Public Health

Free. That word instantly draws your attention and excites even when you think of it. Health care is much like every other industry, the word “free” always comes with an asterisk. I am currently employed at McDonough District Hospital and it is my goal to be the CEO of a hospital one day. Because of this, I want what is the best for not only the hospital itself but the patients that are taken care of; and it is a passion of mine to study how to make the health care industry better whenever I can.

According to Frank Newport, the editor-in-chief at Gallup in his November 2, 2018 for the Gallup website, health care is the most important political issue to the American public, ranked as important to 80% of Americans. Universal health care is a hotly debated topic; but overall, the United States moving to government-controlled health would not only be bad for Americans, but it would be bad for the rest of the world in general. Today, I will show you how the current US health system works very well, as well as how universal health care systems in other countries are not as much of a free and easy ride as you would believe and how much worse the quality and quantity of heath care and health insurance would become if the government were to be in total control of your body’s well-being.

The US health care system works very well and is beneficial for everyone around the globe. Our current health care system is a very good system that provides some of the best health care for Americans as it already is. The World Health Organization’s 2017 Global Health Observatory (GHO) reports how Americans’ mortality rates and life expectancy are among the highest in the world. According to the GHO, the USA’s infant and motherhood mortality rates are at 6.5 and 14 (per 1000 births) are the lowest of any region, respectively.

The closest is Europe at 9.6 and 16. The GHO also reports that Americans’ life expectancy is among the highest in the world, 79.25, with Europe again being the closest at 76.7. Many of America’s worst health problems come from our culture of eating, as I had mentioned in my previous speech about our obsession with fast food. As I had mentioned previously, there are direct causes between our eating habits and increases of cardiovascular disease.

Many of the statistics showing the US’ poor health care conditions often base themselves on the percentage of cardiovascular disease, but these eating habits are directly killing people younger and younger because of the fast food culture. Because of this obsession, this causes a sharp increase in deaths from these cardiovascular diseases. There is no magic cure for someone who eats Burger King three times a day and has a heart attack. Not only is the USA’s health care system good for Americans, it is also very good for people around the world, covering the costs for many of the countries with universal health care whose health systems would be unsustainable otherwise.

The United States is the number one leader in health care innovation in the world. In Keyhani MD, Wang MD, Helbert PhD, Carpenter PhD and Anderson PhD’s article in the 2010 June edition of the American Journal of Public Health, they found that 36.4% of pharmaceutical innovation came from the United States every year, nearly 4x that of the nearest country, the UK at 10.4%. The US also spends tens billions of dollars yearly to aid foreign health care systems. iv.

According to USAID, the State Department’s division that gives aid to foreign countries for development and health care, their own website reports that for the 2019FY their budget is $39.3 billion. (Transition): The US’ health system does provide great care, but obviously we are not at the #1 position for all measurements of health quality. However, if universal health care were truly better in every way, then the US would surely be at the bottom of every measure, if you were to listen to claims that the US is the only country in the world that does not have universal health care. Switching to this system would not only end the benefits of our current system, but we would also have to suffer from the negative consequences of health care for all.

Countries with universal health care are not as much better off than the United States than what is claimed. Though it is portrayed as being an American problem, the inequality of care continues even when health insurance is made public. Flato and Zhang, researchers for the Fafo Research Foundation, wrote in the International Journal for Equity in Health on June 22nd, 2016 about how health care was utilized in China before and after universalization.

Their article stated that the rich were still far more likely to receive care than the poor, and that they still sought care more often. They also had stated that health needs had become less important for determining care, stating that the poor were increasingly disadvantaged. This means that one of the principal arguments against any private sector market is directly contradicted by the result. It may, at first, appear like a takeover of our health will help those who cannot afford care in the current system, but in the end it still means that the rich are able to care for themselves while the poor are left to die. The only thing that changes is that there are no affordable alternatives due to a lack of competition.

Universal health care does not truly mean health care for ‘all’. The World Health Organization published an article on their website on January 13, 2016, stated that ‘rationing’ is a necessary part of any Universal Healthcare System. According to the WHO’s article, the governments decide for their people the most cost-effective treatments and utilize waiting lists for treatment. Even though these systems are supposed to be “Free health care for all”, the government still requires its citizens to pay copays for their treatment. The government also has to mandate that some types of treatment are not covered at all, and the people have no choice otherwise.

