Amberley O.S.H.C.

Children are our future, We are dedicated to their success!

4.18 Children with Medical Conditions

Amberley OSHC recognizes the increasing prevalence of children attending OSHC who have been diagnosed with medical conditions and are committed to a planned approach to the management of such medical conditions to ensure the safety and well-being of everyone at this service.

Children’s medical needs may be broadly categorized into two types:

  • Short-term – which may affect their participation in activities while they are on a course of medication. Short-term medical needs are typically an illness that the child will recover from in a short period (e.g. tonsillitis, chest infection, etc.)
  • Long-term – potentially limiting their participation and requiring extra care and support. Long term medical needs are typically ongoing (e.g. asthma, diabetes, anaphylaxis, celiac disease)

Our service is committed to ensuring our educators are equipped with the knowledge and skills to manage situations to ensure all children attending OSHC receive the highest level of care and to ensure their needs are considered at all times. Providing families with ongoing information about medical conditions and their management is a key priority.

Relevant Laws and other Provisions

The laws and other provisions affecting this policy include:

  • Duty of Care
  • Check local authority regulations, e.g. Brisbane City Council by-laws on keeping relevant animals
  • NQS Area: 1.1.5; 2.1, 2.2.1; 3.1.1, 3.2.1; 4.1, 4.2.1; 5.1, 5.2; 6.1, 6.3.3; 7.2.1, 7.3.1, 7.3.2, 7.3.5.
  • Policies: 2.11 – Including Children with Special/Additional Needs, 4.1 – General Health and Safety, 4.2 – Infectious Diseases, 4.1 – General Health and Safety, 4.3 – Hygiene, 4.4 – Preventative Health and Wellbeing, 4.6 – Medication, 4.10 – Anaphylaxis Management, 4.11 – Emergency Health and Medical Procedure Management, 4.15 – Asthma, 4.20 – Supervision of Children, 5.1 – Food Handling and Storage, 5.6 – Menu Development, 7.1 – Emergency Equipment and Facilities, 8.4 – Educator Professional Development and Learning, 8.10 – Employee Orientation and Induction, 9.2 – Enrolment, 9.3 – Communication with Families, 10.9 – Risk Management and Compliance10.24 – Privacy.

Procedures

Children’s short term medical needs will be managed in accordance with Amberley OSHC’s Illness, Injury or Trauma Policy and the Medications Policy.

Amberley OSHC will minimise the risks around children’s specific health needs, allergies or other relevant medical conditions by:

  • Collaborating with parents/guardians of children with specific health needs, allergies or other relevant medical conditions to develop a risk minimisation plan;
  • Informing all educators and volunteers, of children with specific health needs, allergies or other relevant medical conditions and the risk minimisation procedures for these;
  • Ensuring children with specific health needs, allergies or other relevant medical conditions have a current risk minimisation plan that is accessible to all educators; and
  • Ensuring all educators are adequately trained in Amberley OSHC’s emergency medical management procedures and the administration of emergency medication.

Parents/guardians will be requested, through the initial enrolment procedures to provide details of any specific health care needs or medical conditions of the child, including asthma, diabetes, allergies and whether the child has been diagnosed at risk of anaphylaxis.  It is the responsibility of parents/guardians to update Amberley OSHC with any new information relating to their child’s specific health care need or medical condition.

Amberley OSHC will involve all educators, families and children in regular discussion about medical conditions and general health and wellbeing.  Amberley OSHC will adhere to privacy and confidentiality procedures when dealing with individual health needs.

To promote consistency and ensure the welfare of all children using Amberley OSHC, all educators will follow the health, hygiene and safe food handling policies and procedures.

If a child with a chronic illness or medical condition that requires invasive clinical procedures or support is enrolled at Amberley OSHC, prior arrangements will be negotiated with the parent/guardian, coordinator and appropriate health care workers to prepare for the event that the child will require a procedure while in attendance at OSHC.  Such arrangement and procedures will be established in consultation with the child’s medical practitioner.  Arrangements will be formalised prior to the child commencing at Amberley OSHC.

Identifying Children with Medical Conditions

Any information relating to individual children’s health care needs, allergies or other relevant medical conditions will be shared with the coordinator, educators and other staff members of Amberley OSHC.

