你知道吗

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.

您还需要教人员如何模拟与传染病相关的健康习惯。例如，确保工作人员知道如何覆盖他们的咳嗽和适当的手套佩戴程序。提供围绕标准和普遍预防措施的持续培训（参见第两节）：手套穿着，清洁和消毒程序等。

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 the什么时候该送孩子回家以下学习活动部分的资源）。您还必须熟悉常见传染病的症状和体征（参见迹象和症状图表，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

Model practices that prevent the spread of infectious diseases. Follow the Centers for Disease Control and Prevention's guidelines for covering your cough and handwashing (Lesson Two). You can also model talking to children about healthy habits. For example, if a child sneezes while you are in a classroom, remind them child to go wash their hands. You can also help staff members remember to wash their own hands and the child's hands after wiping a child's nose. It's OK to kindly remind staff members, trainers, and coaches to take steps to prevent the spread of disease, too. This helps promote a culture of healthy habits in your program.

You might be called when a staff member suspects a child is ill. Be prepared to conduct a health check and look for signs of illness (see the Explore Activity resources below for more information on performing daily health checks). Follow your program's procedures for exclusion and readmission. In the event of an emergency or illness, model proper sanitation procedures in the presence of body fluids like blood, vomit, urine, or feces. Remain calm in these situations and help staff use their training. You might also need to supervise children while staff members respond to the emergency.

Infectious Disease Prevention

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

• 覆盖打喷嚏并咳嗽得当
• Proper handwashing
• 正确的尿布程序
• Thorough sanitation techniques
• Precautions against contact with bodily fluids
• Immunizations

疾病的迹象

为了防止在您的计划中传播传染病，工作人员每天监控所有儿童和青少年。应通过完成每个孩子的健康检查，因为他们进入该计划而且整个日期都应该通过完成健康检查来完成。作为方案经理，您有责任确保您的员工知道在儿童中寻找的疾病迹象。工作人员应该寻找以下内容：

• Changes in behavior, such as drowsiness or sluggishness
• Changes in appearance from the previous day
• 皮疹，皮肤瘙痒皮肤和头皮
• Rise in body temperature
• 抱怨疼痛，感觉不舒服
• Drainage from eyes
• 呕吐，腹泻
• Severe coughing
• 呼吸困难或急促
• 喉咙痛，吞咽困难
• Yellowish skin or eyes
• 不寻常的黑尿或灰白色大便
• 颈部僵硬伴高温

如果孩子有生病的迹象，你将被要求采取适当的行动来支持和保护孩子和你的计划。

照顾生病儿童的政策

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.

必须随时监督儿童和青少年，所以你可能会选择把生病的孩子和青春移到办公室，并将其放在婴儿床或婴儿床上，直到他们的家庭到达。您必须确保您的员工了解您的计划的政策是关注生病的儿童和青年时的政策。工作人员应注意洗手，并在生病儿童使用后洗净任何污染的床上用品和使用的婴儿床或婴儿床。

如果卫生保健专业人员确定一名儿童患有传染病，则应通知所有受感染儿童的家属和工作人员。这可以在一天结束的提货时间通过便条或备忘录完成。应为患病儿童保密，只应分享有关疾病的信息，而不应分享患病儿童的姓名。检查您的计划中有关向家庭分发笔记的策略。

Your programs should notify the staff and families of children who have come into contact with a child who is ill with one of the following conditions:

• Meningitis
• 百日咳
• 侵袭性感染，如链球菌
• Chickenpox
• 皮肤感染或侵扰（头虱，疥疮和癣）
• 胃肠道感染（常伴有腹泻）和甲型肝炎病毒（HAV）
• 流感嗜血杆菌b型（hib）
• 第五病（Parvovirus B19）
• 麻疹
• 肺结核

Families and staff should also be notified if two or more unrelated persons affiliated with the facility are infected with a vaccine-preventable or infectious disease.