Health Systems limited by government dominance leads to the inevitable problem of all government bureaucracy: slow, inefficient systems. The 2013 Commonwealth Fund International Health Policy Survey in Eleven Countries reported the wait time results for health care in, as the name says, eleven countries. This survey reported by the Commonwealth Fund showed that the wait times for purely single-payer health care systems often used as the ideal system have the longest wait times, with Sweden and Canada far ahead of the United States. The wait times reported by patients were separated into two categories: under 4 weeks and two months or more.

The United States was at 80% for under 4 weeks and 6% for over two months. Canada and Sweden were at 39% and 54% respectively for 4 weeks, and 17% and 29% for over two months. Wait times in health care are incredibly important, and these dangerously long extensions can cost people their lives. What good is health care that you don’t have to directly pay for, if you never live to get the care? Transition: All of these effects are just part of what comes with any change to full socialist health care. If the US were to change to this system, the effects would be much worse.

The moves towards universal health care in this country have already made the health care system much worse and moving to it fully would spell even more disaster for everyone. Legislation to like the Affordable Care Act and other laws that moves us closer to socialized medicine have already made health care in the US worse. The Affordable Care Act, AKA Obamacare, took effect on the nation starting in 2014. This legislation not only tightened regulation on health insurance companies but forced every American without private insurance to either sign up for their health insurance or pay a fine.

Another largely advertised part of this bill was forcing insurance companies to accept people with pre-existing conditions. This act was meant to be a step forward, towards universal care, and its negative effects have already begun to take place. According to a report from the Center for Disease Control (CDC), their 2017 Health Report, up until 2015 the life expectancy rate was growing at a steady rate. Ever since 2015, though, the life expectancy for both men and women has begun decreasing more and more every year. This is the first time in the United States’ history where we will live shorter lives than our parents.

Holahan, Blumberg and Wengle, writers for the Robert Wood Johnson Foundation, published in a report called “Changes is Marketplace Premiums 2017-2018” reported that in the United States, insurance premium rates for lower end plans, called “silver plans” increased by 32%, and higher tier “gold plans” went up by 19.1%. iv. If this plan was meant to make health care more accessible and affordable for the poor and hurt the rich, why are the plans for poorer Americans increasing at nearly twice the rate as the rate for the rich? In my personal experience, the current government aid system is ruining not only the hospital experience for patients in need, but also the hospitals themselves.

Many times, patients on Medicare or Medicaid often come to McDonough District Hospital, often for mundane injuries/illnesses because they do not have to pay for it. This leaves the Emergency Room and other areas of the hospital much busier and detracts from patients with actual issues getting the speedy treatment that they deserve and need. This once again shows how a universal health care system detracts from real patients with real issues as I had stated earlier.

The hospital I am employed at itself is suffering because of the public aid programs. Currently, the hospital is running out of money giving so many Medicaid patients treatment, because the state itself is out of money and Medicare is horribly inefficient. Currently, the debt owed to the hospital is in the hundreds of millions and this alone is a massive cause for the struggling state of the hospital. People have been laid off, outsourced and outright fired because the hospital cannot afford getting along without this debt. If the US continues on this trend, the negative effects of UHC will make everyone’s lives worse.

Charles Blahous, a senior researcher at George Mason University, wrote for the Mercatus Working Paper on July 30th, 2018 about the costs of the “Medicare-For-All” (M4A) plan proposed by the 2016 Democratic presidential candidate Bernie Sanders. This report found that DOUBLING taxes on every single American and all businesses large and small would still be insufficient to cover the costs for the first 10 years of this plan, increasing every year after.

This means not only the rich, but also the poor and middle class, which this plan claims it would ‘help.’ The report also found that this plan is designed to cut provider pay by 40%. This means the hospitals, doctors and nurses all making nearly half of the pay they make now. iv. These results are unfair for the public as well as the health care providers. The costs would make health costs increasingly to expensive for Americans, thus creating the same inequity present in China’s recent UHC implementation. The shortage of health care centers and providers would exacerbate the shortage of providers and make the rationing problem even worse for us than the other countries.

Conclusion

Because of all these negatives that WILL occur, I hope I have helped you at least reconsider what you think of the American health care system; you now hopefully have thought through some of what I have said and question what you may have been told before about how ‘universal’ health care is not a true ‘universal’ cure. I made sure to inform you about the ways that America’s health care system is the backbone of the world’s health care industry and without our innovation the other socialized medicine countries would not be able to thrive. I told you also about how the many negatives of UHC are too great for real benefits to be seen by our society.

