Know

All staff members who work with children are required to complete training in to learn how to help prevent the spread of infectious disease. Often, a nurse or health care professional provides this training. You can help support staff members' learning. Make sure you are familiar with the resources related to infectious disease provided in this Healthy Environments course.

You will also need to teach staff members how to model healthy habits related to infectious disease. For example, make sure staff members know how to cover their coughs and proper glove-wearing procedures. Provide ongoing training around standard and universal precautions (see Lesson Two): glove-wearing, cleaning and disinfecting procedures, etc.

You will also need to make sure staff know how to perform and document daily health checks. This includes recognizing when a child experiences illness or a health concern. Make sure new staff members know your program's exclusion policy. You may be called to help a staff member make a decision about whether a child is ill and needs to be sent home (see theWhen Should A Child Be Sent Homeresource in the Learn Activities section below). You must also be familiar with the signs and symptoms of common infectious diseases (see theSigns and Symptoms Chart,also in the Learn Activities section below) and your program's policies. You may also be responsible for communicating with families when certain infectious diseases occur in your program. Be prepared to make sure staff members follow exclusion and readmission policies themselves: sick staff members can spread illnesses, too.

Model

模型实践，防止传染病传播。遵循疾病控制和预防的中心，以覆盖咳嗽和洗手（课程二节）。您还可以模拟与儿童谈论健康习惯。例如，如果孩子在课堂上打喷嚏，请提醒他们孩子洗手。您还可以帮助工作人员记得在擦拭孩子的鼻子后清洗自己的手和孩子的手。请善意提醒员工，培训师，教练，采取措施防止疾病的传播。这有助于促进您的计划中的健康习惯文化。

当一个员工嫌疑人生病时，你可能会被调用。准备进行健康检查，寻找疾病的迹象（请参阅下面的探索活动资源，了解有关进行日常健康检查的更多信息）。遵循您的计划的排除程序和入住。在发生紧急情况或疾病的情况下，在血液，呕吐物，尿液或粪便等体液存在下模型适当的卫生程序。在这些情况下保持冷静，帮助员工使用他们的培训。您可能还需要监督儿童，而工作人员应对紧急情况。

传染病预防

The transmission of disease can be greatly reduced by using the following precautions:

• Cover sneezes and coughs properly
• Proper handwashing
• Proper diapering procedures
• Thorough sanitation techniques
• 防止与体液接触的注意事项
• 免疫

Signs of Illness

To prevent the spread of infectious disease in your program, it is important that staff monitor all children and youth daily. This monitoring should be done by completing health checks for each child as they enter the program and also throughout the day. As the program manager, it is your responsibility to ensure your staff know what signs of illness to look for in children. Staff should look for the following:

• Changes in behavior, such as drowsiness or sluggishness
• Changes in appearance from the previous day
• Skin rashes, itchy skin and scalp
• Rise in body temperature
• Complaints of pain, not feeling well
• Drainage from eyes
• Vomiting, diarrhea
• Severe coughing
• Difficult or rapid breathing
• Sore throat, difficulty swallowing
• Yellowish skin or eyes
• Unusually dark urine or grey, white stool
• Stiff neck with elevated temperature

If a child demonstrates signs of illness, you will be required to take the proper actions to support and protect the child and your program.

Policies for Caring for Ill Children

Unless your program includes a provision for the care of sick children and youth, children who show signs of illness need to be isolated from the other children until they are picked up.

Children and youth must be supervised at all times, so you may elect to have sick children and youth removed to an office and placed on a cot or crib until their family arrives. You must ensure that your staff understands what your program's policies are when it comes to caring for ill children and youth. Staff should take care to wash hands and wash any soiled bedding and used cots or cribs after use by an ill child.

If a health care professional determines that a child is ill with a contagious disease, then families of all the children and staff members who were exposed should be notified. This can be done at the end of the day during pick-up time by a note or memo. The ill child's confidentiality should be maintained and only information regarding the disease, not the ill child's name, should be shared. Check your program's policies for the distribution of notes to families.

您的计划应通知与患有以下条件之一的儿童接触的儿童的员工和家庭通知：

• Meningitis
• Pertussis (whooping cough)
• Invasive infections such as strep
• Chickenpox
• Skin infections or infestations (head lice, scabies, and ringworm)
• Infections of the gastrointestinal tract (often with diarrhea) and hepatitis A virus (HAV)
• Haemophilus influenzaetype B (Hib)
• Fifth disease (parvovirus B19)
• Measles
• Tuberculosis

如果与该设施相关的两个或更多相关的人感染疫苗可预防或传染病，还应通知家庭和工作人员。

如果这些疾病或条件之一是suspected in your classroom, your program will need to notify all families and staff who have come in contact with the child or children. This notification should include (Caring for our Children, 2015):

• The names, both the common and the medical name, of the diagnosed disease to which the child was exposed, whether there is one case or an outbreak, and the nature of the exposure (such as a child or staff member in a shared room or facility)
• Signs and symptoms of the disease for which the parent/guardian should observe
• Mode of transmission of the disease
• Period of communicability and how long to watch for signs and symptoms of the disease
• 卫生部门推荐的疾病预防措施（如果是合适的话）
• Control measures implemented at the facility
• 皮肤病变或皮肤状况的图片可能对父母或监护人有所帮助（例如，鸡痘，扁桃体上的斑点等）

In some cases, you may need to contact medical professionals or public health officials. There are certain illnesses that are considered "reportable illnesses." Your program will need to follow health guidelines to notify families and staff about the occurrence of these types of illness. A list of reportable illnesses is updated annually by the Centers for Disease Control and Prevention (CDC) and is available athttps://wwwn.cdc.gov/nndss/conditions/notifiable/2018/.

