DIABETES POLICY Policy Statement & Commitments

Transcription

1 Plicy Statement & Cmmitments Willaura Primary Schl Outside Schl Hurs Care Service 1 DIABETES POLICY 2018 Children with Diabetes are n mre likely t be sick than ther yung peple and can generally be expected t d everything their peers d. They may, hwever, need special cnsideratin when planning sprt, excursins and ther activities; extra tilet prvisins; extra cnsideratin if unwell; sme individual supervisin; t eat at additinal times, especially when invlved in physical activity; and/r special prvisins if testing fr bld glucse levels and injecting insulin. Administering medicatin t a child is cnsidered a high risk practice, and legislative requirements cntained within the Educatin and Care Services Natinal Law Act 2010 (including the Educatin and Care Services Natinal Regulatins) are t be strictly adhered t by Willaura PS OSHC Service including Educatrs, students and vlunteers. Willaura PS OSHC Service is cmmitted t: prviding the necessary strategies t ensure the health and safety f all persns with Type 1 and Type 2 Diabetes invlved with Willaura PS OSHC Service, including respnding t hypglycaemia and hyperglycaemia This plicy applies when a child diagnsed with Diabetes by a qualified medical practitiner is enrlled at Willaura PS OSHC Service. It applies t the child enrlled, their parents/guardians, Educatrs, and the OSHC Management Sub-cmmittee. It als applies t ther relevant members f the cmmunity, such as students, vlunteers and visiting specialists. Definitins Type 1 Diabetes an aut-immune cnditin that ccurs when the immune system damages the insulin prducing cells in the pancreas. Type 1 Diabetes ccurs due t a severe deficiency f insulin. Insulin is the hrmne that cntrls bld glucse levels (BGLs). Type 1 Diabetes is an aut-immune disease in which the bdy s wn immune system attacks the insulin-making cells in the pancreas and destrys them ver time. There is n risk f cntracting Diabetes frm affected individuals. Signs and symptms f Diabetes ccur ver a perid f days and weeks. They include lethargy, weight lss, increased urinatin and excessive thirst. Withut insulin the disease prgresses t a life threatening cnditin marked by dehydratin, high bld glucse levels and a build-up f acids (ketnes) in the bld (ketacidsis). Treatment fr Type 1 Diabetes invlves insulin injectins, bld glucse mnitring and fd management.

2 Willaura Primary Schl Outside Schl Hurs Care Service 2 Type 2 Diabetes Occurs when either insulin is nt wrking effectively (insulin resistance) r the pancreas des nt prduce sufficient insulin (r a cmbinatin f bth). Type 2 Diabetes usually des nt emerge until adulthd and is assciated with the fllwing risk factrs: being verweight, inactivity and a genetic predispsitin. Hwever, Type 2 Diabetes affects sme children, in particular children with identified risk factrs that are cmpunded by disadvantaged sciecnmic cnditins and/r ther medical cnditins. Type 2 Diabetes is different frm Type 1 Diabetes. Peple with Type 2 Diabetes are able t make insulin but when it is released int the bld stream, it is unable t wrk efficiently (insulin resistance). This leads t high BGLs (hyperglycaemia). Diabetes Actin Plan A medical management plan prepared and signed by a dctr prviding the child s name and medical cnditin and treatment, a phtgraph f the child and clear instructins n treating an episde. An example f this is prvided n the Diabetes Victria website: Nminated Educatr An Educatr nminated t be the liaisn between parents/guardians f a child with Diabetes and the OSHC Management Sub-cmmittee. This persn als checks the hyp kit is current and leads Educatr practice sessins fr respnding t hyps. Health Supprt Plan A plan specific t Willaura PS OSHC Service that specifies each child s health supprt needs, the ways that each child with Diabetes culd becme hypglycaemic while in the care f the Service, practical strategies t maintain bld glucse levels, and wh is respnsible fr implementing the strategies. The Health Supprt Plan shuld be develped by families f children with Diabetes and the Service and shuld be reviewed at least annually, but always upn the enrlment r diagnsis f each child wh is diabetic. Trained Educatr Fr the purpses f this plicy, this refers t thse Educatrs wh have received relevant prfessinally-run training in the treatments r techniques required t supprt the health needs f a child with Diabetes. They als hld first aid training, anaphylaxis management training, and emergency asthma management training qualificatins apprved by ACECQA, as prescribed in the Educatin and Care Services Natinal Law Act in accrdance with regulatin 137 (1) (e). Hyperglycaemia A high bld glucse level is where there is t much glucse in the bld stream fr nrmal functining. The number is usually abve 15.0mml/L. High bld glucse levels can be caused by nt enugh insulin, t much fd, cmmn illness (e.g. a cld) and stress. Hypglycaemia A lw bld glucse level is where there is nt enugh glucse in the bld stream fr nrmal functining. The number is usually belw 4.0mml/L. Lw bld glucse levels can be caused by t much insulin, exercise, r nt eating enugh exchanges (carbhydrates). Hyp Kit The preferred kit fr individual children, prvided by the child s family, fr use in the event f hypglycaemia, r hyp.