I also showed how the current steps towards socialized care is hurting the health care industry and any steps to move closer to socialism would only make it much, much worse; especially for those that the plans would claim to help. For everyone here, I am not trying to get you to become an expert on all things health care before you vote. All that you need to do to be a more informed person on the direction that the most important part of our lives, our health, is headed. All that I ask is that next time you think about our health care system, you look past the buzz words and the attractive promises to the underlying dark side of the “FREE” deal. Like the old adage always says, “if it seems to good to be true, it is.”

Also it would put my colleagues at risk of becoming ill so more staff would be off work and they in turn would be taking the illness back to their homes thereby spreading the bug even further. So by making sure hands are thoroughly washed after aiding each service user, wearing the appropriate aprons gloves mask etc I can help prevent spreading any by germs and bugs and by keeping good hygiene I will help keep myself healthy and if I was to become ill to make sure I did not go back to work until I was given the all clear by doing this I will help to keep the service users, work colleagues family and friends from catching any germs. . 3 Explain the most thorough method for hand washing. . Wet hands with hot water. . Apply enough soap and handsaws to cover all hands surfaces.. Rub hands palm alma. . Right palm or the other hand with interlaced fingers and vicar versa.. Palm to palm interlaced. . Backs of fingers to opposing palms with fingers interlocked.. Rotational rubbing of left thumb clasped in right palm and vice versa.. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa.. Rinse hands with warm water. . Dry thoroughly with towel. Duration of procedure at least 15 seconds. 4. Describe when to use different types of personal protective equipment. . Gloves= when aiding each service user to help prevent the spread of any germs.. Asks= To cover mouth and nose when dealing with the service user who may be ill or have a contagious bug, So I will not catch or help spread the bug.. Goggles= A shield against body fluids, blood, faces, urine. This helps to stop these fluids from getting injured or contaminated.. Aprons= When aiding a service user with washing or personal care, I will keep my clothes clean and I can dispose of apron afterwards so will stop any spread of infection..

Shoe covers= If a service user has a contagious so my shoes will not spread any germs through the home. Outcome 5 know how to move and handle equipment and other objects safely. . 1 Identify legislation that relates to moving and handling. Manual handling operations regulations (MOOR) 1992 amended 1998 Provision and use of work equipment regulations 1992 (POWER) Lifting operations and lifting equipment regulations 1998 (LOWER) 5. 2 List principles for safe moving and handling 1. Plan the move and prepare the environment. 2. Starting position. 3. Lifting effort. 4. Completing the move. Ensure that the object is light enough to lift, is stable and unlikely to shift or move.. Heavy or awkward loads should be moved using a handling aid.. Make sure the route s clear of obstructions. . Stand as close to the load as possible, and spread your feet to shoulder width.. Bend your knees and try and keep the backs natural upright posture.. Grasp the load firmly as close to the body as you can. . Use the legs to lift the load in a smooth motion as this offers more leverage reducing the strain on your back.. Carry the load close to the body with elbows tucked into the body..

Avoid twisting the body as much as possible by turning your feet to position yourself with the load. 5. 3 Explain why it is important for moving and handling tasks to be carried out allowing specialist training. By having the correct training I can lift safely and know how to use the correct equipment for the Job intended and know how and when to use it. By also attending the courses and training my employers are meeting the health and safety regulations to make myself and other staff safe and also the service user is safe during the transfer.

If I had not been trained correctly and got injured through lack of training they could be accountable , also they would be putting the service user at risk if I did not know how to assist them correctly. So by having the erect training every body is safe and also we are meeting the policy and procedures of the home. Outcome 6 Understand the principles of assisting and moving an individual. 6. 1 Explain why it is important to have specialist training before assisting and moving individual. By having specialist training I can move or assist the service user safely.

Also by having the correct training I can use the correct equipment safely needed to assist myself and the service user to be able to move, If I did not have specialist training I could not assist the service user safely and I would not know how o use the equipment correctly or safely. As I will be trained how to fit the equipment trained so I will know how to lift correctly so I will not injure myself, and I will not put the service user at risk. 6. 2 Explain the importance of following an individuals care plan and fully engaging with them when assisting and moving.

