Medical Cnditins Plicy NQS QA2 2.1.1 Each child s health needs are supprted. 2.1.4 Steps are taken t cntrl the spread f infectius diseases and t manage injuries and illness, in accrdance with recgnised guidelines. 2.3.2 Every reasnable precautin is taken t prtect children frm harm and any hazard likely t cause injury. Natinal Regulatins Reg 90 Medical cnditins plicy 90(1)(iv) Medical Cnditins Cmmunicatin Plan 91 Medical cnditins plicy t be prvided t parents 92 Medicatin recrd 93 Administratin f medicatin 94 Exceptin t authrisatin requirement anaphylaxis r asthma emergency 95 Prcedure fr administratin f medicatin 96 Self-administratin f medicatin EYLF LO3 Children are happy, healthy, safe and cnnected t thers. Educatrs prmte cntinuity f children s persnal health and hygiene by sharing wnership f rutines and schedules with children, families and the cmmunity Educatrs discuss health and safety issues with children and invlve them in develping guidelines t keep the envirnment safe fr all Aim The service and all educatrs can effectively respnd t and manage medical cnditins including asthma, diabetes and anaphylaxis at the service t ensure the safety and wellbeing f children, staff and visitrs. Related Plicies Additinal Needs Plicy Administratin f First Aid Plicy Death f a Child Plicy Emergency Service Cntact Plicy Emergency Management and Evacuatin Plicy 1
Enrlment Plicy Fd Nutritin and Beverage Plicy Health, Hygiene and Safe Fd Plicy HIV AIDS Plicy Immunisatin and Disease Preventin Plicy Incident, Injury, Trauma and Illness Plicy Infectius Diseases Plicy Privacy and Cnfidentiality Plicy Implementatin The service will invlve all educatrs, families and children in regular discussins abut medical cnditins and general health and wellbeing thrughut ur curriculum. The service will adhere t privacy and cnfidentiality prcedures when dealing with individual health needs. A cpy f the Medical Cnditins Plicy must be prvided t all educatrs and vlunteers at the service. The Plicy must als be prvided t parents f children enrlled at the service including thse whse child has been identified as having a specific health care need r allergy. Educatrs are als respnsible fr raising any cncerns with a child s parents abut any medical cnditin/suspected medical cnditin, r knwn allergens that pse a risk t the child. N child enrlled at the service will be able t attend the service withut medicatin prescribed by their medical practitiner. In particular, n child wh has been prescribed an adrenaline aut-injectin device, insulin injectin device r asthma inhaler is permitted t attend the service r its prgrams withut the device. Families are required t prvide infrmatin abut their child s health care needs, allergies, medical cnditins and medicatin n the Enrlment Frm and are respnsible fr updating the service abut f these things, including any new medicatin, ceasing f medicatin, r changes t their child s prescriptin. All educatrs and vlunteers at the service must fllw a child s Medical Management Plan in the event f an incident related t a child s specific health care need, allergy r medical cnditin. Our service will implement the fllwing cmmunicatins plan t ensure that parents are reminded t advise f any changes which will impact the Medical Management Plan and Risk Minimisatin Plan: Medical Management Cmmunicatin Plan Upn enrlment, families will be prvided with allergy and dietary requirement dcumentatin t cmplete, as well as within the child s enrlment frm. Any child diagnsed with asthma r anaphylaxis must prvide a current actin plan and this must be updated every 12 mnths. Allergy and dietary requirement frms are required t be cmpleted every six mnths and include a current pht f the child. All medicatin, including epipens and Ventlin, must be prvided t the centre which will kept in the first aid kits. Lng term medicatin kept n the premises must be checked regularly fr expiry dates and als t ensure a prescriptin label is n the medicatin with the child s name and dctrs instructins fr us. 2