3 Willaura Primary Schl Outside Schl Hurs Care Service 3 Prcedures fr plicy implementatin Active implementatin f this plicy is a shared cmmunity respnsibility. The OSHC Crdinatr will: discuss with Educatrs their knwledge f issues fllwing their participatin in any Diabetes infrmatin sessins and/r training selectively audit enrlment checklists (e.g. annually) t ensure that dcumentatin is current and cmplete discuss this plicy and its implementatin with parents/guardians f children with Diabetes t gauge their satisfactin with bth the plicy and its implementatin in relatin t their child respnd t cmplaints. The Nminated Educatr (as nminated by the OSHC Crdinatr) will: determine the levels f Educatr cmpetence and cnfidence in the management f Diabetes, including respnding t hypglycaemia rutinely review the children s medicatin and hyp-kits t ensure that it is cmplete and that nthing has expired. Liaise with the OSHC Management Sub-cmmittee (thrugh the OSHC Crdinatr) and parents f children with Diabetes. Families will: read and be familiar with the Diabetes Plicy identify and liaise with the nminated Educatr bring relevant issues t the attentin f bth Educatrs and the OSHC Crdinatr maintain a fd plan and hyp kit fr the Service, which includes extra carbhydrates. Prcedures fr managing Diabetes Currently there are n children enrlled at Willaura PS OSHC Service wh have been diagnsed with Diabetes. In preparatin fr ptential families presenting t Willaura PS OSHC Service fr enrlment f a child wh has been diagnsed, the fllwing prcedures will be fllwed: The OSHC Crdinatr will discuss with Educatrs their knwledge and experience f Diabetes in yung children, and arrange fr infrmatin sessins t be held at the Service. The OSHC Crdinatr will discuss this plicy and its implementatin with parents/guardians f children in preparatin fr enrlment t gauge their satisfactin with bth the plicy and its implementatin in relatin t their child.

4 Willaura Primary Schl Outside Schl Hurs Care Service 4 The OSHC Crdinatr will review the adequacy f the respnse f Willaura PS OSHC Service if a child displays hypglycaemia r hyperglycaemia, and will cnsider the need fr additinal training and ther crrective actin. Upn enrlment r diagnsis f Diabetes Families will be required t: infrm Educatrs, either n enrlment r n diagnsis, f their child s Diabetes prvide Educatrs with a Diabetes actin plan and written cnsent t administer treatment strategies identified in the actin plan prvide Educatrs with a cmplete hyp kit regularly check the cntent and expiry date f the hyp kit and any medicatin assist Educatrs by ffering infrmatin and answering any questins regarding their child s Diabetes, including histry ntify the OSHC Crdinatr and Educatrs f any changes t their child s status and prvide a new Diabetes actin plan in accrdance with these changes cmmunicate all relevant infrmatin and cncerns t Educatrs, fr example, any matter relating t the health f the child advise Willaura PS OSHC Service f their child s fd plan fr Diabetes be respnsible fr supplying Willaura PS OSHC Service with the fd and drink needed by their child. Care fr diabetic health needs Whenever a child with Diabetes is enrlled at Willaura PS OSHC Service, r newly diagnsed as having a Diabetes, a Health Supprt Plan will be develped t dcument special needs and cnsideratins including: creating a safe envirnment fr the child prviding assistance with recgnitin f signs and symptms and apprpriate treatment f hypglycaemia (lw bld glucse level) and hyperglycaemia (high bld glucse level) ensuring adequate supervisin f and ability t perfrm bld glucse testing if required taking f medicatin and/r insulin injectins advcating and psitively supprting healthy dietary behaviur encuraging physical activity and special precautins fr exercise.