By reading an individual ‘s care plan I will know the mobility and capabilities of the service user, also what equipment is needed to assist the service user. When I need to assist the service user by talking to the service user and engaging them in the whole process hey will feel confident about the procedure and in control as the service user will be able to tell me if they are comfortable, and if they are ready to start the movement process, thereby the service user will stay calm and relaxed and in control making the whole process calm and easy for all involved. Outcome 7 know how to handle hazardous substances. . 1 Identify hazardous substances that may be found in the social care settings. 1 Urine 2 Blood 3 Vomit 4 faces 5 cleaning chemicals bleach, sprays, carpet cleaning chemicals. 6 medications 7. 2 Describe safe practices for: Storing hazardous substances= Cleaning chemicals are to be kept in a locked cupboard. Medication can be harmful so these are kept in a medicine cabinet with only authorized personal to have the keys, other medication that needs to be refrigerated will also only be accessed by relevant personnel. Make sure no chemicals are left out unattended if in use.

Using hazardous substances= When using hazardous substances like cleaning fluids, wear the appropriate equipment ‘e: gloves, masks, goggles,and aprons, this will help from getting splash back and stop chemicals getting clothes, skin or in the eyes, this will also apply when aiding a arrive user with their personal care so the career will not get contaminated by urine, vomit, faces, they will keep clean when aiding the service user in washing, dressing, or personal care, the career can on finishing take off the gloves and apron etc and dispose of them safely and therefore prevent any cross contamination or spreading of germs whilst keeping themselves clean. Disposing of hazardous substances; .

Sharps- When using a needle make sure you have a sharps box so the needle can be disposed of safely and the nurse/career does not risk the chance of scratching or rocking themselves by carrying the needle around trying to find a sharps box. Make sure it is kept closed when not in use, also to make sure it is not over filled, and when it reaches the full limit that it is taken away and disposed of correctly.. Clinical waste- Pads or soiled clothes or soiled bed linen need to be disposed of safely to prevent cross contamination. Pads need to go into a yellow bag and disposed off in the clinical waste bin this is collected by a company that deals with clinical waste. Load or faces this can be put into a washing machine on a high temperature and after the wash the bag is disposed off safely thereby the soiled linen does not have to be touched by staff or contaminate the other laundry. .Medication- Medication that has been refused or no longer needed must be documented and disposed of in the correct manner ‘e: deposited in a container and sent back to the pharmacy to dispose of correctly. Outcome 8 know environmental safety procedures in the social care setting 8. 1 Outline procedures to be followed in the social care setting to prevent; . Fire= You can prevent fire by first identifying hazards and who could be at risk. Evaluate them ND take action to reduce them. Record findings and actions and develop a plan.

Norovirus, also known as the “Norwalk Virus”, is a highly contagious food-related illness that got its name when it was first discovered in Norwalk, Ohio in 1972

1. It is said to be frequently found in cruise ships, daycares and nursing homes that hold large amounts of people in close proximity
2. Causes of Norovirus include a cook or bartender serving food or drink without washing their hands properly, having direct or close contact with someone is infected (touching them and then touching the mouth or nose) and drinking an infected person’s water or using their utensils
3. The very first cause listed is something an individual may not be able to control, which is why norovirus is so common and contagious.The more ordinary symptoms of norovirus include nausea, vomiting, diarrhea and abdominal cramps, but the more unlikely symptoms consist of headache, a fever, chills and muscle aches3.

A person exposed to this illness can expect to develop symptoms within 24 to 48 hours4, which may feel like a long amount of time, but isn’t as bad as other illnesses. More serious effects of Norovirus can include not getting enough nutrients and fluids in your system, which would lead to malnutrition and dehydration5.

There is no medicinal treatment for norovirus, but drinking lots of water and sticking to your regular eating schedule will help in avoiding these effects. The person will be contagious from the moment they are ill to at least 3 days after recovery4, so it is best not to touch them or be near them as much as possible as mentioned previously.Shellfish such as oysters and raw fruits and vegetables are the most likely sources if they have been contaminated by unclean water2.

Cruise ships serving large amounts of shellfish that wasn’t checked for contamination is guaranteed to get at least one passenger sick, which is why it’s better to be mindful of this and stick with the foods that you know are safe to eat. Untreateddrinking water is a major source as well that has been linked to norovirus2, so running water through a filter is essential when wanting to avoid norovirus.

Proper hygiene and safe food preparation is key when aiming to prevent norovirus. Wash hands with warm water and soap after going to the washroom, before and after preparing food, and changing a dirty diaper4. Constant hand washing will help insure that the bacteria from one object will not remain on your hands and transfer over to another area.