Information relating to a child’s specific health care need, allergy or other relevant medical condition, including the child’s medical management plan, medical conditions risk minimisation plan and the location of the child’s medication will be shared with all educators and other staff members of Amberley OSHC.

Information about a child’s specific health care need, allergy or other relevant medical condition, including the child’s medical management plan, medical conditions risk minimisation plan and the location of their medication will be displayed in the following areas of Amberley OSHC to ensure all practices and procedures are followed accordingly:

  • The OSHC office – in the child’s enrolment record and in an area visible to Amberley OSHC telephone;
  • The staff room or noticeboard;
  • Inside the kitchen cupboard door (for children with food related conditions);
  • In the OSHC room (with parent/guardian permission).

All educators will be required to follow the child’s Medical Management Plan in the event of an incident related to the child’s specific health care need, allergy or other relevant medical condition.

All educators, other staff and volunteers must be able to identify a child with a specific health care need, allergy or other relevant medical condition and be able to locate their medication/s easily.

Medical Management Plan

To comply with regulatory requirements, the parents/guardians of children with specific health care needs, allergies or other relevant medical conditions must provide Amberley OSHC with a medical management plan for their child. This medical management plan must be followed in the event of an incident relating to the child’s specific health care need, allergy or relevant medical condition.

The medical management plan should be developed in consultation with the child’s registered medical practitioner with the advice from the medical practitioner documented in the medical management plan. The medical management plan should include the following:

  • A photo of the child;
  • Details of the specific health care need, allergy or relevant medical condition including the severity of the condition;
  • Any current medication prescribed for the child;
  • What may trigger the allergy or medical condition (if relevant);
  • Signs and symptoms to be aware of as well as the response required from Amberley OSHC in relation to the emergence of symptoms;
  • Any treatment/medication required to be administered in an emergency;
  • The response required if the child does not respond to initial treatment;
  • When to call an ambulance for assistance;
  • Contact details of the doctor who signed the plan.

Copies of the child’s Medical Management Plan will be kept with their medication and taken on all excursions/regular outings they attend whilst enrolled at Amberley OSHC.

Medical Conditions Risk Minimisation Plans

A risk-minimisation plan must be developed in consultation with the parent/guardian of a child with specific health care needs, allergies or other relevant medical conditions to ensure that:

  • Any risks relating to the child’s specific health care need, allergy or relevant medical condition are assessed and minimised; and
  • If relevant, practices and procedures for the safe handling, preparation, consumption and serving of food are developed and implemented; and
  • The parent/guardian is notified of any known allergens that pose a risk to a child and strategies for minimising the risk are developed and implemented; and
  • All educators are able to identify the child, and know the location of the child’s medical management plan and medication; and
  • If relevant, practices and procedures are developed and implemented to ensure that the child does not attend Amberley OSHC unless the child has at Amberley OSHC their relevant medications, if this would pose a significant risk.

Amberley OSHC will provide support and information to parents/guardians and other members of the community about resources and support for managing children’s specific health care needs, allergies or other relevant medical conditions.

 Medical Conditions Communication Plans

To ensure regulatory compliance, Amberley OSHC shall develop a communication plan and implement procedures to ensure that:

  • Relevant educators, staff members and volunteers are informed about the medical conditions policy and the medical conditions management plan and medical conditions risk minimisation plan for each child with a specific health care need, allergy or other relevant medical condition; and
  • A parent/guardian of a child with a specific health care need, allergy or other relevant medical condition can communicate any changes to the medical conditions management plan and medical conditions risk minimisation plan for their child.

 Management of Medical Conditions

Children identified with asthma or anaphylaxis allergies will be managed in accordance with the specific Asthma Management and Anaphylaxis Management Policies of Amberley OSHC.

Children with other health care needs or relevant medical conditions will be managed in accordance with their individual medical conditions management plan and medical conditions risk minimization plan.

