Handout H: Daily Health Check

Do the daily health check when you greet each child and parent as they arrive. It usually takes less than a minute. Also observe the child throughout the day.

LISTEN: Greet the child and parent. Ask the child, "How are you today?" Ask the parent, "How are you doing? How's (name of child)?" "Was there anything different last night?" "How did he sleep?" "How was her appetite this morning?"

LOOK: Get down to the child's level to see her clearly. Observe signs of health or illness. FEEL: Gently run the back of your hand over the child's cheek, forehead, or neck. SMELL: Be aware of unusual odors. Handout I: Symptom Record

Child's name:________________________________
Date:_______________________________________

MAIN SYMPTOM:___________________________
When it began:___________________________ How long has it lasted:___________________
How much:______________________________How often:____________________________
Staying constant, getting better or worse?____________________________________________

OTHER SYMPTOMS: Complaints:_________________________________
    General appearance (e.g., comfort, mood, behavoir, activity level, appetite)

CIRCLE THE SYMPTOMS:
Breathing:    coughing    wheezing    breathing fast    difficulty breating    other_________
Skin:    pale    flushed    rash    sores    swelling    bruises    itchiness    other________
Vomiting: (# times)___________ Diarrhea: (# times) _____________ Urine:___________
Eyes:    pink/red    watery    discharge    crusty    swollen    other_________
Mouth:    sores    drooling    difficulty swallowing    other_________
Odors: (e.g., breath, stool)
Temperature:__________________ (axillary, oral, rectal, other_______________)

WHAT HAS BEEN DONE? Comfort:__________________Rest:_____________________
Liquids (name, amount, time) ____________Food: (name, amount, time)_______________
Medications: (name, amount, time)______________________
Emergency measures:___________________
Who was called and when: (e.g., parent/guardian, emergency contact person, health consultant, child's health provider, emergency medical services)_________________________________________________
Signature:________________________________________________________________________

Handout J: Does the Child Look Sick?

One of our best signs of whether a child is seriously ill is how she looks and acts. Check the child for signs of health and illness.
 
 

 
Looking Healthy
Looking Sick
General Appearance
Breathing
Skin
Eyes, Nose, Ears, and Mouth
Odors
 
Handout K: When a Child Is Too Sick to Attend

Most children with mild illnesses can safely attend child care. But, a child may be too sick to attend if:

Handout L: What Would You Do?

Story #1:

Story #2: Story #3: Story #4: Story #5: Handout M-1: Handling an Outbreak

Outbreak #1: Many children in your center are sick with Chicken Pox. Some of the children and adults who haven't gotten sick yet have never had chicken pox. A child with AIDS and a pregnant teacher are in the center.

Handout M-2: Handling an Outbreak

Outbreak #2: Two staff people and three parents in your infant-toddler center have become ill and jaundiced. They have been diagnosed with Hepatitis A.

Continuing Professional Development 

 
This guide helps Head Start staff develop their skills in preventing, recognizing, and managing communicable diseases. To continue to learn about communicable diseases:

Review the program's policies and practices in preventing and managing communicable diseases. Every year, work with the Health Services Advisory Committee or a health consultant to review the health policies and ensure that they are up to date. Assess the facilities for hand washing, diapering, toileting, and food preparation to ensure that proper supplies are available for infection control. Observe staff, children, and parents doing hand washing, diapering, toileting, cleaning, and food preparation. Identify practices that need improvement and address these in a work shop.

Develop an educational program on communicable diseases for new Head Start staff The program should include:

Periodically reserve time during staff meetings to discuss challenges in dealing with communicable diseases. For example, has communication with parents regarding illnesses been difficult? Have head lice or ringworm been persistent problems in the program? Develop strategies to address the challenges.

Reassess your personal knowledge and skills in managing communicable diseases. Have staff members each identify one aspect of communicable diseases that they would like to learn more about. For example, a teacher might want to develop her skill in discussing a child's illness with the parent; or a food service worker might like to develop ideas for less perishable lunches and snacks. Develop a personal action plan for improve ment.

Investigate other Head Start programs that are managing communicable diseases effectively. At meetings (e.g., local and regional health coordinators meetings, Head Start Association conferences, health conferences), discuss strategies for preventing and managing communicable diseases. Share sample health policies, exposure notices, and ideas for teaching
children about germs. Visit other programs and bring back information and techniques.

