QUALITY AREA 2: CHILDREN’S HEALTH AND SAFETY
DEALING WITH MEDICAL CONDITIONS POLICY
POLICY: The centre will facilitate effective care and health management of children with acute episodes of illness and medical emergencies.
BACKGROUND: Medical conditions include, but are not limited to asthma, diabetes or a diagnosis that a child is at risk of anaphylaxis. In many cases these can be life threatening. Our service is committed to a planned approach to the management of medical conditions to ensure the safety and well-being of all children at this service. Our serviceis also committed to ensuring our educators are equipped with the knowledge and skills to manage situations to ensure all children receive the highest level of care and to ensure their needs are considered at all times. Providing families with ongoing information about medical conditions and the management conditions is a key priority.
· Children are supported to feel physically and emotionally well, and feel safe in the knowledge that their wellbeing and individual health care needs will be met when they are not well.
· Families can expect that educators will act in the best interests of the children in their care at all times; meet the children’s individual health care needs; maintain continuity of medication for their children when the need arise.
· Educators feel competent to perform their duties; understand their liabilities and duty of care requirements; are provided with sufficient information and training regarding the administration of medication and other appropriate treatments.
· Collaboration with families of children with diagnosed medial conditions to develop a Risk Minimisation Plan for their child;
· All staff, including casual staff,educators and volunteers, are informed of all children diagnosed with a medical condition and the risk minimisation procedures for these;
· All families are provided with current information about identified medical conditions of children enrolled at the service with strategies to support the implementation of the Risk Minimisation Plan;
· All children with diagnosed medical conditions have a current Risk Minimisation Plan that is accessible to all staff;
· All staff are adequately trained in the administration of emergency medication.
· Education and Care Services National Law Act 2010; 173
· Education and Care Services National Regulations 2011; 90, 91, 96
LINK TO NATIONAL QUALITY STANDARDS
- Standard 2.1: Each child’s health is promoted
- Standard 2.3: Each child is protected
- Standard 7.1: Effective leadership promotes a positive organisational culture and builds a professional learning community
· On application for enrolment families will be required to complete full details about their child’s medical needs. We will assess whether Educators are appropriately trained to manage the child’s special health needs at that time.
· Where children require medication or have special medical needs for long term conditions or complaints, the child’s doctor or allied health professional and parent/guardian must complete a Medical Management Plan. Such a plan will detail the child’s special health support needs including administration of medication and other actions required to manage the child’s condition.
· The Nominated Supervisor will also consult with the child’s family to develop a Risk Minimisation Plan. This plan will assess the risks relating to the child’s specific health care needs, allergy or medical condition; any requirements for safe handling, preparation and consumption of food; notification procedures that inform other families about allergens that pose a risk; procedures for ensuring educators/students/volunteers can identify the child, their medication.
· Children with specific medical needs must be reassessed in regard to the child’s needs and our service’s continuing ability to manage the child’s special needs, on a regular basis, depending on the specific child’s medical condition.
· If a child’s medical, physical, emotional or cognitive state changes the family will need to complete a new Medical Management Plan and our service will re-assess its ability to care for the child, including whether educators are appropriately trained to manage the child’s ongoing special needs.
Administration of Prescribed Medication
Prescribed medication, authorised medication and medical procedures can only be administered to a child:
- with written authorisation from the parent/guardian or a person named in the child’s enrolment record as authorised to consent to administration of medication (Regulation 92(3)(b))
- with two adults in attendance, one of whom must be an educator. One adult will be responsible for the administration and the other adult will witness the procedure
- if the prescribed medication is in its original container bearing the child’s name,dose and frequency of administration.
Medical Management Plans
Medical Management Plans are required if a child enrolled at our service has a specific health care need, allergy or relevant medical condition. This involves:
- requiring a parent of the child to provide a medical management plan for the child. The medical management plan must include a current photo of the child and must clearly outline procedures to be followed by staff in the event of an incident relating to the child’s specific healthcare needs
- requiring the medical management plan to be followed in the event of an incident relating to the child’s specific health care need, allergy or relevant medical condition.
Risk Minimisation Plans
Risk Minimisation Plans are required to be developed in consultation with the parents of a child:
- to ensure that the risks relating to the child’s specific health care need, allergy or relevant medical condition are assessed and minimised.
- if relevant, to ensure that practices and procedures in relation to the safe handling, preparation, consumption and service of food are developed and implemented.
- if relevant, to ensure that practices and procedures to ensure that the parents are notified of any known allergens that pose a risk to a child and strategies for minimising the risk are developed and implemented.