In order to effectively manage other health care needs and medical conditions Amberley OSHC will implement the following procedures:

Diabetes

In developing individual children’s medical conditions management plans, Amberley OSHC will implement procedures where possible to ensure children with diabetes do not suffer any adverse effects from their condition while at Amberley OSHC. These include ensuring they do not suffer from hypoglycemia (have a “hypo”) which occurs when blood sugar levels are too low. Things that can cause a “hypo” include:

  • A delayed or missed meal, or a meal with too little carbohydrate;
  • Extra strenuous or unplanned physical activity;
  • Too much insulin or medication for diabetes;

Children with Type 1 diabetes may also need to limit their intake of sweet foods. Amberley OSHC will ensure information about the child’s diet including the types and amounts of appropriate foods is part of the child’s medical conditions management plan and that this is used in developing their individual medical conditions risk minimisation plan.

Amberley OSHC will ensure that educators are adequately and appropriately trained in the use of insulin injection devices (syringes, pens, pumps) used by children at Amberley OSHC with diabetes.  In the event of major concerns regarding insulin levels of a child an ambulance will be called.

If a child is displaying symptoms of a “hypo” Amberley OSHC will:

  • Ensure a first aid trained educator provides immediate first aid which will be outlined in the child’s medical conditions management plan and may include giving the child some quick acting and easily consumed carbohydrate;
  • Call an ambulance by dialling 000 if the child does not respond to the first aid and CPR if the child stops breathing;
  • Contact the parent/guardian or the person to be notified in the event of illness if the parent/guardian cannot be contacted.

Skin Rashes

Rashes are common in children and can be caused by many different viral infections and may not be infectious. It is important to be able to describe the rash as this may help with diagnosis.

When viewing a rash, educators should also consider if the child is unwell as the rash may not affect the child’s well-being at all.  There are however, usually other signs and/or symptoms to consider in conjunction with a rash. These might include (but are not limited to):

  • Fever;
  • Unusual behaviour (cranky or less active; cries more than usual; seems uncomfortable/irritable; just seems unwell);
  • Loss of appetite
  • Vomiting;
  • Headache, stiff neck;
  • Frequent scratching, crusty skin/discharge from skin;
  • Trouble breathing.

Also when observing the rash, educators should note:

  • What the rash looks like (e.g. dark red like a blood blister; small red pinheads; large red blotches; a solid red area all joined together or blisters);
  • How does the rash feel to touch (e.g. raised slightly, with small lumps or swollen;
  • Is the rash itchy and where on the body did the rash start (e.g. head, neck);
  • Where is the rash now (e.g. head, neck, abdomen, arms, legs).

The coordinator should be informed of any children presenting with a rash to determine whether there is cause for concern for the child’s health (and potentially that of the other children and also educators).  If there is doubt as to a child’s wellbeing with regards to a rash the parent/guardian will be called immediately.

All rashes should be documented on an Injury, Illness or Trauma Form.  Educators must regularly check the appearance of the rash and note time and any changes on the form. This is important information in case the child needs medical attention.

If concern is expressed about the rash then the child will be isolated from other children until the parent/guardian can collect the child from Amberley OSHC. If educators are concerned about serious symptoms in conjunction with the rash or perhaps the rash being purple, or spreading very quickly, then an ambulance will be called.

Eczema

If a child suffers from eczema, parents/guardians will be requested to supply a doctor’s certificate stating this. A medical conditions management plan will be developed and implemented to enable educators to follow any treatment prescribed by the child’s medical practitioner.

A child with eczema is not excluded from attending as this is a chronic condition that has to be managed.

 Educator Training and Qualifications

The coordinator will ensure that educators have appropriate education or training to enable them to undertake basic support of the health needs of children, including administering medications, allergic reactions, basic first aid and special dietary requirements.

The coordinator will ensure that, at least one educator with the required first aid qualifications, anaphylaxis management and emergency asthma management training as prescribed under Education and Care Services National Regulations 2011  is in attendance at any place children are being care for, and immediately available in an emergency, at all times children are being cared for.

References

State Government Victoria. (2013, September). National Quality Framework – Children with Medical Conditions Attending Education and Care Services. Retrieved from Department of Education and Early Childhood Development: http://www.education.vic.gov.au/Documents/childhood/providers/regulation/nqfmedicalconditionsfactsept2013.docx

University of Wollongong. (2013, August). Medical Conditions Policy. Retrieved from UniCentre – University of Wollongong: http://unicentre.uow.edu.au/content/groups/public/@web/@unic/@mrkt/documents/doc/uow146296.pdf

Added 9 June 2015


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