Families can update infrmatin regarding their childs medical cnditins at any time in writing by cmpleting/amending the allergy and dietary requirement frms r submitting an amended actin plan authrised by a medical practitiner. The Service will remind families arund prviding infrmatin fr medical cnditins thrugh newsletters, emails, ntices arund the centre and face t face cnsultatin. Infrmatin that must be prvided in Enrlment Recrd The service s Enrlment Frm prvides an pprtunity fr parents t help the service effectively meet their child s needs relating t any medical cnditin. The enrlment recrd will include details f any: specific health care needs r medical cnditins f the child, including asthma, diabetes, allergies, and whether the child has been diagnsed at risk f anaphylaxis. any Medical Management Plan prvided by a child s parents and/r registered medical practitiner. This Plan shuld: have supprting dcumentatin if apprpriate include a pht f the child if relevant, state what triggers the allergy r medical cnditin first aid needed cntact details f the dctr wh signed the plan state when the Plan shuld be reviewed. Cpies f the plan shuld be kept with the child s medicatin and als accmpany them n any excursins. Where there is a Medical Management Plan, a risk minimisatin plan must be develped and infrmed frm the child s Medical Management Plan. Nte parents are respnsible fr updating their child s Medical Management Plan/prviding a new Plan as necessary and will be regularly reminded by the service as per the Medical Management Cmmunicatins Plan. Any new infrmatin will be attached t the Enrlment Frm and kept n file at the service. Educatrs will ensure infrmatin that is displayed abut a child s medical cnditins is updated. Identifying Children with Medical Cnditins Any infrmatin relating t a child s medical cnditins will be shared with relevant educatrs, vlunteers and the family day care c-rdinatr at the service. Educatrs will be briefed by the family day care c-rdinatr n the specific health needs f each child. Our service will implement the fllwing cmmunicatins plan t ensure that relevant educatrs, staff and vlunteers are: 3
infrmed abut the Medical Cnditins Plicy easily able t identify a child with medical cnditins are aware f the requirements f any medical management plans and risk minimisatin plans aware f the lcatin f each child s medicatin updated n the child s treatment alng with any regulatry changes that may affect practices fr specific medical cnditins. Educatrs will be infrmed abut any medical cnditins during the childs enrlment prcess and rientatin. Risk minimisatin plans will be prvided t the child s educatrs which will be readily accessible in the Health and Wellbeing flder in each rm. Educatrs will be infrmed abut related plicies during staff meetings, newsletters, mems and thrugh inductin prcess f the Service. Our service will display infrmatin abut a child s medical management plan, risk minimisatin plan, and the lcatin f each child s medicatin in an area near a telephne that is visible and easily accessed by all educatrs eg fd preparatin r serving area t ensure all prcedures are fllwed. We will ensure the display f infrmatin meets privacy guidelines and is nt accessible t visitrs r ther families. We will explain t families why this is imprtant fr the safety f the child and btain parental cnsent. Where a child has been diagnsed at risk f anaphylaxis, a ntice stating this must be displayed at the service s it is clearly visible frm the main entrance. The privacy and cnfidentiality f the child will be maintained at all times and the public ntice will nt name the child. Medical Cnditins Risk Minimisatin Plan Using a child s Medical Management Plan, ur service will develp a Medical Cnditins Risk Minimisatin Plan in cnsultatin with a child s parents and medical prfessinals which will ensure that: any risks are assessed and minimised if relevant, practices and prcedures fr the safe handling f fd, preparatin, cnsumptin and service f fd fr the child are develped and implemented (nte we will fllw all health, hygiene and safe fd plicies and prcedures) all parents are ntified f any knwn allergens that pse a risk t a child and hw these risks will be minimised a child des nt attend the service withut medicatin prescribed by their medical practitiner in relatin t their specific medical cnditin. Our service will prvide supprt and infrmatin t all parents and ther members f ur cmmunity abut resurces and supprt fr managing allergies, anaphylaxis asthma and diabetes. Our service will rutinely review each child s medicatin t ensure it hasn t expired. 4
