Managing children's medical conditions in early childhood services

Overview

The safety, health and wellbeing of all children is central to the NQF and the Children’s Services Act (CS Act). Both Acts impose the same legal requirements on services to safely manage the medical needs of children with:

• diagnosed health care needs
• allergies
• asthma
• at risk of anaphylaxis or
• any relevant medical conditions.

Medical conditions policy and procedures

All NQF services and Children’s Services regulated under the Children’s Services Act (CS Act) must have a Medical conditions policy and procedures.

The policy must be:

• understood and followed by all educators, staff, volunteers and the nominated supervisor
• easily accessible at all times, and a copy given to all parents of a child enrolled at the service who has a diagnosed health care need, allergy or relevant medical condition.

It must describe how the service will manage:

• medical conditions, including asthma, diabetes, or a diagnosis of being at risk of anaphylaxis of any children attending the service
• how the service will ensure that the nominated supervisor, staff members and volunteers are aware of how these medical conditions will be managed
• how the medical needs of any children enrolled at the service with a specific health care need, allergy or relevant medical condition will be managed.

Enrolling a new child at the service

Before children can commence orientation or attend the service parents must complete an enrolment record.

The enrolment record must contain:

• detailed health information about each child’s health needs including details of:
  • any diagnosed medical condition
  • allergies and
  • the risk of anaphylaxis (if they have been diagnosed).
• a record of all authorisations to consent to medical treatment.

Services should regularly consult parents regarding any diagnosed health care needs, allergies or relevant medical conditions a child may have developed since enrolment and update their records.

When services review the child’s enrolment form for the first time it alerts them to any diagnosed health care needs, and the extra steps they must take to meet their obligations.

Different rules apply depending on whether the child has:

• a diagnosed health care need, allergy or relevant medical condition such as asthma, diabetes, or has been diagnosed as at risk of anaphylaxis

OR

• a food preference or dietary restriction, for example not drinking cow’s milk as the parents do not want them to, this would not be considered a diagnosed health care need.

A large number of issues must be considered, and key elements must be in place before the child begins orientation and attending the service. The following issues must be considered:

• has the child’s parent provided a medical management plan for the child?
• has a risk minimisation plan been developed in consultation with the parents of the child?
• has the child’s parent provided authorisations for any medication that the child must take?
• will it be necessary to adjust any of the usual practices of the service in order to be fully inclusive of the child?

Medical management plans

A medical management plan and risk minimisation plan must be in place for every child enrolled who has a diagnosed health care need, allergy or relevant medical condition, and kept with the child’s enrolment record. It must be followed at all times.

The child’s medical practitioner must prepare the plan, and the parent must then provide it to the service.

It should include:

• details of the diagnosed health care need, allergy or relevant medical condition including the severity of the condition
• any current medication prescribed for the child
• the response required from the service in relation to the emergence of symptoms
• any 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.

Risk minimisation plans

The service must develop a risk-minimisation plan in consultation with the parents of a child with a diagnosed medical condition.

It must ensure that:

• the risks relating to the child's diagnosed health care need, allergy or relevant medical condition are assessed and minimised
• practices and procedures are in place including the safe handling, preparation, consumption and serving of food are developed and implemented (where relevant)
• parents are notified of any known allergens that pose a risk to a child, and that strategies for minimising the risk are developed and implemented
• staff members and volunteers can identify the child, the child's medical management plan and the location of the child's medication are developed and implemented
• there are practices and procedures to ensure that the child does not attend the service unless they have their relevant medications if this would pose a significant risk to their health.

It should be kept on the child’s enrolment record.

• National Regulations: regulation 90(c)(iii); CS Regulations: reg 59.

Communication plans

The communication plan is part of the medical conditions policy and must set out:

• how staff members and volunteers are or will be informed about the service’s medical conditions policy
• the medical management and risk minimisation plans for all children at the service who have a diagnosed health care need, allergy or relevant medical condition
• parents can communicate any changes to the medical management plan and risk minimisation plan for their child.

This should be kept on the child’s enrolment record.

Ongoing requirements

Once the child is attending, the service must continue to:

• monitor the safety, health and wellbeing of the child
• regularly review the risk minimisation plan for the child
• ensure that parents are regularly asked to provide any updated information relating to the nature of, or management of, their child’s diagnosed health care need, allergies or relevant medical condition
• if necessary, ensure an updated medical management plan is provided by the child’s parents
• ensure the practices and procedures of the service are inclusive of the child
• consider what extra precautions may be necessary in order to protect the safety, health and wellbeing of a child who has a diagnosed health care need, allergy or relevant medical condition.

Medication

Medication must not be given to a child being educated and cared for unless it has been authorised by:

• a parent, or
• another person named in the child’s enrolment record as authorised to consent to the administration of medication.

For more information on authorisations refer to Authorisations Policy.

Administering medication

Everyone at the service must be:

• aware of the Medication policy and any procedures, and
• follow their them when administering medication.

Staff must check:

• there is a proper authorisation to administer the medication to the child
• the medication is administered from its original container with original label attached
• the medication is not expired or passed the use by date
• the dose and instructions on the label, as well as any verbal or written instructions from a medical practitioner are followed.

Before the medication is given to the child:

• another staff member - other than the one administering it - must check the dosage of the medicine AND
• that it is being administered to the correct child (ie. check the identity of the child).

Medication record

A medication record must be kept for each child to whom medication is to be administered by the service. It must include the appropriate authorisations.

In the case of an emergency

Authorisation may be given verbally by a parent or a person named in the child's enrolment record as authorised to consent to administration of medication or:

• if such a person cannot reasonably be contacted in the circumstances, a registered medical practitioner or an emergency service
• Medication may be administered to a child without an authorisation in case of an anaphylaxis or asthma emergency.

First aid, anaphylaxis management and emergency asthma management training

All services must have educators working directly with children that hold the required approved qualifications in:

• first aid
• anaphylaxis management
• emergency asthma management.

Family day care services

All FDC services must ensure that every family day care educator and family day care assistant engaged or registered with the service:

• holds a current approved first aid qualification
• has undertaken current approved anaphylaxis management training, and
• has undertaken current approved emergency asthma management training.

Read about First aid, anaphylaxis management and emergency asthma management qualifications.

Incidents, injuries, trauma and illness

The service must have policies and procedures that explain how educators will respond if a child is injured, becomes ill or suffers a trauma

Parents must be notified as soon as practicable, but not later than 24 hours after the occurrence and the Incident, Injury, Trauma and Illness record is completed.

Services must notify the department of any serious incidents, refer to Incidents and complaints.