ILLNESS POLICY

RATIONALE

Mātua (parents/caregivers) and Kaiako (teachers) share the responsibility for creating a healthy Centre environment, which will protect and nurture tamariki (children). Exclusions of tamariki who are unwell and/or have infectious diseases from Early Childhood Centres is necessary where there is potential for further spread of infection.

PURPOSE

The purpose of this policy is to keep tamariki, staff and whānau safe from illness and infection by clearly stating under what circumstances a tamaiti should be excluded for their own health and wellbeing as well as the health and wellbeing of others in the Centre. This policy outlines when tamariki should be kept home, what happens when a tamaiti becomes unwell at the Centre and the systems we have in place to keep everyone as protected and healthy as possible.

REFERENCES AND REGULATIONS

Te Whāriki (2017): Well-being/Mana Atua:

Children experience an environment where: Goal 1 - Their health is promoted.

            Goal 3 - They are kept safe from harm.

Education (Early Childhood Services) Regulations 2008:

• 46 (1): The health and safety practices standard: general is the standard that requires every licensed service provider to whom this regulation applies to –

(a) take all reasonable steps to promote the good health and safety of children enrolled in the service; and

(b) take all reasonable precautions to prevent accidents and the spread of infection among children enrolled in the service.

Licensing Criteria for Education & Care Services 2008 and Early Childhood Education Curriculum Framework (amended 2022):

• HS26: All practicable steps are taken to ensure that children do not come into contact with any person (adult or child) on the premises who is suffering from a disease or condition likely to be passed on to children and likely to have a detrimental effect on them. Specifically:

• The action specified in Appendix 1 is taken for any person (adult or child) suffering from particular infectious diseases: and
• Children who become unwell while attending the service are kept at a safe distance from other children (to minimise the spread of infection) and returned to the care of a parent or other person authorised to collect the child without delay.

• HS27: All practicable steps are taken to get immediate medical assistance for a child who is seriously injured or becomes seriously ill, and to notify a parent of what has happened.

Te Whatu Ora (Health New Zealand)/Regional Public Health: www.tewhatuora.govt.nz

PROCEDURES

Always call 111 in an emergency

Immunisations

• Te Whatu ora/Health New Zealand requires all licensed early childhood education providers to sight and record every tamaiti immunisation history. Tamariki immunisation certificates/records need to be sighted as accurate by your health care professional. These records are confidential.
• The Centre will keep an immunisation register. In the case of an outbreak, any tamaiti who is not immunised will be excluded from the Centre until the incubation period of the disease has passed and no further cases have been reported.
• The immunisation register will be created on enrolment and will be updated as tamariki receive immunisations.
• It is required that mātua bring in immunisation records as they are updated. Curious Minds Early Learning will periodically audit records and ask for updates of any missing records.
• If a tamaiti attends the Centre after an immunisation, mātua must inform a kaiako, including whether they have had pain relief, so they can monitor the wellbeing of the tamaiti appropriately.

Exclusion

• All persons (tamariki, staff and whānau) suffering from an infectious disease will be excluded from the Centre, as per the guidance of ‘Infectious Diseases: Information & Exclusion List’ (Appendix 1).
• In cases of vomiting and/or diarrhoea the person will be excluded until 48 hours after the last episode.
• Tamariki experiencing high temperatures, 38°C or over, need to stay absent from the Centre for 24 hours after their temperature has returned to a normal range (36.5°C – 37.5°C) and not be reliant on pain relief. This is to prevent the transmission of infection to other persons, as tamariki may still be infectious but appear well.

In the event of an outbreak of an illness in our community, we may initiate exclusion procedures for individual or first-time symptoms to protect the health and well-being of all members of the community.

Decisions on exclusion for illnesses and conditions will be based on the recommendations of Te Whatu Ora/Health New Zealand, "Nga Kupu Oranga" (Healthy Messages- Appendix 1), or on the advice of Regional Public Health – Hutt Valley District Health Board or Public Health South.

General conditions indicating that a tamaiti should not attend the Centre:

• The illness prevents the tamaiti from participating comfortably in the day-to-day routines and customs within the Centre.  This is including outdoor play and experiences.
• The illness results in greater care required than the Centre can reasonably provide without compromising the health and safety of other tamariki.
• The tamaiti has any of the following conditions: fever (high temperature), persistent crying, difficulty breathing or other signs of severe illness or infection.
• Diarrhoea: Tamariki cannot attend if they have diarrhoea. If a tamaiti experiences 2 or more loose motions within a day they need to stay home. They must have also passed at least one normal bowel motion before returning to the Centre. Tamariki must remain home a minimum of 48 hours after the last abnormal bowel motion.
• Vomiting in the previous 48 hours.
• Unexplained rashes are to be verified (by a GP or medical officer of health, e.g. nurse), as non-infectious or contagious.

