Emergency Medical Treatment

Aim

• To ensure that we have all the relevant information related to the child’s illness and reason for medication.
• To comply with guidelines and regulations on administration of medicine.

Objectives

• To ensure Nursery staff follows instructions and comply with the correct manufacturers’ usage of any prescribed medication.
• To protect the child from further illness or reaction.

Operating policy

If a member of staff is asked to administer emergency medication, firstly, they should check there has been a consent form completed and held in the office a copy of which will be in the child’s file.

When the form has been completed in full, the room supervisor or Senior Nursery staff should carefully look over the form and make sure they have checked the following details.

A drugs/medicine register will be kept showing:

• The child’s name.
• The type of drug/medicine administered.
• The date and time drug/medicine was administered.
• The required dosage.
• The name and signature of person administering drug/medicine.
• The name and signature of the witness.
• The time of notification to child’s parents/guardian when an administration of drug/medicine was given in an emergency.
• Note of any known allergy to medication suffered by children attending the nursery.

The consent form should be displayed in the room for the length of time the nursery holds the medication.

If a child needs to be given emergency treatment such as insulin or an antidote for an allergic reaction there should be a written procedure from the parents/doctors of the child, which will be displayed in the child’s folder. This should clearly explain administration details and when the medicine would be needed.

The Nursery would only administer emergency treatment in the case of an extreme emergency and an ambulance summoned immediately by telephone first.

A member of staff trained in First Aid administers the treatment while the other member of staff looks after the remaining children.

Manufactures directions should be adhered to.

Advice can be taken over the phone from an emergency medical team.

The parent/guardian must have signed the consent form to say that they accept all responsibility for the Nursery, administering their child with emergency medication when they brought the Epipen (anti-allergy) or similar in. The Nursery has a supply of Calpol which would only be administered to a child upon approval from their parents and if the Nursery feels immediate steps should be taken to reduce the child’s temperature.

The Nursery will train all staff in the use of epipens, anti-allergy tablets and ventolin for Asthma.

The nursery should be released from any responsibility should the child have a reaction to the Medication.

If a child becomes ill whilst at Nursery we will take every step possible to contact parents, but, if this is not possible, we will take responsible measures to care for the child. We will expect parents to cooperate with us by not bringing children to the Nursery if they have any infectious or contagious illness. Staff will also be asked not to attend work under the same circumstances.

Administration of Prescribed Medicine

Aim

• To ensure that we have all the relevant information related to the child’s illness and reason for medication.
• To comply with guidelines and regulations on administration of medicine.

Objective

To ensure nursery staff follows parent’s instructions and comply with the correct manufacturers usage of any prescribed medication.

Operating policy

If a member of staff is asked to administer medicine, firstly, they should collect a consent form from the office which is to be completed by the parents.

The parent/guardian must signed the form to say that they accept all responsibility for the Nursery administering their child with medicine and release the Nursery from any responsibility should the child have a reaction to the Medication.

When the form has been completed in full the room supervisor or senior nursery staff should carefully look over the form and make sure they have checked the following details:

• The child’s name is clearly printed on the medicine.
• The prescribed dosage is the same on the medication as is indicated on the completed sheet.
• The type of drug/medicine to be administered.
• The date and time administered.
• The medication is within its use by date.
• The prescription has been issue by a doctor within the previous month.
• The first doses are administered at home and the parents confirm this.
• The name and signature of person administering the drug/medicine.
• The consent form should then be displayed in the room for the length of time the medication is to be administered.
• Staff should monitor the child closely and report any adverse effects to the child immediately.

If staff feels they are uncomfortable with administering any medication or lotions they should discuss this with the Manager who will look into the situation.

If the Manager decided the medication is intrusive, unnecessary or does not wish the staff to continue the treatment they have the right to discuss this with the parents and can refuse to continue administration.

