In order to maintain a safe and hygienic environment in your nursery, you have to assess the level of risk you face, as Laura West explains…
Infection control and prevention is critical in childcare settings as there are essential activities that could put both children and staff at risk of passing on or contracting an infection.
The highest risk of these is dealing with clinical waste, also known in the early years world as changing nappies. Infections can be easily contracted and transmitted, but are equally easy to avoid if everyone plays their part and puts into practice proper preventative actions.
First, let’s understand what an infection actually is. Infections are caused by bacteria, fungi or viruses entering the body. They can be minor and stay in one area, like an abscess or boil, or spread through the body, like flu or a blood infection.
General infections are easily dealt with, but sometimes they can cause more serious health problems. Infections like flu or norovirus can be spread from person to person, but not all infections are transmittable.
There are many infections that people can pick up, at work, around the home and in public places. They can be spread by blood, bodily fluids, waste, skin contact or infectious aerosols such as sneezing, dust and water droplets.
The spread of infection is also known as the ‘chain of infection’, and by breaking a link we can halt the process. There are six links to consider:
Infections generally enter the body via one of four routes:
Inhalation – meaning, we breathe it in.
Ingestion – entry through the mouth. This often occurs accidentally through hand-to-mouth transfer, when a person has a substance on their hand and then does something like bite their nails, smokes or eats lunch.
Injection – caused by sharp objects that penetrate the skin and allow harmful substances into the body. Particular hazards include discarded needles and syringes.
Absorption – this usually takes place through cuts or other breaks in the skin, although there are other substances that can penetrate and be absorbed by unbroken skin.
Infection can occur in a number of different ways within a childcare setting, the main way being putting contaminated hands, fingers or pens into the mouth, nose or eyes, or inhaling infectious aerosols or droplets from the air (eg breathing in after someone has sneezed).
Other ways include contamination via broken skin (a wound) or coming into direct contact with a microorganism or something contaminated by microorganisms.
More-serious ways of contamination could involve splashes of bodily fluids such as blood or excrement coming into contact with the eyes, nose, mouth or open wound, or a skin-penetrating injury – eg being contaminated via a discarded needle or animal/insect bite.
In order to control and prevent a potential infection you have to assess the level of risk. Once a source of infection has been identified you must consider how likely it is that infection will occur.
In order to do this, think about how often the task is carried out, how many employees are exposed, and how much infectious material is handled. If you consider that there is a risk, decide whether existing control measures are sufficient or if more are required.
Within industries where people work with people (adults and children) or animals, the basic control principles of occupational hygiene should be applied in all situations. Occupational hygiene principles that all staff should be following include the following:
As well as occupation hygiene, good environmental hygiene and design are also essential. These principles include the following:
Cleaning products is the next area of control and prevention to consider. Disinfectants can be used to reduce bacteria to a safe level; this is achieved by using the disinfectant along with very hot water (82ºC or higher) for best effectiveness.
But remember, they must be diluted to the correct levels and left in place for the specified ‘contact time’ before rinsing. Disinfectants won’t break down grease and dirt.
Detergents will break down grease and dirt but will not kill bacteria, However, sanitisers are a combined detergent and disinfectant that will kill bacteria if left for the correct ‘contact time’.
Washing your hands regularly, effectively and thoroughly is the best way to keep the level of hand-based bacteria to a low or zero level.
Emergencies
As well as controlling the day-to-day risks it’s important to consider potential action that may be required in an emergency situation. If an employee is exposed to blood or potentially infectious materials, you will need to wash the exposed area thoroughly with soap and running water.
If blood or bodily fluids are splashed in the eyes or mucous membrane, flush the eye area with running water for at least 15 minutes.
Report the exposure to your supervisor, document the incident and investigate how this happened using health and safety procedures. It is also advisable to seek medical advice. It is a good idea to have a ‘clean up’ or ‘spill kit’ available.
Washing your hands is one of the most important ways of controlling the spread of infection…
You need to wash your hands before and after:
Laura West is the childcare health and safety specialist at MCW Nursery Support Service Ltd, a family-run business specialising in health and safety, auditing and training for the childcare industry. Visit mcwnss.co.uk.