Keeping raw meat, poultry and seafood away from other items in your cart when shopping and having a separate grocery bag is very important in terms of making sure cross contamination doesn’t occur4.

A person can also prevent others from getting Norovirus by not going to work and avoiding travelling for the duration of their illness. Taking a few days off work will speed up the affected person’s recovery and not get anyone else ill at the same time.

You need to understand the differences between bacteria, viruses, fungi and parasites; this also covers cell structure and growth pathogens.

Common illnesses and infections

Include bacteria for example tuberculosis, MRS., tetanus, gangrene, Legionnaires ‘disease, salmonella and conjunctivitis. Viruses like winter vomiting disease, measles, mumps, chickenpox, HIVE, Hepatitis B, warts and influenza.

Fungal infections a few examples of these are thrush, ringworm and athlete’s foot and finally arise infestations like scabies, lice, head lice, fleas, threadbare and roundworm.

Infection is Microorganisms transmitted to host’s cells, tissues or body cavities they might but do not always cause illness. Infectious diseases are transmissible from one individual to another. Colonization means to cause infection organisms colonies cells and tissues and compete with normal micro-flora in order to multiply to a level which causes harm. Finally non- pathogenic microorganisms colonies the skin, oral cavity, colon to form the normal micro-flora; they do not normally cause disease ND may be beneficial.

Systemic Infection affects whole system of the body, whereas localized Infection affects a specific area of the body.

Poor practices that may lead to the spread of infection includes poor personal hygiene, failure to wear the correct PEP, inadequate cleaning, poor hand washing, reuse of UN-sterilized equipment and failure to follow procedure.

1. Understand the transmission of infection
2. Conditions needed for the growth of micro-organisms are optimum temperature, moisture, nutrients, gases and time.
3. Ways an infective agent might enter the body can be Entry/ exit routes including: nose by inhalation, mouth by ingestion, rectum, urinary tract, eyes, broken skin, unbroken skin, genital tract, body fluids route and blood by Inoculation.

Common sources of infection

Include body fluids for example vomit, tears, breast milk, semen, vaginal secretions, urine, blood, mouth or nose secretions, sweat, sputum, droplets spread by sneezing and coughing; food; water: air-borne and also carried by insects or animals. Infective agents can be reanimated directly from person to person in body fluids or on hands. Indirectly can be transmitted via contaminated water, food, animals, insects, objects, dust etc.

In my family, the “Family Business” is nursing. My mother is a nurse, and an associate professor at NMSU, as well as the chairperson for their CNA program. One of my sisters just finished her nursing program and is studying for her NCLEX and my other sister is an ER nurse just starting her DNP program. So when they each, independently, gave me the following advice, I took it to heart, but assumed they were being facetious, and using humor to help me remember a very important health care worker concept: “Pretend everything around you is covered in sh*t. ” After reading this article, I realize they were not kidding!

C-Difficile is a bacteria found in the intestines of a small number of people. Not all bacteria are bad, particularly when the bacteria are where they are supposed to be. C-Difficile becomes a “bad” bacteria when it overpopulates the intestine, causing stomach cramping and diarrhea. The overpopulation occurs when antibiotics are used to fight the original infection a patient has, and that antibiotic kills off the normal flora living in the intestines. Once that happens, C-Diff is able to make its way out of the intestines and onto health care workers hands, clothing, surfaces (such as call lights and bed rails) and the skin of the patient.

It is transmitted via the fecal-oral route, simply meaning that infected feces made its way into someone’s mouth, causing an infection. An infected person can spread the bacteria by having a bout of diarrhea, not washing their hands with soap and water, and then touching an object, leaving spores on it. Another person comes along, touches the same object, and picks the spores up. That second person (with unwashed hands) then touches their face, mouth or prepares food, and ingests the spores, introducing the bacteria into their body.

C-Diff is able to lay dormant on surfaces for a very long time because it is both anaerobic and spore forming; meaning it does not need oxygen to live, and it forms a spore, protecting itself from being destroyed by typical cleaning measures. However, a bleach and water solution has been effective in killing the spores. It has been found that it takes ingestion of as few as two spores to infect a person. The spores are extremely hearty and upon ingestion, are able to withstand the gastric acids, passing all the way through to the intestines unharmed.