Exclusion and Readmission

As a program manager, it is critical that you apply your exclusion and readmission policy consistently. Infectious disease guidelines from your program's Public Health and Program Medical Advisor may require that children be excluded from your program for 24 to 48 hours. You need to be well versed in the requirements for your local area. Some outbreaks require notification to the health department or your local medical authority. Some illnesses may require a physician's note for re-entry to your program. Your policy should reflect these exclusion parameters.

在你的程序应该是疾病传播tracked and reported to your local medical authority as appropriate. If a pattern of outbreaks emerge from the tracked information, you will need to work with your staff to implement new training or provide additional supports to prevent future outbreaks.

Families must be reminded of your policies when they pick up an ill child or if they call the program to report an absence. Your program's exclusion and readmission policies should be covered in your family orientation process as well as included in your family and staff handbooks.

Many people within your program are responsible for various functions that help ensure the program is free of infectious disease. As a manager, you must be diligent to make sure staff follow and support your program's illness-related policies.

免疫

需要免疫是预防传染病的重要策略。大多数计划要求儿童和青少年在入学时或在一定数上招收后的一定天，并要求免疫持续到最新。您和您的员工需要清楚您的计划关于免疫更新的政策。由于家庭需要时间来制作医生预约并转向形式，您应该在需要至少60天之前提供表格，并在返回表格之前向家庭提供一些常规提醒。一定要保留卫生保健提供者的电话号码，并在家庭档案上保健提供者和免疫诊所。

有些家庭有宗教或文化异议，让孩子或青年免疫。如果发生疫苗可预防的传染病爆发，您的计划可能要求所有未接种疾病疫苗的儿童都被剥夺。作为经理，您有责任知道如何识别那些没有免疫和执行拒绝护理的儿童。您和您的员工至关重要，您可以控制疾病的传播和保护尚未对某种疾病产生免疫力的儿童。根据您的策略检查这些家庭的任何津贴。

It is important to keep copies of the most current immunization records and check them against the schedule on the Centers for Disease Control and Prevention website athttp://www.cdc.gov/vaccines/schedules/index.html. In addition to children and youth, you need to ensure that staff are up-to-date on required immunizations. Just as you do for families, remind staff at least 60 days before they may need immunization updates.

As a program manager, you must also consider how you will address issues of non-compliance in this area. How will you respond if a family or a staff member does not return the necessary documentation to update their child's, or for staff, their own, immunization record? Remember to address such issues respectfully, while keeping in mind that you must ensure the health and safety of all children, families and staff within your program. You will likely need to deny care or employment until the necessary documentation is returned.

监督和支持

Implement a Health-Related Tracking System

审查您对儿童和工作人员免疫的政策，并保持最新的国家要求。作为程序管理器，您必须确保维护适当的免疫跟踪系统。此外，当您监控程序和地址问题时，它非常重要，以确保进行可靠的跟踪系统以确保进行更改和改进，并通过完成。无论您选择使用的系统，确保它是为您的程序工作的。

The Program Administration Scale is an assessment tool created by McCormick Center for Early Childhood Leadership and is one way of assessing the administration of child care programs. It sets the establishment of "systems" as an indicator of a high-quality program. As you have learned in previous lessons, systems help you in the tracking and implementation of policies and procedures; which ultimately keeps everyone safe and healthy.

One system for tracking immunization records is a tickler system, which identifies the immunizations that need to be updated. Such a system helps alert you, or other staff members on your team, to future deadlines, preventing files or updated paperwork from being neglected. Files could be color-coded by month or information could be put into a spreadsheet and organized by date. Another tickler system might involve ordering the information in an index card file or entering it into a calendar program.

支持预防传染病的管理实践

The chart below summarizes your key responsibilities when it comes to managing infectious disease.

Management Practices		Staff Practices
I should always…	确保	工作人员永远不会......
Make certain that staff are trained on our policies for managing infectious disease		Contribute to the transmission of infectious disease because they do not maintain a healthy environment or adhere to healthy practices 忽视日常健康检查 Care for ill children and youth inappropriately Fail to report an outbreak of an infectious disease
Monitor the sanitary conditions throughout the program daily and address concerns immediately		未能遵循政策,以保持健康的environment
Implement our exclusion and readmission policy consistently		Allow sick children and youth to remain in their classrooms where they can infect other children
Communicate verbally and in writing (family and staff handbooks) our policies for managing illness		Put children and youth at risk of becoming ill because they were not following written procedures 感觉不舒服建议说在我们的家庭m's policies

Managing Infectious Disease