When tamariki become ill at the Centre:

• Our Centre protects all tamariki and staff from cross infection.  When a tamaiti becomes ill at the Centre, we will keep them in a designated, safe, and separate area, and ask mātua to collect their tamaiti as soon as possible.
• When mātua are called to collect their tamaiti, kaiako will ask for a timeframe in which they will arrive. Tamariki who are sent home due to illness must be picked up within a reasonable timeframe. If mātua cannot pick up their tamaiti within a reasonable timeframe, they must arrange for an alternative contact person who can pick up the unwell tamaiti swiftly.
• If the Centre is unsure what to do, we will contact the doctor of the tamaiti or call the Healthline on 0800 611 116 and ask for advice. If the tamaiti becomes seriously unwell and shows signs of rapid deterioration, 111 will be called immediately.
• The Centre maintains a list of allergies for children attending. All staff have ready access to the list and are trained in the use of relevant medications in the event of an allergic reaction.
• Curious Minds Early Learning has a Medicine policy and detailed Medicine registers and ensures staff understand and follow them.
• When a tamaiti soils their clothing, they will be sensitively changed and cared for as per the ‘Sick and Soiled procedure’ (Appendix 2).
• Vomit/diarrhoea will be hygienically cleaned using the ‘Sick and Soiled procedure’ (Appendix 2).
• Medicines may only be given with the written authority of mātua or, in an emergency, by a qualified Doctor or ambulance staff.
• A record of the illness is recorded in both the ‘Accident/Incident Notification form’ and ‘Illness Register’.

High Temperatures:

• In the event of a tamaiti having a high temperature, 38°C or higher, while at the Centre, kaiako will attempt to cool them down by removing layers of clothing and encouraging them to rest and drink water. Kaiako will use a tepid (damp, room temperature) cloth to cool their body while comforting them in the isolation area and monitoring them consistently.
• The temperature of the tamaiti will be checked every 10-15 minutes and recorded on the ‘Accident/Incident form’. If, after 20-30 minutes (3 temperature readings) the high temperature hasn’t returned to a normal level, their mātua will be contacted and asked to collect them immediately. Any temperatures of 40°C or higher require immediate medical attention and an ambulance may be called. In this instance mātua will be called immediately regardless of the timeframe and number of temperature readings.

Conjunctivitis:

• In the event of a tamaiti having conjunctivitis- while there is discharge from the eye they are classified as contagious and are excluded from the Centre.  Conjunctivitis presents a significant risk of infection to others and can also be very uncomfortable for tamariki. The tamaiti must have had 24 hours of eye drops and be free from discharge and redness before they can return to the Centre safely. If kaiako notice discharge coming from the eyes of tamariki, they will clean the discharge away from the eye/s. If it returns conjunctivitis will be suspected, the tamaiti will be isolated away from other tamariki and mātua will be called immediately so that they can be collected and medical treatment sort.

Hand, Foot and Mouth Disease:

• In the event of a tamaiti having hand, foot and mouth disease- while they have fresh spots/blisters present on their skin they are classified as being contagious and are excluded from the Centre. Hand, foot and mouth disease is a highly contagious viral infection and presents a significant risk of infection to others. Other symptoms can include high temperatures, sore throat, headaches, loss of appetite and fatigue. If spots/blisters are detected on a tamaiti while at the Centre, they will be isolated away from other tamariki. Mātua will be called so that they can be collected from the Centre immediately and confirmation from a doctor sort.  Tamariki with hand, foot and mouth disease may only return to the Centre once their spots/blisters have either gone or dried up/scabbed over and they are well again. This can take up to 7-10 days.

Ongoing Medical Needs:

• Tamariki with ongoing medical needs are required to have an individual medical plan completed by their Doctor or mātua as per the Medication policy.
• We will work with mātua to identify needs for staff training and to develop plans for providing the best care at all times. Training will be documented.

Illness Prevention:

• Hygiene and cleaning routines support the health and wellbeing of everyone at the Centre. Tamariki are encouraged to cover their mouth and nose with tissues or their elbow when coughing and sneezing, and to avoid touching their face.
• Any notifiable diseases are reported to Te Whatu ora/New Zealand Health.
• Staff and whānau are informed of health warnings and how to recognise signs of any illnesses for which we receive Ministry notifications.
• Whānau will be notified if there have been three or more cases of vomiting/diarrhoea, conjunctivitis, hand, foot and mouth disease or any other infectious illness in the Centre community.