In all cases of administering medication:

• The parent/guardian of each child attending the Nursery must provide details of any known allergy to medication suffered by their child. Such details to be recorded by the Nursery in the drugs/medicine register and consulted before any emergency administration of drugs or medicines.
• The drug/medicine must have been prescribed by the child’s General Practitioner or Consultant.
• All drugs/medicines must be stored in a secure place with access only by authorised persons.
• A clear label, with the child’s name, will be attached to the drugs/medicine.

Notice of absence

If a child is not brought to the nursery on a day when she/he is normally present, the parents/carers must inform the Manager by 10am the reason for the absence and the expected date of return.  If the Manager has not heard from the parent/carer after five days ( not including Saturday and Sunday ) the reserves the right to de-register the child and offer the place to someone else.  If for any reason ( e.g. illness ) a child cannot be brought to the nursery when she/he would normally be present, parents/carers are required to pay the normal fees (if the note from doctor is present: first week-full payment, second week-half of payment, third-no payment until the child returns to nursery).

Illnesses and Injuries Policy

It is our policy to provide a healthy and safe environment for staff and children.

At all times our employees will cooperate fully in implementing health and safety initiatives. They will do everything possible to make sure injuries do not occur to themselves or to others.

We expect our employees to take responsible care of their own health and safety at all times.

It is our intention to make sure at all times that there is a qualified First Aider on the premises.

A First Aid Box is always available which is stocked according to Ofsted requirements. The Deputy Officer in charge is responsible for restocking the First Aid Boxes.

An accident forms (for children) and Accident book (for adults) are available which must be filled in if any child or member of staff sustains an injury whilst on our premises or while in our care. Details of how, where, when and to whom the accident happened must be recorded by the member of staff who saw and dealt with the injury. The treatment given must also be recorded in the accident form/book.

We will act on the advice given by agencies such as Ofsted, environmental health and the fire brigade.

During the Covid -19 outbreak, we ensure that a clear policy of staff sickness is in place:

• Staff to leave the nursery as soon as possible and maintain appropriate distance from others before leaving.
• Staff should only attend the nursery if they are symptoms free, have completed the required isolation period or achieved a negative test result.
• Risk assessment with regular health questionnaires for returning staff is in place.
• Following parents’ request, the temperature of staff and children will be checked and registered into the Staff/Children’s sign in the registration book on their arrival .

Poor mental health of staff:

• Staff will be informed of developments as early as possible.
• Information shared will be accurate, factual, as detailed as possible and shared in a timely manner.
• Training on new or revised procedures will be given.
• Staff can ask questions or raise concerns at formal and informal opportunities (i.e. through the staff whatsapp group).
• Regular supervision sessions will continue either in person or virtually (maintaining social distancing where appropriate).
• Access to mental health & well being support shared with all staff.

Staff from isolated households cannot attend the nursery.

High Temperature Policy

Objective: to ensure children in our care are safely monitored throughout their day to prevent high temperatures. If a child shoes signs or symptoms of high temperature the following procedure needs to be followed:

Please note: the normal body temperature is 36.5 C

• Take child’s temperature
• Record on a temperature form
• If a child has a temperature of 37.5C or just above child to be striped and given cold fluids to try and get the temperature down naturally.
• Monitor for 10 minutes if temperature has gone down no further action needed.
• If the temperature increases the following actions will then be taken:

1. The parent/ carer will be contacted and asked to collect if necessary.
2. Check and observe the child’s level of energy, colour of skin (turning pale) and overall symptoms.
3. If the temperature is 38.5 C or above parents will be called to collect, and verbal permission received from the parent for the nursery Emergency of Calpol to be administered whilst they are on their way to collect their child.

If the child’s temperature is very high at the first acknowledgment, Parents will be asked to collect immediately. Children who suffer from convolutions, parents must get letter from their doctor stating this, so we are able to assist the child with our emergency supply of Calpol. A medical emergency plan would need to be discussed and agreed with parents and healthcare professionals and kept on premises at all times.

If the temperature increases and the parent/ carer cannot be reached or if the child is obviously very ill, an ambulance will be called and the key person will accompany the child to the hospital.