- to ensure that practices and procedures ensuring that all staff members and volunteers can identify the child, the child’s medical management plan and the location of the child’s medication are developed and implemented.
- if relevant, to ensure that practices and procedures ensuring that the child does not attend the service without medication prescribed by the child’s medical practitioner in relation to the child’s specific health care need, allergy or relevant medical condition are developed and implemented.
Our service will maintain the review and development of communication strategies to ensure that:
- Relevant staff members and volunteers are informed about the medical conditions policy and the medical management plan and Risk Minimisation Plan for the child.
- A child’s parent can communicate any changes to the medical management plan and Risk Minimisation Plan for the child, setting out how that communication can occur.
· Whenever a child with asthma is enrolled at our service,or newly diagnosed as having a asthma, communication strategies will be developed to inform all relevant Educators, including students and volunteers,of:
o the child’s name, and room they are educated and cared for (in the child’s Risk Minimisation Plan)
o where the child’s Medical Management Plan will be located
o where the child’s preventer/reliever medication etc.will be stored
o which Educators will be responsible for administering treatment.
· Asthma reliever medications will be stored out of reach of children, in an easily accessible central location.
· Reliever medications together with a spacer will be included in our service’s First Aid kit in case of an emergency situation where a child does not have their own reliever medication with them.
· Asthma Australia provides training in Emergency Asthma Management (EAM) which instructs on all aspects of asthma management and administration of asthma reliever medications. Educators who will be responsible for administering asthma reliever medication to children diagnosed with asthma in their care,will attend or have attended an Asthma EAM course. It is a requirement that at least one Educator or other person that is trained in EAM is at the service at all times children are present.
· Asthma Australia produces recommended guidelines on asthma management within the childcare setting, including an Asthma First Aid Plan and Asthma Record Card.
In the case of an asthma emergency, medication may be administered to a child without written parent/guardian authorisation. If medication is administered the parent/guardian of the child or the child’s registered medical practitioner will be contacted as soon as possible
The National Asthma Council (NAC), recommends that should a child not known to have asthma appear to be in severe respiratory distress, the Asthma First Aid plan should be followed immediately. The following steps are recommended:
- If someone collapses and appears to have difficulty breathing, call an ambulance immediately, whether or not the person is known to have asthma; Give 4 puffs of a reliever medication and repeat if no improvement;
- Keep giving 4 puffs every 4 minutes until the ambulance arrives;
- No harm is likely to result from giving reliever medication to someone who does not have asthma;
* See Asthma Policy for more information.
· Whenever a child with severe allergies is enrolled a tour service, or is newly diagnosed as having a severe allergy, a communications plan will be developed to inform all relevant educators, including students and volunteers, of:
o the child’s name and room they are educated and cared for in; o the child’s Risk Minimisation Plan;
- where the child’s Medical Management Plan will be located;
- where the child’s adrenaline auto-injector is located; and
- which educators/staff will be responsible for administering the adrenaline auto-injector.
· In accordance with the Education and Care Services National Regulations, our service will advise families that a child who has been diagnosed as at risk of anaphylaxis is enrolled at the education and care service. Notices will beposted in the foyer, and on the wall of the room that the child is based in.The notice will advise which foods are allergens and therefore not to bebrought to the service.
· It is required that the child at risk of anaphylaxis will have a Medical Management Plan. (The Australian Society for Clinical Immunology and Allergy (ASCIA) has a plan format). Educators will become familiar with the child’s plan and also develop an Individual Anaphylaxis Risk Minimisation Plan for the child in consultation with the child’s parents/guardians and appropriate health professionals.
· A communication strategy will be developed with parents/guardians to ensure any changes to a child’s health care needs are discussed and the health care plan updated as required.
· See Anaphylaxis Policy for information on how the risk of anaphylaxis will be minimised at the centre, and how the centre will respond to children at risk, including first aid and the administration of an adrenaline auto-injector.
· In the case of an anaphylaxis emergency, medicationmay be administered to a child without written parent/guardian authorisation.If medication is administered the parent/guardian of the child or the child’sregistered medical practitioner will be contacted as soon as possible.
· For anaphylaxis emergencies, educators will follow the child’s Emergency Action Plan. If a child does not have an adrenaline auto-injector and appears to behaving a reaction, the educator will only administer adrenaline if the servicehas an additional adrenaline auto-injector for general use. Staff administeringthe adrenaline will follow the instructions stored with the device. Anambulance will always be called. The used auto-injector will be given to ambulanceofficers on their arrival. Another child’s adrenaline auto-injector will NOT beused.