5 Willaura Primary Schl Outside Schl Hurs Care Service 5 A cmmunicatins plan will be develped t infrm all relevant Educatrs, including students and vlunteers, f: the child s name and cmpnent f care they attend (BSC/ASC) the child s risk minimisatin plan where the child s Emergency Actin Plan/Health Supprt Plan will be lcated where the child s insulin/snack bx etc. will be stred which Educatrs will be respnsible fr administering treatment. Yung children with Diabetes at the Service may need an Educatr t test their bld sugar. Educatrs will be aware f the signs and symptms f lw bld sugar including the child presenting pale, hungry, sweating, weak, cnfused and/r aggressive. Signs and symptms f high bld sugar include feeling thirsty, a need t urinate, ht dry skin, the smell f acetne n the breath. Exercise can result in hypglycaemia, s extra carbhydrate may be required befre, during r after physical activity depending n the duratin and intensity f the activity. Parents will supply the extra carbhydrate and Educatrs will ensure that this is readily accessible frm the place where the physical activity is ccurring. Management f Diabetes in children at Willaura PS OSHC Service will be supprted by the child having in place an Emergency Actin Plan, which includes: Administratin f Insulin, if needed Infrmatin n hw t give insulin t the child, hw much insulin t give, and hw t stre the insulin. Insulin may be delivered as a sht, an insulin pen, r via an insulin pump. Oral medicine Children may be prescribed with ral medicatin. Meals and snacks Including permissin t eat a snack anytime the child needs it. Families are asked t prvide Willaura PS OSHC Service with snacks t give their child when he r she has signs f lw bld sugar. This als includes a list f fds the child can eat, hw much, and when, and a list f fds that the child can have during special ccasins, such as birthday parties, excursins and special events. Bld sugar testing Infrmatin n hw ften and when a child s bld sugar may need t be tested by Educatrs. Fr example, the child may need their bld sugar tested befre lunch and when they have symptms f lw bld sugar. Symptms f lw r high bld sugar One child s symptms f lw r high bld sugar may be different t anthers. The child s Diabetes Actin Plan shuld detail the child s symptms f lw r high bld sugar and hw t treat it. Fr high bld sugar, lw bld sugar, and/r hypglycaemia, Educatrs will fllw the child s Diabetes Emergency Actin Plan

6 Willaura Primary Schl Outside Schl Hurs Care Service 6 Mnitring signs and symptms Signs are bservable indicatrs; symptms are what the persn can feel and reprt. Mnitring a yung persn with Diabetes fr signs and symptms f high r lw bld glucse levels is very imprtant if they are unable t test the bld glucse level using a bld glucse meter. Educatrs will be trained in what signs t lk fr and when t take actin. The family and the Educatrs will have a system in place s that the symptms are reprted and any actin taken is cmmunicated. Families will use the recrd f signs, symptms and actin t make changes t the management f their child s Diabetes. Bld Glucse Testing Bld glucse testing is used t mnitr whether the insulin dses being taken are the right amunts. It als enables safe management f sick days and exercise. Sme yung peple will knw hw t prick their finger and measure the bld glucse using their wn bld glucse meter. Educatrs will nt be expected t d bld glucse tests, but will be trained n hw t supervise it t supprt this aspect f the child s self-management if applicable. Families are required t attend Willaura PS OSHC Service t administer this prcedure if the child s management plan requires it t be cmpleted while the child is attending Willaura PS OSHC Service. Special precautins fr physical activity The OSHC Crdinatr, and/r Educatrs at Willaura PS OSHC Service will need t discuss a plan with families regarding the implicatins fr management f the Diabetes during physical activity. There are many ways in which this culd be dne. The agreed strategies shuld be written in the individual Diabetes care plan and health supprt plan and mnitred thrugh the cmmunicatin bk. The supprt plan shuld determine hw Educatrs will ensure that fd and drinks fr the treatment f lw bld glucse levels (hypglycaemia r hyp ) are available at the place f physical activity and sprt. Educatrs will need t have access t (r be carrying) the hyp kit. Yung peple with Diabetes need additinal supervisin during exercise. The yunger child may als need t have meals supervised, especially befre exercise. Any sprt in which a lw bld glucse level wuld cause a risk t the child shuld be carefully planned and always ccur under strict supervisin.