Record Keeping:

All illnesses involving tamariki and staff members at the Centre or reported from members of our learning community are recorded on our ‘Illness Register’.  The Illness register helps us identify any patterns/contagious illnesses. This register is reviewed on a regular basis (as each new illness is recorded) and shared with Regional Public Health or Public Health South in the event of an illness outbreak.

Outbreak Procedure:

These procedures must be followed whenever there is an outbreak of any infectious (most often) gastrointestinal disease. An outbreak is three or more cases (tamariki or staff) in one area (e.g. under-twos room) showing similar symptoms of illness in 48 hours OR 15% of the Centre are unwell. As outbreaks can occur in separate areas, the outbreak procedure can be carried out in isolated classrooms not effecting others unless it spreads Centre wide.  

In the event of an outbreak:

• All whānau and staff (including cleaning staff) will be notified of an outbreak in the Centre and that the ‘Outbreak Procedure’ has been activated.
• All whānau and staff are to use hand sanitizer upon entering and leaving the building. Hand sanitizer dispensers are conveniently located at reception and near room doors.
• All staff are to be vigilant with hand washing at all times for themselves as well as for tamariki, ensuring they are washing hands before and after mealtimes and after toilet use, washing thoroughly and with soap.
• Tamariki presenting with symptoms are to be sent home immediately. Unwell tamariki are to be kept a safe distance away from other tamariki until they have been collected by a mātua.
• Mātua are to keep children home until 48 hours after symptoms have stopped. Staff are to be vigilant and ensure mātua adhere to this. No Exceptions.
• All water play, sand play, messy play, baking and play dough activities are to stop during the outbreak.
• Only a small number of toys are to be put out for tamariki to play with. These are to be rotated over a period each day. When one lot of toys comes off the floor they are to be washed with hot soapy water, sanitized by wiping with a bleach solution or put through a dishwasher cycle. The type of toys are to be considered during this time. Easy to clean resources are preferable.
• Kaiako are to serve all food during the outbreak, tamariki are not to serve themselves. Kaiako are to use hand sanitizer and wear gloves before serving food.
• Whānau who use re-usable cloth nappies will be asked to cease using these during an outbreak and disposable nappies will be required.
• During the outbreak sanitizing solutions (Sterigene) will be diluted at a higher concentration of 1:100. Normal solution is 1:200.
• All bench tops, taps, door handles and toilets will need to be cleaned at lunch time using a 1:100 sanitizing solution.
• Changing mats are to be wiped down us usual with the cleaning/sanitizing solution (Sterigene) between each change.
• All soiled clothing is to be placed in a sealed plastic bag and kept in the laundry. Mātua will need to collect clothing from there (See Appendix 2).
• The changing area is to be kept clear, nothing within touching distance for the tamariki.
• Gloves (and possibly masks) are to always be worn by teachers when changing tamariki. Once the tamaiti has been changed, kaiako are to remove gloves and wash theirs and the hands of the tamaiti thoroughly with soap.
• If cases spread to 15% or more of the Centre (staff included), Regional Public Health or Public Health South are to be notified.

Head Lice Procedure

• If tamariki have head lice or eggs in their hair they are excluded from the Centre until treatment has been administered and they no longer have lice or eggs in their hair.
• Kaiako will ask to check the hair of tamariki where scratching/itching is identified as a possible contagious risk.
• If a tamaiti is found to have head lice or eggs:

1. Their hair will be tied up if possible.

2. The tamaiti will be isolated from others in an isolation area as head lice can spread easily from one person to another by direct head-to-head contact.

3. Kaiako will use a sensitive approach to ensure their self-esteem/self-image is not damaged.

4. Mātua will be contacted by a kaiako and asked to collect their tamaiti from the Centre so that treatment can be given at home.

5. Upon arrival to collect their tamaiti, Mātua will be given information from Te Whatu Ora on headlice.

6. The Centre will hot wash their bedding (if applicable) and all hats.

7. Dress up clothes will be hot washed and may be removed temporarily if an outbreak is detected.

8. If an outbreak of headlice occurs, whānau will be informed via email and information attached.

‍

Tamariki will be excluded from attending the Centre until treatment has been received and there are no longer eggs or lice, in their hair.