· Whenever a child with diabetes is enrolled at our service, or is newly diagnosed as having diabetes, a communications plan will be developed to inform all relevant educators, including students and volunteers, of: the child’s name and room they are educated and cared for in;
- the child’s Risk Minimisation Plan;
- where the child’s Emergency Action Plan will be located;
- where the child’s insulin/snack box etc. will be stored;
- which educators will be responsible for administering treatment.
· Educators will be aware of the signs and symptoms of low blood sugar including the child presenting pale, hungry, sweating, weak, confused and/or aggressive. Signs and symptoms of high blood sugar include thirst, need to urinate, hot dry skin,smell of acetone on breath
· Management of diabetes in children at our service will be supported by the child having in place an Emergency Action Plan which includes:
o Administration of Insulin, if needed - information on how to give insulin to the child, how much insulin to give, and how to store the insulin. Insulin may be delivered as a shot, an insulin pen, or via an insulin pump.
- Oral medicine – children may be prescribed with oral medication.
- Meals and snacks – Including permission to eat a snack anytime the child needs it.
- Blood sugar testing – information on how often and when a child’s blood sugar may need to be tested by educators
- Symptoms of low or high blood sugar – one child’s symptoms of low or high blood sugar may be different from another. The child’s Action Plan should detail the child’s symptoms of low or high blood sugar and how to treat it. For high blood sugar, low blood sugar, and/or hypoglycemia, educators will follow the child’s Emergency Action Plan.
· See service Policy for Managing Diabetes for further information.
ROLES AND RESPONSIBILITIES:
The Approved Provider:
· Ensuring the development of a communication plan and encouraging on going communication between parents/ guardians and staff regarding the current status of the child’s specific health care need, allergy or other relevant medical condition, this policy and its implementation.
· Ensuring relevant staff receive regular training in managing specific health care needs such as asthma management, anaphylaxis management and any other specific procedures that are required to be carried out as part of the care and education of a child with specific health needs.
· Ensuring at least one educator/staff member who has current accredited training in emergency management requirements for specific medical conditions is in attendance and immediately available at all times that children are being educated and cared for by the service.
· Ensuring that a Risk Minimisation Plan is developed for each child with specific medical conditions on enrolment or upon diagnosis, and that the plan is reviewed at least annually.
· Ensuring that parents/guardians who are enrolling a child with specific health care needs are provided with a copy of this and other relevant service policies.
The Nominated Supervisor/Responsible Person:
· Implementing this policy at the service and ensuring that all staff adhere to the policy.
· Informing the Approved Provider of any issues that impact on the implementation of this policy.
· Identifying specific training needs of staff who work with children diagnosed with a medical condition, and ensuring, that staff access appropriate training.
· Ensuring children do not swap or share food, food utensils or food containers.
· Ensuring food preparation, food service and relief staff are informed of children and staff who have specific medical conditions or food allergies, the type of condition or allergies they have, and the service’s procedures for dealing with emergencies involving allergies and anaphylaxis.
· Ensuring a copy of the child’s medical management plan is visible and known to staff in the service.
· Ensuring staff follow each child’s Risk Minimisation Plan and medical management plan.
· Ensuring opportunities for a child to participate in any activity,exercise or excursion that is appropriate and in accordance with their Risk Minimisation Plan.
· Providing information to the community about resources and support for managing specific medical conditions while respecting the privacy of families enrolled at the service.
· Maintaining ongoing communication between staff and parents/guardians in accordance with the strategies identified in the communication plan to ensure current information is shared about specific medical conditions within the service.
Early Childhood Educators/Certified Supervisors:
· Communicating any relevant information provided by parents/guardiansregarding their child’s medical condition to the Nominated Supervisor to ensureall information held by the service is current.
· Being aware of individual requirements of children with specific medical conditions and following their Risk Minimisation Plan and medical management plan.
· Monitoring signs and symptoms of specific medical conditions and communicating any concerns to the Nominated Supervisor.
· Ensure that parents/guardians are contacted when concerns arise regarding a child’s health and wellbeing.
· Informing the service of their child’s medical conditions, if any, and informing the service of any specific requirements that their child may have in relation to their medical condition.
· Developing a Risk Minimisation Plan with the nominated supervisor and/or other relevant staff members at the service.
· Providing a medical management plan signed by a medical practitioner,either on enrolment or immediately upon diagnosis of an ongoing medical condition. This medical management plan must include a current photo of the child and must clearly outline procedures to be followed by staff in the event of an incident relating to the child’s specific health care needs.
LINKS TO OTHER CENTRE POLICIES
· Asthma Management
· Anaphylaxis Management
· Diabetes Management
Policy reviewed November 2015