Medical Cnditins Risk Minimisatin Plan: Anaphylaxis/Allergy Management While nt cmmn, anaphylaxis is life threatening. Anaphylaxis is a severe allergic reactin t a substance. While prir expsure t allergens is needed fr the develpment f true anaphylaxis, severe allergic reactins can ccur when n dcumented histry exists. We are aware that allergies are very specific t the individual and it is pssible t have an allergy t any freign substance. Anaphylaxis is usually caused by a fd allergy. Fds mst cmmnly assciated with anaphylaxis include peanuts, seafd, nuts and in children eggs and cw s milk. While develping the Medical Cnditins Risk Minimisatin Plan and t minimise the risk f expsure f children t fds that might trigger severe allergy r anaphylaxis in susceptible children, ur service will: nt allw children t trade fd, utensils r fd cntainers. prepare fd in line with a child s medical management plan and family recmmendatins. use nn-fd rewards with children, fr example, stickers fr apprpriate behaviur. request families t label all bttles, drinks and lunchbxes etc with their child s name. cnsider whether it s necessary t change r restrict the use f fd prducts in craft, science experiments and cking classes s children with allergies can participate. instruct educatrs n the need t prevent crss cntaminatin. request all parents nt t send fd with their children that cntain highly allergenic elements even if their child des nt have an allergy by, fr example, placing a sign in the fyer r near the frnt dr reminding families abut this. where a child is knwn t have a susceptibility t severe allergy r anaphylaxis t a particular fd, the service will have a allergy-awareness plicy fr that fd e.g. an Allergy-Aware (Nut) Plicy which wuld exclude children r ther individuals visiting the service frm bringing any fds r prducts cntaining nuts r nut material such as : peanuts, brazil nuts, cashew nuts, hazelnuts, almnds, pecan nuts any ther type f tree r grund nuts, peanut il r ther nut based il r cking prduct, peanut r any nut sauce, peanut butter, hazelnut spread, marzipan any ther fd which cntains nuts such as chclates, sweets, lllies, nugat, ice creams, cakes, biscuits, bread, drinks, satays, pre-prepared Asian r vegetarian fds fds with spices and seeds such as mustard, pppy, wheat and sesame seeds csmetics, massage ils, bdy ltins, shamps and creams such as Arachis il that cntain nut material. be aware that a child may have a number f fd allergies r there may be a number f children with different fd allergies, and it may nt be pssible t have an allergy free plicy fr all thse fds invlved. Nut allergy is the mst likely t cause severe reactin and will take precedence. 5
if apprpriate, seat a child with allergies at a different table if fd is being served that he/she is allergic t. This will always be dne in a sensitive manner s that the child des nt feel excluded. If a child is very yung, the family may be asked t prvide their wn high chair t further minimise the risk f crss infectin. hld nn-allergic babies when they drink frmula/milk r there is a child diagnsed at risk f anaphylaxis frm a milk allergy. ensure all children with fd allergies nly eat fd and snacks that have been prepared fr them at hme where pssible. instruct fd preparatin staff and vlunteers abut measures necessary t prevent crss cntaminatin between fds during the handling, preparatin and serving f fd, such as careful cleaning f fd preparatin areas and utensils. clsely supervise all children at meal and snack times and ensure fd is eaten in specified areas. T minimise risk children will nt be permitted t wander arund the service with fd. ensure meals prepared at the service d nt cntain ingredients such as milk, eggs r nuts. cnsult risk minimisatin plans when making fd purchases and planning menus. Allergic reactins and anaphylaxis are als cmmnly caused by: all types f animals, insects, spiders and reptiles. all drugs and medicatins, especially antibitics and vaccines. many hmepathic, naturpathic and vitamin preparatins. many species f plants, especially thse with thrns and stings. latex and rubber prducts. Band-Aids, Elastplast and prducts cntaining rubber based adhesives. Our service will ensure that bdy ltins, shamps and creams used n allergic children are apprved by their parent. Risk minimisatin practices will