Know

Child and youth programs are environments where infectious diseases can easily spread with all the runny noses, toileting, touching, and mouthing that occurs in learning and play spaces. Your best defense against the spread of infectious diseases is a clean environment and proper hygiene.

When it comes to reducing the spread of infectious disease, nothing is as effective as washing our hands. Classrooms stay healthier when everyone engages in this germ-fighting activity. Staff must constantly model and discuss handwashing with the children in your program. Daily schedules should include frequent handwashing and children should be taught when they need to wash their hands. Children are more likely to wash their hands properly and at appropriate times if they understand why handwashing is so important. When handwashing occurs frequently, children and youth will be healthier, and staff will miss fewer days of work.

Handwashing is one practice that everyone at your program can do to prevent the spread of illness. It is important to ensure staff have been trained in proper handwashing procedures and times to wash their hands. This information is detailed below.

For handwashing to be effective, proper procedures must be followed. Every step of the handwashing procedure is important to the whole process. A missed step can cause re-contamination and the spread of germs. Wash your hands with liquid soap for at least 20 seconds, and always turn off the faucet with a paper towel. Discuss with your staff when and under what conditions staff members or children may use alcohol-based hand sanitizers (i.e., on field trips when water is not available). A poster showing proper handwashing procedures should be posted by every adult and child sink for reference (see Apply attachments). In addition, handwashing supplies should always be well-stocked and accessible.

Staff members can model healthy habits for each other and children. Make sure you wash your hands at the appropriate times (e.g., each time you enter a classroom or program) and that you always follow proper handwashing procedures. See the full list below of times providers should wash their hands. Your adherence to washing your hands at the appropriate times sets a strong example for the rest of your staff. Proper handwashing is an activity that should happen regularly in the classes of children of all ages. The skills your staff teach children can also help bring these practices home. A recent study revealed that after using a public restroom, only 31% of men and 65% of women washed their hands (Judah et al., 2009).

In addition to washing hands when they are visibly soiled, there are specific times when handwashing is especially important. The American Academy of Pediatrics recommends the following:

Young children will need guidance in learning how to wash their hands appropriately. Infants and young toddlers will need physical assistance to thoroughly wash their hands. Check out the Apply section for handwashing materials you can share with staff. Work with your trainers and coaches to ensure all staff members know how to properly support handwashing with the children in their care. For toddlers, preschoolers and school-age children, encourage staff members to construct their own handwashing posters with the children’s help, so that all members of the classroom or program community know what to do. Children are sometimes more inclined to appropriately follow an important routine like handwashing if they see themselves or their friends in the pictures, or if they help create the words.

Standard and Universal Precautions

Another way to reduce the risk of transmission of germs that can cause infection is to practice standard or universal precautions. Standard precautions cover all situations where you may come in contact with body fluids. Universal precautions apply specifically to contact with blood, and do not apply to contact with feces, nasal secretions, mucus, sweat, tears, urine, saliva, or vomit unless these body fluids also contain blood. In child care settings, standard precautions involve using barriers to prevent contact with body fluids from another person, as well as cleaning and sanitizing contaminated surfaces. 

Barriers you or staff members might use to help prevent bodily fluid contact might include:

• Moisture-resistant disposable diaper table paper
• Disposable towels
• Gloves
• Plastic bags, securely sealed

Staff should always use disposable non-porous gloves when blood or body fluids containing blood may be involved. Gloves are optional for diapering and contact with other bodily fluids described above, but adhere to your Service or program guidelines regarding the use of gloves. Gloves are not necessary for feeding human breast milk.

Whenever gloves are worn, make sure staff practice good hand hygiene; wearing gloves does not remove the need to properly wash hands after the task is complete. The appropriate procedure for removing gloves to reduce contamination is also attached.

Coughing and Sneezing

Respiratory infections and germs are spread through coughing and sneezing. In addition to handwashing after coughing or sneezing, here are a couple simple ways to cut down on the spread of those airborne germs:

• Cough into your elbow instead of your hand. Older toddlers can be shown this technique, but know they might not remember to do it all the time. Model this practice to help them start healthy practices.
• Cover sneezes with a disposable tissue if one is available. Dispose of tissues in a hands-free trash can.

Keep tissues well-supplied in all program areas. Encourage staff to take tissues outside to reinforce that healthy habits happen regardless of location. Used tissues should be disposed of immediately, and children should wash their hands after coughing and sneezing. Staff should model these behaviors to help children learn. Proper handwashing after sneezing, coughing into your hand, blowing your nose, or after helping a child who has sneezed is important to maintain a healthy environment and to avoid the spread of disease.

Cuts, Scrapes, and Sores

As wounds heal, they might drip, ooze, or drain. These fluids can spread infection and the wound itself also is susceptible to infection. The American Academy of Pediatrics (2011) recommends covering and containing any wound that is leaking. If the wound is so severe or big that it cannot be contained, the child or adult should stay home until a scab has developed. Hand hygiene is critical before and after a staff member’s contact with his/her, another staff-member’s, or a child’s sores, cuts, or scrapes.

Blood and Other Body Fluids

Blood can carry a variety of pathogens. Bloodborne pathogens include human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Transmission of these diseases in child care is rare. They are most frequently transmitted through needle sticks or when blood or other body fluid enters the body through eyes, nose, mouth, or broken skin. These diseases are not spread through saliva, sweat, or vomit. Casual contact like hugging, sharing a cup, using a public restroom, or coughing and sneezing do not spread bloodborne diseases.

However, to promote hygiene practices and decrease the chance of contracting various infectious diseases, all staff members must wear gloves when blood is present or suspected when helping a child or another staff member who has been injured. Staff must also wash their hands when they are finished and after they have properly removed their gloves. Staff members should wash their hands immediately after contact with other body fluids, excretions, or wound dressings and bandages.

Supervise & Support

Management Practices That Promote Proper Hygiene

The chart below summarizes your key responsibilities in terms of promoting hygiene.

In Summary

When you model healthy habits and set expectations that staff will model healthy habits too, you not only create a healthier today, but a healthier tomorrow for everyone in your program.