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Preparing Child Care Programs for Pandemic Influenza

 

In 2008, the American Academy of Pediatrics (AAP) completed a needs assessment of 1500 licensed child care centers. Results show that more can be done to prepare the early education and child care community for a pandemic influenza. Top choices for improving preparedness were participation in training sessions, use of print materials, and access to downloadable or interactive Web-based tools.

The following strategies are useful to enable child care programs for a pandemic or seasonal influenza outbreak.

Communication
During a pandemic, a strong connection between child care and public health leaders is critical because recommendations and communication strategies evolve rapidly. Early education and child care programs need to be aware of existing mechanisms for information dissemination and decision-making. Preparing effectively involves the following tasks:
  • Compiling a list of key contacts and their e-mail and phone numbers.
  • Assigning responsibilities for who will call whom in what circumstances.
  • Distinguishing a “telephone tree” for information sharing from an alert system.
Training
Training sessions on influenza can achieve the following objectives:
  • Improve day-to-day preparedness.
  • Identify response plans for active outbreaks or pandemics.
  • Engage local pediatricians, health department representatives, and qualified child care health consultants in child care health and safety.
  • Keep staff informed of ongoing community preparedness efforts.
The handout on Preparing Child Care Programs for Infectious Disease Outbreaks or Pandemic Influenza offers more information.

Steps for Improving Preparedness:
  1. Develop a written emergency/disaster plan that includes a process and timeline for updating this document.
  2. Maintain a list of community contacts and establish a call system with lists of key phone numbers in advance to communicate during an emergency.
  3. Identify “trusted sources” of health information (eg, CDC, health department, child care health consultant, community pediatricians).
  4. Determine who will monitor and report back on key findings.
  5. Develop a process for sharing key information with staff, parents, and children during an emergency.
  6. Prepare handouts for staff and parents in advance.
  7. Discuss the process for ordering supplies (and maintaining inventory) during times of staff absences or when there is an increased need for certain hygiene or cleaning supplies. 
  8. Use seasonal influenza as an opportunity to practice preparedness and response efforts.
  9. Collaborate with community partners on preparedness activities or contingency planning.
  10. Review criteria for and steps involved in facility closure.
  11. Implement steps to support families and employees in the development of personal preparedness plans.

Strategies
In addition to the steps described above, child care programs should be encouraged to implement these new strategies to enhance preparedness:
  • Provide seasonal influenza immunizations on site at the child care facility.
  • Collaborate with nearby centers on the use of substitutes, mass supply ordering, and/or training.
  • Create a Web site or answering service message to provide updates.
  • Form a team that includes a child care health consultant and/or local public health representative to make decisions during an outbreak or pandemic.

Disaster Preparedness Standards
Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition has updated or added the following standards related to influenza and H1N1.
  • Standard: 3.1.1.1.: Conduct of Daily Health Check
  • Standard: 3.2.2.2.: Handwashing Procedure​
  • Standard: 3.2.3.2.: Cough and Sneeze Etiquette
  • Standard: 3.3.0.1.: Routine Cleaning, Sanitizing, and Disinfecting
  • Standard: 3.6.1.1.: Inclusion/Exclusion/Dismissal of Children
  • Standard: 3.6.1.2.: Staff Exclusion for Illness
  • ​​Standard: 3.6.1.4.: Infectious Disease Outbreak Control
  • Standard: 3.6.2.1.: Exclusion and Alternative Care for Children Who Are Ill
  • Standard: 7.2.0.1.: Immunization Documentation
  • Standard 7.2.0.3: Immunization of Caregivers/Teachers. Adds the following immunizations: Td/Tdap, HPV (ages 11 to 26), seasonal influenza for all staff (no age restriction).
  • Standard 7.3.3.1: Influenza Immunizations for Children and Caregivers/Teachers – NEW. Recommends written documentation that a child 6 months of age and older has current annual vaccination against influenza unless there is a medical contraindication or philosophical or religious objection.
  • Standard 7.3.3.2: Influenza Control – NEW. Encourages parents/guardians to keep children with symptoms of acute respiratory tract illness with fever at home until their fever has subsided for at least 24 hours without use of fever reducing medication. Same for caregivers/teachers.
  • Standard 7.3.3.3: Influenza Prevention Education – NEW. Recommends refresher training for all staff and children on hand hygiene, cough and sneeze control, and influenza vaccine at beginning of influenza season.
  • Standard: 9.2.4.3.: Disaster Planning, Training, and Communications
  • Standard 9.2.4.4: Written Plan for Seasonal and Pandemic Influenza – NEW. Recommends contents of a plan in the areas of planning and coordination, infection control policy and procedures, communications planning, and child learning and program operations.
  • Standard: 9.4.1.2.: Maintenance of Records

Resources
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