Know

Child and youth programs are natural environments for the transmission of infectious diseases; you could go so far as to say they are germ incubators. With all the runny noses, toileting, touching, picking, and mouthing that occurs within child care and learning programs, it's surprising that anyone is healthy. Your best defense against the spread of infectious diseases is a strong offense. Your actions support wellness when you maintain a clean environment (see Lesson One) and assure staff and children in your program practice good hygiene.

当涉及减少疾病的传播时，没有什么是有效的，就像洗手一样有效。当每个人从事这种细菌活动时，教室保持更健康。工作人员必须不断模拟和讨论程序中的儿童手术。当行动发生时，儿童和青少年将是更健康的，工作人员会错过更少的工作工作。

洗手是一种实践,每个人都在你program can do to prevent the spread of illness. However, many staff members will not have been trained in proper handwashing procedures. You will need to make sure that staff members know the best ways 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, and 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; it should be habit. 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 much guidance in learning how to wash their hands appropriately and infants and young toddlers will need physical assistance to complete the task. 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 microorganisms (germs) that can cause infection is to practice standard or universal precautions. Standard precautions cover all situations where you may come into contact with body fluids, but universal precautions applies specifically to contact with blood, and does not apply to contact with feces, nasal secretions, sputum, sweat, tears, urine, saliva, or vomit unless these body fluids also contain blood. In child care settings, standard precautions involves using barriers to prevent contact with body fluids from another person, as well as cleaning and sanitizing contaminated surfaces. You can read more about standard precautions in the标准和通用预防措施，它们适用于儿童保育设置附件上文。

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

员工应该始终使用一次性无孔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:

• 咳入你的手肘而不是你的手。较旧的幼儿可以显示这种技术，但知道他们可能不记得一直这样做。模拟这种做法，以帮助他们开始健康的实践。
• 如果有可用的话，请用一次性组织盖住打喷嚏。在免提垃圾桶中处理组织。

将组织保存在所有程序领域。鼓励员工在外面服用组织，加强健康的习惯，无论位置如何。使用的组织应立即处理，孩子们应该在咳嗽和打喷嚏后洗手。工作人员应该塑造这些行为来帮助孩子学习。打喷嚏后适当的洗手，咳嗽到你的手中，吹鼻子，或者在帮助一个打喷嚏的孩子后要保持健康的环境并避免疾病的传播。

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.

血液和其他体液

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 should wash their hands before and after helping a child or another staff member who has been injured, and after handling bodily fluids of any kind (i.e., mucus, blood, vomit, saliva, urine). Staff members should wash their hands immediately after contact with blood, body fluids, excretions, or wound dressings and bandages.

监督和支持

Management Practices That Promote Proper Hygiene

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

Management Practices		Staff Practices
I should always…	确保	工作人员永远不会......
Ensure that staff are trained on proper handwashing technique and timing, for both themselves and the children.		有助于传播传染病，因为它们不适当洗手 Fail to teach children when and how to appropriately wash their hands.
Ensure enough handwashing supplies or other hygienic supplies (e.g., tissues, gloves) are available in all relevant program areas.		Fail to follow appropriate handwashing technique or precautions due to lack of materials.
Monitor handwashing procedures at regular intervals and address concerns immediately		未能遵循健康卫生的政策，保持健康的环境
Offer visual reminders (e.g., with posters by program sinks) for proper handwashing technique and timing, and safe hygiene practices (e.g., covering your cough) at relevant places in your program.		Put children and youth at risk of becoming ill because they were not following hygienic practices 在适当的洗手或卫生实践中向儿童和家庭提供不舒服的建议

综上所述

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.

健康习惯