Subscribe to health publications to stay informed about current recom mendations. Keep a library with books, journals, and videos on commumcable diseases. Circulate articles from child care health newsletters that address issues that are important to the program.

Maintain connections with local health professionals. Invite local health care providers, such as pediatricians or public health nurses, to parent- staff meetings to answer questions about communicable diseases. Address common illnesses, such as ear infections, and emerging illnesses, such as HIV/AIDS, hepatitis B, and tuberculosis.

Encourage staff to attend classes and cunferences on communicable diseases. Courses may be available through the local community college, child care resource and referral agency, hospitals, and other health training agencies. Allow staff to attend local, regional, and national conferences on health sponsored by Head Start and child care and public health associations.

Advocate for improved management of communicable diseases in the community. What diseases is your program facing: intestinal parasites, measles, tuberculosis, HIV/AIDS? Join with other community groups advocating for public health improvements, such as sewer systems, water supply, housing, immunizations, and treatment of diseases.

Resources 


Books & Manuals:

American Academy of Pediatrics. In: Peter, G., ed. 1994 Red Book: Report of the Committee on Infectious Diseases. 23rd ed. Elk Grove Village, IL: American Academy of Pediatrics, 1994. 687 pp.

This book is a detailed summary of communicable diseases in children. It represents the recommendations of children's health authorities including the American Academy of Pediatrics (AAP) and The Centers for Disease Control (CDC). It contains a detailed description of each communicable disease-clinical manifestations, epidemiology, diagnostic tests, treatment, control measures. It also has a chapter on Children in Out-of-Home Care.

Contact: American Academy of Pediatrics, P.O. Box 927, 141 North west Point Blvd., Elk Grove Village, IL 60009-0927. Telephone:
(800) 433-9016. $64.95 each (Quantity prices on request).

American Academy of Pediatrics, Pennsylvania Chapter. Preparing for illness: A Joint Responsibility for Parents and Caregivers. Bryn Mawr, PA: Pennsylvania Chapter, American Academy of Pediatrics, 1993. 42 pp.

This brochure presents recommendations for preventing and managing illnesses in early childhood programs. It contains information on keeping children healthy, recognizing the ill child, inclusion/exclusion from child care, and conditions requiring immediate medical evaluation. It also has a chart on illnesses, organized by symptoms or diagnosis, which lists what you see, possible causes, when to exclude the child and/or seek medical advice, and when to readmit the child to the program.

Contact: National Association for the Education of Young Children, 1509 16th Street, NW, Washington, DC 20036-1476. Telephone:
(800) 424-2460. $2.00, includes shipping/handling; discounts for bulk orders.

American Public Health Association and American Academy of Pediatrics. Caring for Our Children: National Health and Safety Performance Standards-Guidelines for Out-of-Home Child Care Programs. Washington, DC: American Public Health Association, 1992. 410 pp.

This is a comprehensive set of health and safety guidelines for out-of home child care programs. It represents the current recommendations of children's health authorities, including the American Academy of Pediatrics (AAP) and American Public Health Association (APHA) and child care associations. It covers staff health and training, child development, nutrition, facilities, and children with special needs. It has a chapter on health promotion that includes detailed information on preventing communicable diseases; and a chapter on infectious diseases that addresses managing illnesses. Each recommendation includes an explanation of why the standard is important.

Contact: American Public Health Association, 1015 15th Street, NW, Washington, DC 20005. Telephone: (202) 789-5665. $35.00 members ($50.00 non-members), plus $7.00 for shipping/handling.

American Red Cross. American Red Cross Child Care Course. Washing ton, DC: American Red Cross. Multiple volumes.

This is an easy-to-use curriculum on childhood illnesses and injuries. The section on illnesses addresses preventing infectious diseases and caring for ill children. It includes charts, pictures, handouts, forms, and exercises for teaching child care staff and children about commu nicable diseases.

Contact: Contact your local chapter of the American Red Cross or the national office of the American Red Cross, 1709 New York Av enue, Suite 208, Washington, DC 20006. Telephone: (202) 728-6523. Cost is determined by your local American Red Cross Chapter.

Aronson, S., and H. Smith. Model Child Care Health Policies. Bryn Mawr, PA: Pennsylvania Chapter, American Academy of Pediatrics, 1993. 90 pp.