Once they reach the intestines and they are exposed to the bile acids they emit two toxins. Those two toxins are responsible for the damage to the colon, and that damage ultimately causes the symptoms of C-Diff. Namely, in mild cases, abdominal cramping and diarrhea, all the way to severe damage such as pseudomembranous colitis (an illness that’s symptoms mimic colitis). In the most severe cases, fatalities have even occurred in as high as 80% of the cases. The most effective way to prevent the spread of C-Diff is using proper hand-washing techniques.

However, it should be noted that hand-washing does not kill the spores; it simply removes the spores from the hands so that they are not carried to another location. Soap and water is a must, as the alcohol-gel based hand sanitizers do not kill the spores. A CNA should don PPE’s (gowns and gloves) when assisting patients/residents who have C-Diff. This will prevent the CNA from carrying the spores on their clothes to another person. Again, the number one prevention that a CNA can utilize is properly washing their hands, especially when travelling from one patient to another.

What is bioterrorism and how might you prepare for its effects? Bioterrorism uses pathogenic biological agents, such as biological warfare agents, which are colorless, and odorless derived from microorganisms that can be spread in the air as aerosols or placed into food or drink to infect as many people as possible. The agents are concealed easily and said to be difficult to detect. Terrorists tend to attack major cities or densely crowded areas, and government buildings (Nicolson, 2001).

One such agent that was used as early as 1520 by Cortez as an assault on the Aztec capital city of Tenochtitilan in Mexico was the smallpox virus. The American Government used this weapon during the wars with the Native Americans. The United States has eradicated the disease with vaccines over the many years (Graber, 2010). The latest known agent that imploded on the communities was the Anthrax virus, which was known to be in affect since 2001.

Some people would actually take the agent and put it in boxes, envelopes, etc. and send it in the mail to affect others with the disease. Nurses can help to be ready in different situations, by not only knowing about early warning signals of diseases, but to know how to deal with the terrorist attacks. Healthcare workers can review disaster plans in the workplace, be available as a first responder, review the evacuation plan, and help others to deal with the events that are taking place (Stanhope & Lancaster, 2008).

Nurses need the understanding of disaster plans in their workplace and community and review these plans every 6 months for changes and updates. Planning for future outbreaks of disease is always a good idea, as we can never know when a disaster may strike.

References: Graber, M. (2010). Terrorism Updates. Retrieved from http://www. emedmag. com. Nicolson, G. (2001). Bioterrorism. Retrieved from http://www. immed. org. Stanhope, M. , & Lancaster, J. (2008). Public Health Nursing: Population Centered Health Care in the Community (7th ed. ). St. Louis, MO: Mosby, Inc.

My support networks will include:

PEACE for training advice and support. Including recommended paperwork and contract help. Network coordinator and the Local Authority are helpful to advise about updates on latest training requirements and any policy updates.

Health

Visitors are invaluable to maintain current knowledge of young hillside’s milestones’ and to ensure healthy development. Parents nobody understands their own children like their parents, so it is imperative to have a good relationship with the most important people in their lives. Teachers spend the most time with school age children other than parents and keeping strong links with schools can be very helpful in ensuring that children are happy and settled. My family/relatives in order to maintain a good work/life balance keeping strong relationships with my own family and friends is really important.

Childbearing groups

Childbearing networks could be really helpful to share NY tips or difficulties around being a children and what that in tales, sharing joint experiences (whilst maintaining confidentiality) is useful for career progression. Training/ Publications and magazines such as Who Minds, Childcare websites and OFFSET is vital for staying updated with the latest policies and procedures whilst ensuring that the level of service provided is at the highest standard possible.

Explain the key components off healthy and safe home based environment

Key components; Nappies will be disposed of by sealing in nappy sacks and placing in a sole repose bin within the changing area until the end of day when they will be put into an outside wheelie bin. The changing mat will be wiped with appropriate anti-bacterial cleaner following use. The children and I will wash hands following nappy changes/toilet breaks, before eating and after playing outside or following messy play. Plastic toys will be wiped if visibly dirty after play and washed in the dishwasher weekly (minimum).

I will ensure any pet beds and cages are kept clean and away from any food preparation areas. Any pets will be appropriately vaccinated, roomed and flea protected following veterinary advice. Pet waste will be disposed in a sanitary way, and any litter boxes will not be accessible to the children. Children will not be able to play with any animals when unsupervised. When using any equipment I will ensure that it is age appropriate, in full working order and used according to the manufacturers guidance.