Medication & Sickness

Some of the childhood illnesses specified are chicken pox, conjunctivitis, cryptosporidiosis, dysentery, gastroenteritis, giardiasis, glandular fever, hand, foot and mouth disease, hepatitis, HIV, meningitis, measles, mumps, streptococcal infections, tuberculosis, whooping cough as well as skin conditions such as head lice, impetigo, ringworm,  scabies and verrucae are also listed.

We understand that from time to time unexplained rashes may appear which may accompany temperatures as well as those which do not appear to have any other symptoms, may happen with young children. The Nursery staff are not medically trained and therefore should your child develop a rash we may ask that parents make an appointment to see their doctor to seek an expert opinion as soon as possible.

Should your doctor advise you that the rash is not serious and it cannot be passed on to other children or adults and that your child is fit and well enough to return to nursery, we will require written proof from your doctor.

This letter must be clearly dated and the name and address of your doctor included.

If the Nursery staffs is at all worried that your child’s rash may be more serious, or if one or more of the symptoms of meningitis are present, an ambulance will be called immediately. We will make every effort to contact you and a member of staff will accompany your child to the local hospital.

Should your child develop a temperature whilst at Nursery, we will do our very best to contact you and advise you of your child’s condition and how they have been throughout the day so far. With our permission, we will administer the age appropriate dosage of Calpol. We will ask you to telephone us after half an hour to find out if your child’s temperature has reduced and if they are more comfortable. If there has been little or no improvement, you will be asked to come to collect them.

If you advise us that you have given Calpol or Neurofen prior to bringing your child into Nursery due to them having had a bad night or a temperature, and your child then develops a further temperature during the morning, we may make the decision that your child is not well enough to remain at nursery and call you to come to collect them.

Children become unwell with symptoms of coronavirus while in the nursery setting:

 A  fluid resistant face mask should be worn by the supervising adult if a distance of 2 meters cannot be maintained.

• If contact with the child is necessary, then disposable aprons and gloves should be worn by the adult.
• Whilst waiting for the child to be collated, the child should be isolated from others in their bubble room or designated area (assembly hall) .
• the staff member responsible for the child during this time should be a staff member from their bubble.
• The area should be thoroughly cleaned immediately, windows opened.
• The person responsible for the cleaning should wear appropriate PPE.

 Children from isolating households cannot attend the setting.

 

Conjunctivitis

Should the Nursery suspect your child has contracted conjunctivitis (red eye), you will be asked to collect your child as soon as possible and to get appropriate medication. Your child will not be accepted back into nursery without a parent taking measures to treat the condition. Conjunctivitis is extremely contagious and if the spread within a room is evident, it may be necessary to exclude all affected children until they fully recover.

As with any medication for illness, all children are excluded from Nursery for the first 24 hours of a course of treatment.

 Sickness and diarrhoea 

Diarrhoea. Children may have diarrhoea for many different reasons, the following procedure will need to be followed to prevent a bug in the nursery.

1. 1^st occurrence will need to be recorded on the nappy/potty chart or the toilet run chat in the comment section.
2. On the 2^nd occurrence a common childhood illness form must be completed and parents to be contacted.
3. On the 3^rd occurrence parents will be asked to collect and advised to seek a medical advice.

Sickness. If child becomes sick whilst at nursery the following actions will take affect:

• If the child has more than 1 occurrence they will need to be collected and parents and parents advised to seek medical advised.
• The child will be observed and given cold fluids and temperature checked.
• If the child’s symptoms are lethargic and pale in colour, the parent/ carer will be immediately and asked to collect.
• All equipment and toys will be checked and cleaned to avoid cross infection and where it has come into contact with bodily fluids, should be cleaned with Milton tablets.

If there is an illness bug in the nursery our main aim is to get clear of this infection as quickly as possible, therefore we ask children to be collected after the first occurrence of sickness or diarrhoea. The child cannot return until there has been 48 hours of the occurrence of vomiting and child is eating normaly.