This manual provides a sample health policy for early childhood pro grams. It addresses admissions, supervision, discipline, health plan, emergencies, safety, and staff health. It includes several sections on communicable diseases-sanitation and hygiene, food handling, care of ill children, and medications. It contains handouts such as a symptom record, medication log, and a health and safety checklist. It also has a chart on illnesses, organized by symptoms or diagnosis, which lists what you see, possible causes, when to exclude the child and/or seek medical advice, and when to readmit the child to the program. The model policies are available on diskette to help programs develop their own health policies.

Contact: National Association for the Education of Young Children, 1509 16th Street, NW, Washington, DC 20036-1426. Telephone:
(800) 424-2460 or (201) 232-8777. $5.00. Order No. 716.

California Department of Education and The Center for Health Training.
Keeping Kids Healthy: Preventing and Managing Communicable
Disease in Child Care. Sacramento, CA: California Department of
Education, 1994. Manual 94 pp; video 29 minutes.
This manual addresses preventing, recognizing and managing communicable disease in child care. It contains handouts on infection control, daily health check, symptom record, medications, when a child is too sick to attend, emergencies, and exposure notices for each communicable disease. It also presents suggestions on effective communication between early childhood professionals, parents and health care providers about health and illness. A companion video is also available.

Contact: Bureau of Publications, Sales Unit, California Department of Education, P0 Box 271, Sacramento, CA 95812-0271. Telephone:
(916) 445-1260. Anticipated cost: manual $8-9, video $16-17.

Kendrick, A.S., R. Kaufmann, and K.P. Messenger, eds. Healthy Young Children: A Manual for Programs. Washington, DC: National Association for the Education of Young Children, 1995. 297 pp.

This is a comprehensive book on health in early childhood programs. It addresses health promotion, healthful environments, safety and first aid, preventive health care, nutrition, children with special needs, and child abuse and neglect. It has several chapters on preventing and managing infectious diseases that contain current recommendations from public health authorities. These include practical charts, check lists, and exposure notices for parents.

Contact: National Association for the Education of Young Children.
1509 16th Street, NW, Washington, DC 20036-1426. Telephone:
(800) 424-2460 or (202) 232-8777; fax (202) 328-1846. $15.00, no
shipping/handling for regular mail orders under $20.00.

National Pediatric HIV Resource Center. Getting a Head Start on HIV: A Resource Manual for Enhancing Services to HIV-Affected Children in Head Start. Newark, NJ: National Pediatric HIV Resource Center, in cooperation with Region II Head Start Resource Center, 1992. 56 pp.

This is a manual on caring for HIV-affected children in Head Start. It describes the impact of HIV infection on a child's physical health, growth, development, and mental health; special health care concerns; and legal issues. The manual includes activities for children and practical strategies for working with HIV-affected families. It also includes sample policies and staff training on HlV/AIDS.

Contact: National Maternal and Child Health Clearinghouse
(NMCHC), 2070 Chain Bridge Rd., Suite 450, Vienna, VA 22182-
2536. Telephone: (703) 821-8955; fax (703) 821-2098. Available at no charge. NMCHC invoice code F097.
Seattle-King County Department of Public Health. Child Care Health Handbook. 3rd ed. Seattle, WA: Seattle-King County Department of Public Health, 1990. 184 pp. $10.00.

This is a comprehensive manual on health and safety in child care. It covers growth and development, health screening, nutrition, dental health, behavior, injuries, child abuse and neglect, and staff health. It has several chapters that address preventing and managing illnesses. These include charts outlining recommended responses to illness, organized by symptoms and diagnosis.

Caregiver-Parent Health Connection; Communicable Disease Prevention. Seattle, WA: Seattle-King County Department of Public Health, 1994. $15.00 plus postage/handling.

This is a practical manual for preventing and managing commumcable diseases in child care. It includes general information for caregivers and parents, sample fact sheets and parent letters on communicable diseases, and self-assessment checklists for caregivers.

Contact: Child Care Health Program, Seattle-King County Depart ment of Public Health, 110 Prefontaine Place South, Suite 500, Seattle, WA 98104. Telephone: (206) 296-4613.

U.S. Department of Labor, Occupational Safety and Health Administra tion. Occupational Exposure to Bloodborne Pathogens. Federal Register, Vol. 56, No. 235, December 6, 1991.

This document represents the Occupational Safety and Health Administration (OSITA) legal regulations on bloodborne pathogens in workplaces in the United States. It defines "bloodborne pathogens" and "exposures," and covers the requirements for developing an exposure control plan, universal infection control measures, hepatitis B vaccine, reporting and following-up exposures, and staff training.