I will ensure that plug sockets are covered, stairs are not accessible, children are aware Of evacuation procedures (if age appropriate) and my fire alarms and carbon monoxide detectors are fully working and regularly tested. When dealing with food in my home/setting the Five Keys to Safer Food are:

1) keep clean;

2) separate raw and cooked;

3) cook thoroughly;

4) keep food at safe temperatures;

5) use safe water and raw materials.

This includes using separate chopping boards for meat and Vega. Ensuring food is within its use by date and labeling food with dates when not kept in its original packaging.

When considering illness in order to protect all of the children present any child with a rash should be considered infectious and assessed by their doctor. Chickenpox children will be asked to remain at home until all icicles have crusted over. Cold sores, (Herpes simplex) Avoid contact with the sores. Cold sores are generally mild and self-limiting. German measles Four days from onset of rash. Hand, foot and mouth. Will contact the local HIP if a large number of children are affected. Exclusion may be considered in some circumstances.

Impetigo Until lesions are crusted and healed, or 48 hours after starting antibiotic treatment Antibiotic treatment speeds healing and reduces the infectious period Measles

Four days from onset of rash Preventable by vaccination (MR. xx). Ringworm; Exclusion not usually required Treatment is squired Scabies Child can return after first treatment Household and close contacts require treatment Scarlet fever Child can return 24 hours after starting appropriate antibiotic treatment Antibiotic treatment is recommended for the affected child Slapped cheek/fifth disease.

Ovoviviparous None (once rash has developed) Shingles Exclude only if rash is weeping and cannot be covered. Can cause chickenpox in those who are not immune, ii have not had chickenpox. It is spread by very close contact and touch. Warts and overrule. Overrule should be covered in swimming pools, gymnasiums ND changing rooms Diarrhea and/or vomiting the child should remain at home for 48 hours from last episode of diarrhea or vomiting Conjunctivitis should be treated on the advice of GAP.

Diphtheria

Exclusion from setting is essential. Will contact the HIP. Preventable by vaccination. Your local PHEW centre will organize any contact tracing necessary Head lice, Treatment is recommended only in cases where live lice have been seen Hepatitis A. Exclude until seven days after onset of jaundice (or seven days after symptom onset if no jaundice) In an outbreak of apatite’s A, the local PHEW centre will advise on control measures Hepatitis HIVE/AIDS are bloodstone viruses that are not infectious through casual contact. For cleaning of body fluid spills see:

• Good Hygiene Practice Macroeconomic meningitis specialist
• Until recovered Meningitis C is preventable by vaccination.
• There is no reason to exclude siblings or other close contacts of a child.

Meningitis due to other bacteria Until recovered Hip and phonological meningitis are preventable by vaccination. There is no reason to exclude siblings or other close contacts of a case. Meningitis viral Milder illness; There is no reason to exclude siblings and other close contacts of a case. Contact tracing is not required MRS.; Good hygiene, in particular handshaking and environmental cleaning, are important to minimize any danger of spread.

Mumps

Exclude child for five days after onset of swelling Preventable by vaccination (MR. xx doses) Toreadors; Treatment is recommended for the child and household contacts Tonsillitis; There are many causes, but most cases are due to viruses and do not need an antibiotic. Denotes a noticeable disease. It is a statutory requirement that actors report a noticeable disease to the proper officer of the local authority In case of any accident the first aid kit should be easily accessed and that the first eider should act in accordance to their training and contact medical professionals if required.

An Accident

Incident Record Book will be used to record any accidents and also to log any medication administered including any long term medication. Parents will sign a consent form regarding administration of medication and then afterwards to confirm that you have advised them that the medication has been administered this includes inhalers, diabetic injections etc. If a child has known allergies and is required to have access to an penne the correct training Will be undertaken to administer this if required, via Correct medical professional or SST Johns Ambulance training.

Any child’s allergies will be recorded and every possible effort will be made to avoid triggers, ensuring that ingredients are know if a food allergy, pet hairs are avoided if an allergy relating to animals, and if wayfarer I will be aware of the pollen count whilst planning activities, allergies will be managed with support from parents who are used to their child’s allergy needs. . Explain the principles of safe supervision of children in the home based setting and off site Everyday activities; school pick ups, toddler groups, trips to the park, beach, shops, visits to swimming pools, zoo and beach, will all carry its own particular risks and supervision needs.