 

Sickness and medical requirements

The Manager is not allowed to admit onto the premises any child who appears to be suffering from an infectious or contagious illness or disease. Any child who has a sore throat, discharge from the eyes or nose, sickness, diarrhoea or any contagious/infectious illness should be kept at home until a doctor has certified, in writing, that s/he is fully recovered or 48 hours have elapsed since the last outbreak. Please do not bring children who are unwell into the nursery as they will be sent home upon arrival.

Parents/carers are required to inform the nursery where they can be reached in the event of an accident or sudden illness. However, since it may sometimes be impossible to find a parent/carer in emergency, parents/carers are required to provide the Manager with signed permission for her to act in their absence.

If a child becomes seriously ill or injured during his/her attendance at the nursery, the nursery reserves the right to call for emergency assistance and, if necessary, remove him/her to hospital and give permission for emergency treatment to be administered. If we have to take your child to hospital as a result of an illness or accident, we will do our utmost to inform you immediately (using the details on your Application Form). It is therefore vital that this information is kept up to date and that you inform us of your timetable/whereabouts. Please inform the Manager of any changes to these details as soon as possible.

Please inform us as soon as possible if you child will be absent for a period of time due to illness.

Local Authority regulations state that parents/carers are required to give the following information to the Manager: name, address and date of birth of each child; name, home address and place of work with respective telephone numbers of the parents/carers of each child ( we ask that a copy of the parent/carers current timetable should be left with the Manager to ensure that contact can be made in an emergency ); name, address and telephone number of each child’s doctor and the state of immunisation and infectious diseases suffered by each child.

All accidents are reported in an Accident Report Folder which is kept in the Nursery Office. Parents/carers will be asked to sign these in the event of their child having an accident at the end of the day the accident occurred.

 Medication

If your child has been prescribed a course of antibiotics, we will continue to administer the medicine as we have always done. We ask that children remain at home for the first 24 hours to ensure the medication has had ample time to take effect and the child will fell more like themselves and able to enjoy their day at nursery.

We will not administer any medication which does not come into nursery in its original box together with the information leaflet provided by the manufacturer.

This will alert us to any possible side effects. Your child’s name, date of issue and the recommended dosage must also be clearly visible.

We are permitted to administer children’s cough linkups which are within current date and the dosage clearly marked with your written permission.
(This medicine can now be store bought and not prescribed)

Should your child appear to be distressed, unwell or acting out of character without any specific signs or symptoms of illness, we reserve the right to ask you to seek medical advice or keep your child at home until they are fully recovered and fit to be at Nursery.

The Nursery does reserve the right refuse to give any medication we do not feel comfortable to administer.

We also require you to keep your child at home for 24 hours after any medication has been administered by a doctor. This includes childhood inoculations and holiday vaccinations.

We ask that parents inform us immediately if they have been in contact with communicable diseases in order for us to take proper precautions to protect our children, staff and other parents. With this information we ask that you be especially vigilant about disease which could affect pregnant staff or other parents. The Nursery has an obligation to inform the Department of Health if there is a spread of communicable disease in the Nursery setting.

Staff medication

The first box  for staff should be kept in a readily accessible position, but out of reach of children.

First aid boxes should only contain items permitted by the Health and Safety (First Aid)Regulations Act 1981, such as sterile dressing, bandages, and eye pads. No other medical items, such as paracetamol should be kept in the first aid box.

Storage

All medication for children must have the child’s name clearly written on the original container and kept in a closed box, with is out of reach of all children and under supervision at all times.

Emergency medication , such as inhalers and epipens, will be within easy reach of staff in case of an immediate need, but will remain out of children’s reach and under supervision at all times.

Any antibiotics requiring refrigeration must be kept in an area inaccessible to children.

All medications must be in their original containers, legible and not tampered with or they will not be given.All prescriptions must be in their original containers, legible and not tempered with or they will not be given.All prescription medications should have pharmacist’s details and notes attached to show the dosage needed and the date the prescription was issued.This will all be checked, along with expiry dates,before staff agree to administer medication.