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Diarrhea policy


Tinytowners
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Hi all,

 

My first time posting a topic on this forum, so here goes.

 

My question is about nurseries policy on how many instances of diarrhea will a child have before you send them home? and once you do, how long do you require they be off for?

 

Our policy has been 3 instances and 24 hours, however we feel that the 24 hours is not enough as when the bug goes around it's hard to get rid of, children are returning to nursery still sick or the parents are being dishonest about the instances at home.

 

We will be changing the policy to 48 hours but I anticipate that parents will not be happy about this. I would like to refer the parents to some kind of official statement or document to back up the reasons we need the exclusion period.

 

Please let me know your thoughts.

 

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http://www.nhs.uk/Conditions/Diarrhoea/Pages/Introduction.aspx

 

"Stay at home until at least 48 hours after the last episode of diarrhoea to prevent spreading any infection to others."

 

This quote comes directly from the NHS website - you might also try Health Protection Agency which is government run.

 

Naturally your parents think, well my child caught it there, others have had it and passed it on, etc, I need to get back to work blah blah blah.

 

What is difficult to get carers to understand is, if only they followed the advice in the first place, i.e. 48 hours then further instances would be far less.

 

Hand hygiene is essential to keep risks down for both adults and children.

 

We have said to carers in the past that if they don't follow the guidelines and the nursery staff come down with a bug, we will shut down the nursery until we are all well again - this can shake them up a bit!

 

Hope you can get your policy together. You really do have to stay tough on it, once parents know you are tough, in other words you turn a child away immediately as soon as parent says anything, or you have the evidence before you, they are more likely to tow the policy line because everyone will be treated equally.

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We send home after one 'episode' and are very strict with enforcing our 48 hour rule - this is the government guidelines.

The exclusion periods for all illnesses can be found here - http://www.publichealth.hscni.net/sites/default/files/A2%20Schools%20poster_1.pdf(although I believe that one is out of date now?) so we also have the document found on her - https://www.gov.uk/government/publications/infection-control-in-schools-poster

 

We do have some complaints from parents saying their child was only sick once or they only had an upset tummy once because they had eaten loads of vegetables or something but we do stand firm :)

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Once - to be honest you can usually tell whether it's 'to many veg' or a bug.

 

48 hours. Like Pandas I remind all parents that if we get two members of staff sick we will need to close for 48hours.... then we would have to do a thorough 'Deep Clean' which could take another 48+ hours. (well all the rugs would have to dry :lol: ) so that means we would possible need to close a full week........

 

Usually finds this works well at helping them to stick to the rules. :1b :1b

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We're quite open and honest with our parents - not being too graphic, but their child's key person knows what is 'normal' for them toileting-wise as much as the parents...So if it's one episode that is definitely unwell, they go home (and it's 48hrs following NHS guidelines.) If the key person isn't sure we 'wait and see' - but 3 max. If there is a bug going round (as we've had these last 6 weeks or so) then it's out at the first sign, regardless, and parents have been told this. It seems to have worked as we've all been clear for a week now, thank goodness!

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Ditto 48 hours clear for vomiting also. Got twins settling currently. On the first two visits one screamed so much they made themselves sick. Without wanting to go into too much detail it was just phlegm so disregarded. They turned the following week and one had thrown up outside the gate everywhere! I told Mum she couldn't bring the child in and she was very unhappy. She said she'd given banana and milk before coming and the child had been running which made them ill. I apologised and repeated the policy. She then wanted a refund so I explained the policy on that. We agreed to take the other child in and Granddad was to stay with him. Granddad was neither use nor ornament and ended up leaving and not long afterwards the child threw up so I phoned Mum to take them home too. She was insistent child wasn't unwell and wanted to them to come in again the following day but I told her no. I explained that we just didn't know the children well enough yet to make a decision (we had another child who regularly used to make himself sick but we knew that was something he often did). Anyway she wasn't happy and brought up the subject of money again. I like the having to close argument and will use that in future.

 

We had scarlet fever do the rounds recently and one parent was furious with me for letting children back in once they'd had 24 hours antibiotics. Can't win sometimes!

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Once for us as well - I think as said you know whether it's too much fruit/veg or not. 48 hours from LAST bout not first though as one parent said to me "Oh well it started on Monday morning and it's now Wednesday so that's 48 hours"

When I asked when last bout was she said "Oh yesterday morning"

Trouble comes when they have the problem at home as they will rarely tell you about it.

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Thank you for all the advise, I'm glad for the 48 hour rule and the back up of the NHS guildlines.

 

I do think that one episode of diarrhea is too few as teething is very often a reason behind it. It would be nice if there were spacific guildlines as to how many but I think the argument of needing to close the nursery if staff are ill will work very well.

 

 

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  • 3 weeks later...

Thanks everyone! Was looking for reassurance with our policy following 48 hours and complaints from working parents, I've got it from this topic! Sounds like we're all in the same boat (up s$%t creek) sorry, couldn't resist.

 

I am expecting a complaint from a parent tomorrow who was sent home on Tuesday "and has been absolutely fine since" Current total is 7 children and 4 staff who've had it in the last 3 weeks. I will be using the tips I've read on here!!

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  • 1 month later...

We always stick to our 48 hour policy. Had a mum ring in on Tuesday morning to say her child had had diarrhoea in the night so he wouldn't be in in that day but she would see how he was. I said he wouldn't be able to come in until Thursday at the earliest and only if no other episodes. She rang back at 10am to say he had now been sick so she would keep him off the rest of the week.

An hour later another mum called to say her son had been sick in the night so repeated the same info to that mum.

On Wednesday afternoon the first mum rang to say her son had only been sick the once on Tuesday at 10am and no sign of an upset tummy since and he was climbing the walls as fit as a fiddle, please could he come back on Thursday.

Our answer was the same NO. To be honest, in line with our policy, we could in this instance have said he could come in at 10am on Thursday which would have been 48 hours, but because another child had also been sick we requested 2 full days clear before the children come back.

Mum was not too pleased but I explained how quickly these could spread and if we didn't adhere to our policy her child could be ill again the following week she soon agreed.

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