If one of these diseases or conditions is 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
• 疾病的传播方式
• 可传播的时期以及观察疾病症状和体征的时间
• Disease-prevention measures recommended by the health department (if appropriate)
• 设施实施的控制措施
• Pictures of skin lesions or skin condition may be helpful to parents or guardians (e.g., chicken pox, spots on tonsils, etc.)

在某些情况下，您可能需要联系医疗专业人员或公共卫生官员。有些疾病被认为是“可报告的疾病”。您的计划需要遵循健康指南，将这些疾病的发生通知家庭和员工。疾病控制和预防中心（CDC）每年更新一份可报告疾病的清单，可在https://wwwn.cdc.gov/nndss/conditions/notified/2018/.

排除和入院

作为计划经理，您至关重要您始终如一地应用排除和入住策略。课程公共卫生和计划医疗顾问的传染病指南可能要求将儿童从您的计划中排除24至48小时。您需要在您当地的要求中熟悉。一些爆发需要向健康部门或当地医疗权威通知。有些疾病可能需要医师的注意重新进入您的计划。您的策略应反映这些排除参数。

应酌情跟踪和向当地医疗管理局进行追踪并报告疾病。如果爆发的模式从履带式信息中出现，您需要与您的员工合作，以实施新的培训或提供额外的支持，以防止未来的爆发。

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.

你的项目中有许多人负责各种功能，以确保项目没有传染病。作为一名管理者，你必须努力确保员工遵守并支持你项目的疾病相关政策。

Immunizations

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。

Some families have religious or cultural objections to having their children or youth immunized. In the event of an outbreak of an infectious disease that is preventable by vaccine, your program may require that all children who are not vaccinated against the disease be denied care. As the manager, it is your responsibility to know how to identify those children who are not immunized and to enforce the denial of care. It is essential that you and your staff do all you can to control the spread of disease and to protect children who have not yet developed an immunity to a certain disease. Check for any allowances for these families based on your policies.

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.

作为项目经理，您还必须考虑如何解决该领域的不合规问题。如果一个家庭或一个工作人员没有返回必要的文件来更新他们的孩子，或工作人员，他们自己的免疫记录，你将如何回应？记住要尊重地解决这些问题，同时要记住，你必须确保你项目中所有儿童、家庭和工作人员的健康和安全。你可能需要拒绝照顾或就业，直到必要的文件返回。

Supervise & Support

实施健康相关跟踪系统

Review your policies on immunizations for children and staff, and stay up-to-date on state requirements as well. As the program manager, you must ensure a proper immunization tracking system is maintained. Additionally, it is important as you monitor your program and address concerns that you keep a reliable tracking system to ensure changes and improvements are conducted and that follow through is complete. Regardless of the system you chose to use, be sure it is one that works for your program.

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.

用于跟踪免疫记录的一个系统是一个棘爪系统，它标识需要更新的免疫。这样的系统有助于您或您团队中的其他工作人员提醒未来的截止日期，防止文件或更新文书工作被忽视。文件可以按月或信息将颜色编码或信息可以放入电子表格并按日期组织。另一个Tickler系统可能涉及在索引卡文件中排序信息，或将其输入到日历程序中。

管理实践that Support the Prevention of Infectious Disease

下表总结了您在管理传染病方面的主要职责。

管理实践		员工实践
I should always…	To ensure	Staff never…
Make certain that staff are trained on our policies for managing infectious disease		有助于传播传染病，因为它们不保持健康的环境或坚持健康的实践 Neglect to conduct daily health checks 不适当地照顾生病的儿童和青少年 Fail to report an outbreak of an infectious disease
Monitor the sanitary conditions throughout the program daily and address concerns immediately		不遵守政策维护健康环境
Implement our exclusion and readmission policy consistently		让生病的孩子和青年留在他们的classrooms where they can infect other children
口头和书面沟通（家庭和员工手册）我们的疾病管理政策		使儿童和青年处于生病的危险之中，因为他们没有遵守书面程序 Feel uncomfortable advising families on our program's policies

管理传染病