Nurseries provide the perfect breeding ground for a whole host of germs because of the close proximity of so many children. The problem is compounded by the fact that many pre-school children may not have yet developed good hygiene habits or built up an immunity against infection.
Ailments that most commonly plague nurseries include coughs, colds, diarrhoea and vomiting illnesses, head lice, skin conditions such as ringworm and infections such as chickenpox. Good infection control measures are essential for ensuring the protection of both children and staff.
Nursery managers will wish to keep a brief summary of every child's history of infectious diseases and immunisations. They should be kept informed if any child has been in contact with any infectious disease.
A good nursery will have policies and guidelines for the prevention and control of infection. The kitchen areas, toilets, rest areas, including floors, corridors and walls along with equipment and furniture, must be spotless and the building well ventilated. Each child should have their own area to keep their toiletries and towel separate from others.
Hand hygiene
Regular and effective hand-washing by both staff and children is one of the most effective ways of controlling the spread of germs.
* Hands should always be washed after using the toilet, dealing with waste/spills or playing with animals, and before eating or handling food.
* Warm water and a mild, liquid soap should be used to wash hands.
* Hands should be rubbed vigorously so both sides are properly cleaned, and rinsed in warm, running water.
* Hands should then be thoroughly dried with a disposable paper towel.
* Handwash basins and toilets should be kept clean, regularly checked and not used as a source of drinking water.
Protective clothing
All nurseries should have disposable gloves and plastic aprons for staff to wear when handling body fluids such as urine, faeces, blood or vomit, and during nappy changing.
Cleaning up body fluid spills
Any spillage of body fluids should be cleaned up immediately with paper towels and an effective disinfectant solution. Paper towels should be removed safely to a waste bin site. Floor mops used to clean up spillages should be rinsed with hot water and detergent and allowed to dry; disinfectant may be used. Any contaminated clothing should be removed from the child and given to the parent to take home.
Nappy changing areas
All nurseries that cater for children in nappies should:
* Change nappies in designated areas away from play facilities, food or drink
* Dispose of soiled nappies in a designated bin with a foot operated lid
* Clean nappy changing mats with a wet wipe or soapy water after each change, and replace them if torn
* Provide hand-washing facilities for staff after every change.
Children on potties
* Potties must only be used in designated areas away from food and drink
* Designate a sink for cleaning potties (not a handwash basin).
* Contents of potties should be flushed down the toilet. Potties should be cleaned with soapy water, dried and stored inverted to dry.
Food management
There should be a food hygiene policy which includes these rules:
* Always wash hands before handling food and check the 'use by' date
* Never leave food out or uncovered, and place raw meat and fish at the bottom of the fridge to avoid them dripping on to other foods
* Keep children and pets away from the food preparation areas
* Use separate chopping boards for meat and vegetables to avoid cross-contamination
* Never reheat food more than once and don't cook food too far in advance.
Head lice
Few children get though nursery without a bout of head lice, which can move from person to person when there is head to head contact. Be suspicious if any child is constantly scratching their head. Lice can be eradicated with lotions and wet combing. Don't allow children to share hairbrushes and accessories or trade hats.
Immunisations
By the age of two all children should have had three doses of diphtheria, tetanus, whooping cough, Hib and polio vaccines and at least one dose of measles, mumps, rubella and MenC.
If an outbreak occurs
If a nursery suspects that some children are part of an outbreak of infection it should inform the Consultant in Communicable Disease Control in public health. Infected children should be sent home to avoid risk to others. Once they are better and no longer at risk of infecting others they can return.
Researched and written by Marcella McEvoy