be carried ut t ensure that the service is t the best f ur ability prviding an envirnment that will nt trigger an anaphylactic reactin. These practices will be dcumented and reflected upn, and ptential risks reduced if pssible. The service will display an Australasian Sciety f Clinical Immunlgy and Allergy inc (ASCIA) generic pster called Actin Plan fr Anaphylaxis in a key lcatin at the service, fr example, in the children s rm, the staff rm r near the medicatin cabinet http://www.allergy.rg.au/cntent/view/10/3/#r1 Our service will ensure that the aut-injectin device kit is stred in a lcatin that is knwn t all staff, including relief staff, easily accessible t adults (nt lcked away), inaccessible t children, and away frm direct surces f heat. Educatrs shuld be n the lkut fr symptms f an allergic reactin as they need t act rapidly if they d ccur. If a child is displaying symptms f an anaphylactic reactin ur service will: 6
call an ambulance immediately by dialling 000 ensure the first aid trained educatr/educatr with apprved anaphylaxis management training prvides apprpriate first aid which may include the injectin f an aut immune device EpiPen in line with the steps utlined by the Australian Sciety f Clinical Immunlgy and Allergy http://allergy.rg.au/health-prfessinals/anaphylaxis-resurces/ascia-actinplan-fr-anaphylaxis and CPR if the child stps breathing. cntact the parent/guardian r the persn t be ntified in the event f illness if the parent/guardian cannt be cntacted. Medical Cnditins Risk Minimisatin Plan: Asthma Management Asthma is a chrnic lung disease that inflames and narrws the airways. While develping the Medical Cnditins Risk Minimisatin Plan ur service will implement prcedures where pssible t minimise the expsure f susceptible children t the cmmn triggers which can cause an asthma attack. These triggers include: dust and pllutin inhaled allergens, fr example muld, pllen, pet hair changes in temperature and weather, heating and air cnditining emtinal changes including laughing and stress activity and exercise Risk minimisatin practices will be carried ut t ensure that the service is t the best f ur ability prviding an envirnment that will nt trigger an asthmatic reactin. These practices will be dcumented and reflected upn, and ptential risks reduced if pssible. The service will display an Asthma chart called First Aid fr Asthma Chart fr under 12 years r Asthma First Aid in a key lcatin at the service, fr example, in the children s rm, the staff rm r near the medicatin cabinet http://www.natinalasthma.rg.au/uplads/cntent/22-nac-first-aidfr-asthma-chart-kids-final.pdf r http://asthmaaustralia.rg.au/wpcntent/uplads/2012/07/aa-live-well-with-asthma-0512-web.pdf An asthma attack can becme life threatening if nt treated prperly. If a child is displaying asthma symptms, ur service will: ensure a first aid trained educatr/educatr with apprved asthma management training immediately attends t the child. If the prcedures utlined in the child s medical management plan d nt alleviate the asthma symptms, r the child des nt have a medical management plan, the educatr will prvide apprpriate first aid, which may include the steps utlined by Asthma Australia as fllws: 1. Sit the child upright Stay with the child and be calm and reassuring 2. Give 4 puffs f blue reliever puffer medicatin 7
Use a spacer if there is ne Shake puffer Put 1 puff int spacer Take 4 breaths frm spacer Repeat until 4 puffs have been taken Shake, 1 puff, 4 breaths 3. Wait 4 minutes If there is n imprvement, give 4 mre puffs as abve 4. If there is still n imprvement call emergency assistance 000 Keep giving 4 puffs every 4 minutes until emergency assistance arrives cntact the child s parent r authrised cntact where the parent cannt be reached The service will ensure that an asthma First Aid Kit is stred in a lcatin that is knwn t all staff, including relief staff, easily accessible t adults (nt lcked away), inaccessible t children, and at rm temperature in dry areas. An Asthma First Aid kit shuld cntain: Blue r grey reliever puffer A spacer device that is cmpatible with the puffer A face mask cmpatible with the spacer fr use by children under 5 The service will ensure that an Emergency Asthma First Aid Kit is stred in a lcatin that is knwn t all staff, including relief staff, easily