7 Willaura Primary Schl Outside Schl Hurs Care Service 7 Sme features f a lw bld glucse level may be masked by the cler bdy temperatures experienced during water-based activity. Water-based activities need very careful planning and supervisin because lw bld glucse level may increase the risk f drwning. Fr excursins in and/r arund water an Educatr will be lcated n the edge f the water-based activity as a safety watch fr the child. Strage f Children s Hyp Kits Bld glucse mnitring equipment shuld be safely stred s that it is accessible as required by the Educatr, but is nt accessible t children. Typically this equipment is stred with the child s hyp kit. Hyp kits will be stred in the OSHC Office. Prcedures fr Dealing with Hypglycaemia (Lw Bld Glucse Levels) Hypglycaemia may ccur at any time, but there is a greater chance f this happening with exercise r befre the next meal is due (usually mrning tea r lunch). Hypglycaemia may be dangerus. The signs can prgress frm mild t severe very quickly prmpt first aid treatment is crucial. Mild Mderate Severe sweating, paleness, trembling, hunger, weakness changes in md and behaviur (e.g. crying, argumentative utbursts, aggressiveness) inability t think clearly, lack f crdinatin inability t help neself glazed expressin being disrientated, unaware r seemingly intxicated inability t drink and swallw withut much encuragement headache, abdminal pain r nausea inability t stand inability t respnd t instructins extreme disrientatin inability t drink and swallw (leading t danger f inhaling fd int the lungs) uncnsciusness r seizures (jerking r twitching f face, bdy r limbs)

8 Willaura Primary Schl Outside Schl Hurs Care Service 8 First Aid fr Hypglycaemia Mild t mderate hyps can be treated by giving fds r drinks by muth. Families will prvide the Willaura PS OSHC Service with their child s preferred hyp kit. The essentials in the treatment f mild t mderate hyps are as fllws. Step 1 Give glucse immediately t raise the bld glucse level (e.g. half a can f nrmal [with sugar] sft r fruit drink, r five t six jelly beans. Step 2 Wait 5 minutes. Step 3 If n imprvement, repeat Step 1. Step 4 If the cnditin imprves, fllw up with a snack f ne piece f fruit r ne slice f bread r dried biscuits, nly when recvered (usually 5 minutes). Step 5 If there is still n imprvement, call an ambulance. State clearly that the persn has Diabetes, and whether he r she is cnscius. Infrm emergency cntacts. Step 6 If uncnscius, maintain airway, breathing and circulatin (the ABC f first aid) while awaiting the ambulance. Severe hyps require either an injectin f glucse int the vein (this can be given nly by a dctr r a trained paramedic) r the intramuscular injectin frm the Glucagen Hyp Kit given by a dctr, a paramedic, r a parent r guardian. Step 1 Lie the child n ne side and prtect frm injury. Step 2 Prvide first aid, checking that there is n danger arund, and maintain airway, breathing and circulatin (the ABC f first aid). Check that the muth is clear t allw unbstructed breathing. Skin clur shuld remain pale t nrmal if the persn is breathing prperly. Step 3 Call an ambulance and infrm the peratr that there is a diabetic emergency. Step 4 Infrm emergency cntacts as per plicy.

9 Willaura Primary Schl Outside Schl Hurs Care Service 9 Never put fd r drink in the muth f a persn wh is uncnscius, cnvulsing r unable t swallw, in case it is inhaled. Dealing with Hyperglycaemia (High Bld Glucse Levels) Hyperglycaemia (high bld glucse levels) can be caused by nt having enugh insulin, t much fd, cmmn illness (e.g. a cld) and stress. When bld glucse levels are high fr a lng perid f time, the bdy starts t break dwn fat and muscle fr energy. When this happens, the bdy makes ketnes. A urine test can detect ketnes. Signs fr this cnditin may develp ver several days and can include the fllwing. Mild Mderate Severe Educatrs ften becme aware f this when the child cnstantly asks fr permissin t g t the tilet and t btain a drink. As signs develp ver time, mild hyperglycaemia isn t always visible t Educatrs. Cmmunicatin with families abut children s wellbeing assists in identifying changes t children s health. frequent urinatin excessive thirst change in behaviur (usually irritability) lethargy weight lss lack f cncentratin rapid labured breathing vmiting sweet acetne smell t breath abdminal pains flushed cheeks severe dehydratin First Aid fr Hyperglycaemia An ambulance shuld be called immediately if any f the abve symptms f severe hyperglycaemia are bserved, as hspitalisatin is needed urgently. In sever hyperglycaemia, the fllwing steps shuld be taken. Step 1 Lie the child n ne side and prtect frm injury. Step 2 Prvide first aid, checking that there is n danger arund, and maintain the airway, breathing and circulatin (the ABC f first aid). Check that the muth is clear t allw

