropriate instructions from parents, or who have qualifications.

·        Copies of all letters relating to these children must first be sent to the insurer for appraisal. Written confirmation that the insurance has been extended will be issued by return.