accessible t adults (nt lcked away), inaccessible t children, and at rm temperature in dry areas. An Emergency Asthma First Aid kit shuld cntain: Blue r grey reliever puffer At least 2 spacer devices that are cmpatible with the puffer At least 2 face masks cmpatible with the spacer fr use by children under 5 Spacers and masks can nly be used by ne persn. That persn can re-use the spacer r mask but it cannt be used by anyne else. We will ensure the child s name is written n the spacer and mask when it is used. Medical Cnditins Risk Minimisatin Plan: Diabetes Diabetes is a chrnic cnditin where the levels f glucse (sugar) in the bld are t high. Glucse levels are nrmally regulated by the hrmne insulin. The mst cmmn frm f diabetes in children is type 1. The bdy s immune system attacks the insulin prducing cells s insulin can n lnger be made. Peple with type 1 diabetes need t have insulin daily and test their bld glucse several times a day, fllw a healthy eating plan and participate in regular physical activity. See http://www.diabeteskidsandteens.cm.au/whatisdiabetes.html fr an nline presentatin fr children explaining hw diabetes affects the bdy. 8
Type 2 diabetes is managed by regular physical activity and healthy eating. Over time type 2 diabetics may als require insulin. While develping the Medical Cnditins Risk Minimisatin Plan ur service will implement prcedures where pssible t ensure children with diabetes d nt suffer any adverse effects frm their cnditin while at the service. These include ensuring they d nt suffer frm hypglycaemia (have a hyp ) which ccurs when bld sugar levels are t lw. Things that can cause a hyp include: A delayed r missed meal, r a meal with t little carbhydrate Extra strenuus r unplanned physical activity T much insulin r medicatin fr diabetes Vmiting Children with Type 1 diabetes may als need t limit their intake f sweet fds. Our service will ensure infrmatin abut the child s diet including the types and amunts f apprpriate fds is part f the child s Medical Management Plan and that this is used t develp the Risk Minimisatin Plan. Our service will ensure ur first aid trained educatr is trained in the use f the insulin injectin device (syringes, pens, pumps) used by children at ur service with diabetes. If a child is displaying symptms f a hyp ur service will: ensure the first aid trained educatr prvides immediate first aid which will be utlined in the child s medical management plan and may include giving the child sme quick acting and easily cnsumed carbhydrate. call an ambulance by dialling 000 if the child des nt respnd t the first aid and CPR if the child stps breathing. cntact the parent/guardian r the persn t be ntified in the event f illness if the parent/guardian cannt be cntacted. Educatr Training and Qualificatins The apprved prvider must ensure that at least ne educatr attending the service : hlds a current apprved first aid qualificatin has undertaken current apprved anaphylaxis management training and has undertaken current apprved emergency asthma management training. If immediately prir t 1 January 2012 the educatin and care services law did nt require that educatrs have: anaphylaxis management training, the service will implement this by 1 January 2013. asthma management training, the service will implement this by 1 January 2013. Our staffing Arrangements Plicy has mre details abut educatr training and qualificatins in this area. Educatrs in ur service recgnise hw serius anaphylaxis is and will undertake steps t minimise the pssibility f ccurrence. The service will ensure that all educatrs n the premises are qualified in the administratin f the adrenaline aut-injectin device (epipen) and CPR regardless f whether r nt a child is enrlled wh is diagnsed at risk f anaphylaxis. 9
Supervised Self-Administratin f Medicatin by Children ver Preschl Age The service des nt permit a child f any age t self-administer medicatin. Surces Educatin and Care Services Natinal Regulatins 2011 Natinal Quality Standard Asthma Australia Natinal Asthma Organisatin Australasian Sciety f Clinical Immunlgy and Allergy www.allergy.rg.au Australian Diabetes Cuncil Review The plicy will be reviewed annually. The review will be cnducted by: Management Emplyees Families Interested Parties Last reviewed: July 2016 Date fr next review: July 2017 10