Contact: OSliA, 200 Constitution Ave., NW, Washington, DC
20210. Telephone: (202) 219-4667.

Videos

American Academy of Pediatrics. Before It's Too Late, Vaccinate. Elk Grove Village, IL: American Academy of Pediatrics, revised 1994.

This is a 17-minute video on the importance of immunizations for children. It addresses what immunizations are, the diseases they protect against, and the recommended schedule for immunizations in early childhood. The video is available in English and in Spanish.

Contact: American Academy of Pediatrics, P.O. Box 927, 141 North west Point Blvd., Elk Grove Village, IL 60009-0927. Telephone:
(800) 433-9016.

American Academy of Pediatrics and National Association for Education of Young Children. Caring for Our Children. Elk Grove Village, IL:
American Academy of Pediatrics, 1995. $75.00, plus $8.75 shipping/handling.

This is a series of six 30-minute videos on health and safety in out-of- home child care settings. The videos are based on the book, Caring for Our Children: National Health and Safety Performance Standards, developed by the American Academy of Pediatrics and American Public Health Association. The videos cover staff health, basic caregiving, preparing for emergencies, setting up safe child care, maintaining safe child care, and dealing with illness.

Contact: American Academy of Pediatrics, P.O. Box 927, 141 North west Point Blvd., Elk Grove Village, IL 60009-0927. Telephone: (800) 433-9016. or National Association for Education of Young children, 1509 16th Street, NW, Washington, DC 20036-1426. Telephone: (800) 424-2460 or (202) 232-8777; fax (202) 328-1846.

California Department of Education and The Center for Health Training.
Keeping Kids Healthy: Preventing and Managing Communicable Disease in Child Care. Sacramento, CA: California Department of Education, 1994.

This is a 29-minute video on preventing, recognizing and managing communicable disease in child care. It explains how communicable diseases spread in child care, and demonstrates measures to prevent the spread of disease. It shows a daily health check and possible signs and symptoms of common childhood diseases. It also has suggestions on effective communication between early childhood professionals and parents about health and illness.

Contact: Bureau of Publications, Sales Unit, California Department of Education, P0 Box 271, Sacramento, CA 95812-0271. Telephone: (916) 445-1260. Anticipated cost: $17.

U.S. Department of Health and Human Services. The ABC'S of Clean; Hooray for Handwashing-pamphlet & video. New York, NY: The Soap and Detergent Association.

This is a 16-minute video that explains how illnesses spread among children in group care. It demonstrates simple measures for adults and children to reduce the spread of disease. The educational package also includes an audio tape with songs promoting hand washing and hygiene, teachers' guide, posters, and handouts for parents.

Contact: The Soap and Detergent Association, 475 Park Avenue South, New York, NY 10016. Telephone: (212) 725-1262. Cost: None.

Newsletters

American Academy of Pediatrics, Pennsylvania Chapter, ECELS. Early Childhood Health Link.

Contact: Healthy Child Care Pennsylvania (ECELS), PA AAP, Building 2; Suite 307, Rosemont Business Campus, 919 Conestoga Rd., Rosemont, PA 19010. Telephone: (610) 520-9125. Web: http:// www.delcom.com/paaap/ped.html.

National Center for Education in Maternal and Child Health (NCEMCH). MCH Program Interchange. U.S. Dept. of Health and Human Services.

Contact: NCEMCH, Maternal and Child Health Bureau, 2000 15th St., North. Arlington, VA 22201. Telephone: (703) 524-7802.

San Diego State University. Child Care Health Connections, 1995.

Contact: San Diego State University, Child Care Health Connections,
6505 Alvarado Road, #108, San Diego, CA 92120. Telephone: (619)
594-4373. Yearly cost: $15.

National Organizations

American Academy of Pediatrics:

Contact: 141 Northwest Point Blvd., Elk Grove Village, IL 60009- 0927. (708) 228-5005

American Public Health Association:

Contact: 1015 15th St., NW, Washington, DC 20005. (202) 789-5600

Centers for Disease Control:

Contact: Center for Health Promotion & Education, Centers for Disease Control, 1600 Clifton Rd., NE, Atlanta, GA 30329. (404) 639-3311

National Association for the Education of Young Children:

Contact: 1509 16th Street, NW, Washington, DC 20036-1426. (800) 424-2460 or (202) 232-8777

National Maternal and Child Health Clearinghouse: Contact: 2070 Chain Bridge Rd., Suite 450, Vienna, VA 22182-2536. (703) 821-8955