Know

Child and youth programs are natural environments for the transmission of infectious diseases; you could go so far as to say they are germ incubators. With all the runny noses, toileting, touching, picking, and mouthing that occurs within child care and learning programs, it's surprising that anyone is healthy. Your best defense against the spread of infectious diseases is a strong offense. Your actions support wellness when you maintain a clean environment (see Lesson One) and assure staff and children in your program practice good hygiene.

When it comes to reducing the spread of disease, nothing is as effective as washing our hands. Classrooms stay healthier when everyone engages in this germ-fighting activity. Staff must constantly model and discuss handwashing with the children in your program. When handwashing occurs as it should, children and youth will be healthier and staff will miss fewer days of work.

洗手是一种实践,每个人都在你program can do to prevent the spread of illness. However, many staff members will not have been trained in proper handwashing procedures. You will need to make sure that staff members know the best ways and times to wash their hands. This information is detailed below.

For handwashing to be effective, proper procedures must be followed. Every step of the handwashing procedure is important to the whole process, and a missed step can cause re-contamination and the spread of germs. Wash your hands with liquid soap for at least 20 seconds, and always turn off the faucet with a paper towel. Discuss with your staff when and under what conditions staff members or children may use alcohol-based hand sanitizers (i.e., on field trips when water is not available). A poster showing proper handwashing procedures should be posted by every adult and child sink for reference (see Apply attachments). In addition, handwashing supplies should always be well stocked and accessible.

工作人员可以为彼此和儿童建模健康习惯。确保在适当的时间内洗手（例如，每次输入课堂或程序时），并且您始终遵循适当的洗手程序。查看下面的全部列表，提供者应该洗手。您在适当的时间内遵守您的手为您的其余工作奠定了强烈的榜样。适当的洗手是一项活动，应该在所有年龄段的儿童课堂上定期发生;它应该是习惯的。您的员工教孩子的技能也可以帮助将这些实践带回家。最近的一项研究表明，在使用公共洗手间后，只有31％的男性和65％的女性洗手。（犹大等，2009）。

In addition to washing hands when they are visibly soiled, there are specific times when handwashing is especially important. The American Academy of Pediatrics recommends the following:

Young children will need much guidance in learning how to wash their hands appropriately and infants and young toddlers will need physical assistance to complete the task. Check out the Apply section for handwashing materials you can share with staff. Work with your trainers and coaches to ensure all staff members know how to properly support handwashing with the children in their care. For toddlers, preschoolers and school-age children, encourage staff members to construct their own handwashing posters with the children's help, so that all members of the classroom or program community know what to do. Children are sometimes more inclined to appropriately follow an important routine like handwashing if they see themselves or their friends in the pictures, or if they help create the words.

标准和通用预防措施

减少可引起感染的微生物（细菌）传播风险的另一种方法是练习标准或普遍的预防措施。标准预防措施涵盖了您可以接触到体液的所有情况，但通用预防措施专门应用于与血液接触，并且不适用于与粪便，鼻腔分泌物，痰，汗液，泪液，尿液，唾液或呕吐物接触，否则这些体液还含有血液。在儿童保育设置中，标准预防措施涉及使用屏障，以防止与另一个人的身体流体接触，以及清洁和消毒受污染的表面。您可以阅读更多关于标准预防措施的更多信息标准和通用预防措施as they Apply to Child Care Settingsfact sheet attached.

Barriers you or staff members might use to help prevent bodily fluid contact might include:

• 耐湿的一次性尿布表纸
• Disposable towels
• 手套
• 塑料袋，牢固密封

员工应该始终使用一次性无孔gloves when blood or body fluids containing blood may be involved. Gloves are optional for diapering and contact with other bodily fluids described above, but adhere to your Service or program guidelines regarding the use of gloves. Gloves are not necessary for feeding human breast milk.

每当穿戴手套，都要确保员工练习良好的手动卫生;戴手套不会在任务完成后删除需要适当洗手。还附有用于减少污染的手套的适当程序。

Coughing and Sneezing

呼吸道感染和细菌通过咳嗽和打喷嚏。除了咳嗽或打喷嚏后的洗手，这里还有一些简单的方法，可以减少那些空气毒细菌的传播：

• Cough into your elbow instead of your hand. Older toddlers can be shown this technique, but know they might not remember to do it all the time. Model this practice to help them start healthy practices.
• Cover sneezes with a disposable tissue if one is available. Dispose of tissues in a hands-free trash can.

保持组织从所有项目领域。Encourage staff to take tissues outside to reinforce that healthy habits happen regardless of location. Used tissues should be disposed of immediately, and children should wash their hands after coughing and sneezing. Staff should model these behaviors to help children learn. Proper handwashing after sneezing, coughing into your hand, blowing your nose, or after helping a child who has sneezed is important to maintain a healthy environment and to avoid the spread of disease.

Cuts, Scrapes, and Sores

As wounds heal, they might drip, ooze, or drain. These fluids can spread infection and the wound itself also is susceptible to infection. The American Academy of Pediatrics (2011) recommends covering and containing any wound that is leaking. If the wound is so severe or big that it cannot be contained, the child or adult should stay home until a scab has developed. Hand hygiene is critical before and after a staff member's contact with his/her, another staff-member's, or a child's sores, cuts, or scrapes.

Blood and Other Body Fluids

Blood can carry a variety of pathogens. Bloodborne pathogens include human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Transmission of these diseases in child care is rare. They are most frequently transmitted through needle sticks or when blood or other body fluid enters the body through eyes, nose, mouth, or broken skin. These diseases are not spread through saliva, sweat, or vomit. Casual contact like hugging, sharing a cup, using a public restroom, or coughing and sneezing do not spread bloodborne diseases.

However, to promote hygiene practices and decrease the chance of contracting various infectious diseases, all staff members should wash their hands before and after helping a child or another staff member who has been injured, and after handling bodily fluids of any kind (i.e., mucus, blood, vomit, saliva, urine). Staff members should wash their hands immediately after contact with blood, body fluids, excretions, or wound dressings and bandages.

Supervise & Support

Management Practices That Promote Proper Hygiene

The chart below summarizes your key responsibilities in terms of promoting hygiene.

Management Practices		Staff Practices
I should always…	To ensure	Staff never…
Ensure that staff are trained on proper handwashing technique and timing, for both themselves and the children.		Contribute to the transmission of infectious disease because they aren't appropriately washing their hands 未能教孩子何时以及如何适当地洗手。
Ensure enough handwashing supplies or other hygienic supplies (e.g., tissues, gloves) are available in all relevant program areas.		由于缺乏材料而无法遵循适当的洗手技术或预防措施。
Monitor handwashing procedures at regular intervals and address concerns immediately		Fail to follow policies for healthy hygiene and maintaining a healthy environment
Offer visual reminders (e.g., with posters by program sinks) for proper handwashing technique and timing, and safe hygiene practices (e.g., covering your cough) at relevant places in your program.		Put children and youth at risk of becoming ill because they were not following hygienic practices Feel uncomfortable advising children and families on proper handwashing or hygiene practices

In Summary

When you model healthy habits and set expectations that staff will model healthy habits too, you not only create a healthier today but a healthier tomorrow for everyone in your program.

Healthy Habits