10 Willaura Primary Schl Outside Schl Hurs Care Service 0 unbstructed breathing. Skin clur shuld remain pale t nrmal if the persn is 1 breathing prperly. Step 3 Call an ambulance and infrm the peratr that there is a diabetic emergency. Step 4 Infrm emergency cntacts as per plicy. Surces & Legislative References Diabetes Australia (Victria), Parenting Jurneys with Type 1 Diabetes, images/stries/pdf_files/recipes fr living with D-Kids.pdf?phpMyAdmin=fsgZ8MzPBx-Okd83pnO,vcNPM5 Ryal Children s Hspital, Caring fr Diabetes in Children & Adlescents, Diabetes/Diabetes_Bk_Third_Editin.pdf Educatin & Care Services Natinal Law Act 2010 (Vic) Sectins 167(1)(2)(3) & 175(1) Educatin & Care Services Natinal Regulatins (2011) Regulatins 90, 91, 92, 93, 94, 95, 168(2)(d), 177, 181, 183 & 184 Natinal Quality Standard fr Early Childhd Educatin and Care & Schl Age Care (2010) Standard 4.1; Elements 2.1.1, 2.1.4, & Infrmatin Privacy Act 2000 (Vic) Infrmatin Privacy Principles Privacy Act 1988 (Cwlth) Natinal Privacy Principles Health Act 1958 Public Health & Wellbeing Guidelines Health Recrds Act 2001 (Vic) Health Privacy Principles Occupatinal Health & Safety Act 2004 (Vic) Prviding a safe wrk envirnment

11 Willaura Primary Schl Outside Schl Hurs Care Service 11 Enrlment Checklist fr Children with Diabetes A health supprt plan, which includes a fd plan, identifies strategies t address the particular needs f each child with Diabetes, and this plan is implemented. Parents f a child with Diabetes have been prvided a cpy f Willaura PS OSHC Service s Diabetes Plicy. All parents/guardians are made aware f the Diabetes plicy. Diabetes health supprt actin plan fr the child is signed by the child s dctr and is visible t all Educatrs. A hyp kit is available fr use at any time the child is in the care f Willaura PS OSHC Service. Diabetes management medicatin is stred in a lcatin easily accessible t adults (nt lcked away), inaccessible t children and away frm direct surces f heat. All Educatrs, including relief Educatrs, students and vlunteers, are aware f each hyp-kit lcatin, and any ther medicatin r mnitring apparatus. Educatrs nminated as respnsible fr each child at risk f Diabetes undertake apprpriate training, which includes strategies fr management, recgnitin f hypglycaemia and emergency treatment. Willaura PS OSHC Service s Emergency Actin Plan fr the management f Diabetes is in place and all Educatrs understand the plan. The current cntact details f each parent/guardian f a child with Diabetes are available, including emergency cntacts. Infrmatin regarding any ther medicatins r medical cnditins (fr example asthma) is available t Educatrs.

12 Willaura Primary Schl Outside Schl Hurs Care Service 12 Service Snapsht Children with Diabetes Child s Name BSC/ASC/VAC Days f attendance 2 injectins / multiple, r insulin pump Actin Plan lcatin Hyp kit lcatin Bld glucse testing

13 Willaura Primary Schl Outside Schl Hurs Care Service 13 Diabetic Health Supprt Fd Plan Child s Name: Type f fd Family t cmplete Why? Fd cntaining slwly absrbed carbhydrates must be eaten at each meal. Timing f meals Quantities f fd Supervisin & rutine requirements Mst fd plans are based n three majr meals (breakfast, lunch and evening meal) and three snacks (mrning, afternn tea and at bedtime). If the interval between meals and snacks is t lng, a lw bld glucse level can ccur and an additinal snack may have t be eaten. The amunt f fd fr each meal is als imprtant and meals shuld never be skipped. Families are taught t cunt carbhydrate quantities using the exchange system (15g carbhydrate equals 1 exchange). Carbhydrate fds have been given an exchange value and the yung persn with Diabetes will be eating a specific number f exchanges at main meals and snacks. Very yung children may require extra supervisin at meal and snack times. Mst children will have a fd plan that fits in with regular rutines, aviding the need t eat regularly thrughut the day r at dd times. Yung peple with Diabetes usually cannt delay meal times Sign & Date:

14 Willaura Primary Schl Outside Schl Hurs Care Service 14 Individual Cmmunicatin Plan fr Children with Diabetes Child s Name: When will the child be attending Willaura PS OSHC Service? Have all staff, including students and vlunteers been infrmed f the details in the child s risk minimisatin plan, and health supprt plan? Where will the fllwing items be lcated? Risk Minimisatin Plan Health Supprt Plan Emergency Actin Plan Hyp kit/insulin Where will the child s insulin and/r snack bx be stred, and wh will have access? Wh will be respnsible fr supprting this child s health needs, which may include administering treatment including first aid? Name/Sign & Date:

15 Willaura Primary Schl Outside Schl Hurs Care Service 15 Individual Risk Management Plan fr Children with Diabetes Child s Name BSC/ASC/VAC Type Actin Plan lcatin Hyp kit/insulin/ snack bx lcatin Specific risk management strategies Date cmpleted Parent/guardian has been prvided with a cpy f the Willaura PS OSHC Service Diabetes Plicy, and plicy n dealing with medical cnditins and medicatin. Parent/guardian has prvided a hyp kit fr the child, and any ther medicatin required. Willaura PS OSHC Service displays the child s Diabetes Actin Plan with current pht, in a key lcatin and keeps a cmpleted ambulance card by the telephne/s. Parent/guardians are aware f the plicy that the child is NOT permitted t attend Willaura PS OSHC Service withut a hyp kit and health supprt plan. Test that all staff, including relief staff, knw where hyp kits and any required medicatin are kept fr the child. Regular expiry-date checks f the hyp kit held by Willaura PS OSHC Service are undertaken by a nminated staff member and the family f each child. A new written request is sent t families if Willaura PS OSHC Service intends n changing the way it supprts the child s diabetic health needs.

16 Willaura Primary Schl Outside Schl Hurs Care Service 16 What measures are in place by Willaura PS OSHC Service in relatin t knwn signs and symptms f lw bld sugar? Think abut times when the child culd ptentially be at risk f lw bld sugar and develp apprpriate strategies, including wh is respnsible fr implementing them. Risk Minimisatin Plan Risk Strategy Wh is respnsible

17 Willaura Primary Schl Outside Schl Hurs Care Service 17 Diabetes Emergency Drill Recrd Regular emergency drills are undertaken t ensure that the relevant peple knw what actin t take if a child has hypglycaemia (lw bld glucse level) r hyperglycaemia (high bld glucse level) Date & Time f Drill: Scenari/Lcatin: Actins: Date & Time f Drill: Scenari/Lcatin: Actins: Date & Time f Drill: Scenari/Lcatin: Actins: Date & Time f Drill: Scenari/Lcatin: Actins: Date & Time f Drill: Scenari/Lcatin: Actins:

18 Willaura Primary Schl Outside Schl Hurs Care Service 18 Diabetes Emergency Management and Actin Plan Review Criteria fr evaluatin Ntes Diabetes Actin Plan has been reviewed by Parent / guardian/ Dctr and Willaura PS OSHC Service. Review the Diabetes Management Plan with families f children with Diabetes at Willaura PS OSHC Service, and always upn enrlment f each at risk child and after any incident. Knw what each child s Diabetes Actin Plan says and hw t implement it. In case f emergency, Educatrs shuld: knw wh will administer the apprpriate treatment f hypglycaemia (lw bld glucse level) and hyperglycaemia (high bld glucse level) and stay with the child knw wh will telephne the ambulance and the parents knw wh will ensure the supervisin f the ther children knw wh will let the ambulance fficers int Willaura PS OSHC Service and take them t the child knw wh will g in the ambulance with the child. The Educatr with respnsibility fr children with Diabetes at Willaura PS OSHC Service has undertaken apprpriate training and is bth cmpetent and cmpetent.