Chld Health and Well Being. 'Healthy Hands Promotion', Sample of Reports

9 pages, 4064 words

‘Healthy Hands’ Promotion

Introduction

The author of this report is a Deputy Manager within a non-profit making Early Years setting with charitable status. Currently, 42 children between the ages of 2-5 are registered to attend.

In the first few weeks of the autumn term of September 2010, it was noted that there were 2 cases of impetigo (bacterial skin infection), and 3 cases of sickness and diarrhoea within the setting. As a result, staff observed that some children and parents (see appendix 1) were not washing their hands after they had used the toilet. The children’s hand hygiene practices were a cause of concern for the team, who were not only aware of the speed in which this would spread infection, but of how this would ultimately impact on a child’s learning and development.

The view that children’s health and wellbeing impacts on their development and learning, is not a new concept: 19th century Pioneer Margaret McMillian, founder of the first school clinic in 1908, and the first open air nursery in 1914, for example, sought to address not only the physical and educational needs of children, but also the need for a child to be healthy in order to be able to learn effectively. She also identified that ‘health’ was linked to parental, community and school participation (MacLeod-Brudenell, 2004), and not just the ‘medical model’, which focussed predominately on diagnosis and treatment of diseases.

2 pages, 825 words

The Essay on Urbanism And Child Mental Health Journal Review

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In line with McMillan’s holistic view of health, the World Health Organisation (WHO, 1946) defined ‘health’ as: A state of complete physical, mental and social well being and not merely the absence of disease and infirmity’ (cited in Dryden et al 2005 pg 18).

This definition was further broadened through the Ottawa Charter for health promotion (WHO, 1986) when, despite opposition from the medical profession (Mahon 2010), health was described as ‘a resource for everyday life, not the object of living…..a positive concept emphasising social and personal resources, as well as physical capacities.’ (WHO, 1986, pg 1).

More recently, this ‘social model’ of health, was further supported by Britain’s previous Labour’ government who, through The National Service Framework for Children, Young People and Maternity services (NSF) core standards (DOH 2004), advocates that services should be child-centred and look at the whole child – not just the ‘medical’ illness. In addition, it was felt that staff from all sectors across a broad spectrum of services such as: health, social care and education, needed to take preventative action by working together and thus provide a more holistic package of care (pg 2).

Along side of this, key policies and initiatives such as: Every child Matters (DFES 2004), Sure Start Children Centres (SSCC) and the Early Years Foundation Stage (EYFS), establish a responsibility for all Practitioners who work within Early Years Services (EYS) to promote healthy practices for children. For example the statutory welfare requirements of the EYFS states that:

“That provider must promote the good health of the children, take necessary steps to prevent the spread of infection and take appropriate action when they are ill” (DFES 2008, pg19).

In addition, child health experts Hall and Elliman (2006), define Health Promotion as:

‘Any planned and informed intervention which is designed to improve physical or mental health or prevent disease, disability and premature death’(pg 6).Due to the increases in infection within the setting, therefore, the author and the nursery team decided to undertake health promotion in respect of hand hygiene. The aim of the promotion is to help children develop the skills of effective hand washing along with appropriate hand washing habits. To support relevant understanding of this, it was decided that the promotional tools would be: the development of a resource pack (SEE resource pack), along with a visit from a health protection nurse to provide visual information.

2 pages, 562 words

The Essay on Bio medical Model vs The Psycho-Socio-environmental model

The Bio-Medical Model is known as a set of principles underpinning western medical systems and practices. The Psycho-socio Environmental Model on the other hand is known for its promotion of health through socio-environmental and behavioral changes. In both very different models, the main objective which is to get the patient better is shared. Before any form of treatment is finalized, all visible ...

This report will firstly discuss both medical and social models of health and the resulting hygiene practices on children’s health. It will then evaluate the resource pack produced and, finally, will formulate conclusions for which recommendations for future interventions will be based.

Models of health

There are many infections and communicable diseases that children may come into contact with including: measles, mumps, chicken pox, common cold, influenza, swine flu, conjunctivitis, impetigo, norovirus (winter vomiting disease) and rotavirus (most common cause of infantile gastroenteritis) (HPA 2009).

These can be spread in a variety of different ways such as: person to person contact (including hand-to-hand), airborne (coughing and sneezing), food, water and body fluids.

In terms of the medical model, which focuses predominately on the treatment and eradication of illness (Dryden et al 2005), immunisation is the safest and most effective way of protecting children against serious infections: the administration of vaccines during infancy has saved many lives by preventing disease and the complications that arise from them.

However, in the late 1990’s, parental concerns over safety of some childhood immunisations, in particular the combined Measles, Mumps and Rubella (MMR) vaccine, lead to a decrease in the number of children being vaccinated. Consequently, this saw a rise in the number of children contracting measles (Dryden et al 2005).

In essence, then, for the medical model to be effective, parental participation is necessary. This would suggest that ‘health’ incorporates social measures.

Further, Canadian minister of health and welfare, Marc Lalonde’s (1981), ‘Health Field Concept’ model suggests the impact on health as being a complex web of factors across 4 fields: genetics, environment, lifestyle and medical services (Dryden et al 2005).

2 pages, 904 words

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For example, in relation to protecting children from infectious disease, medical services provide the vaccine, however it relies on parental participation for children to receive them. Thus, the children’s home environment has an impact on their health outcomes.

In relation to health promotion work in Early Years services, Practitioners, therefore, need to consider not only their immunisation schedule, but of the childrens’ lifestyle and the environments in which they live and play.

Infection control

According to Kearns 2008 some public health professional believe the battle against infectious disease has been won (Kearns 2008).

However, figures on the World Health Organisation’s (WHO) website (www.who.int) may suggest otherwise: identifying diarrhoea and lower respiratory infection (chest infections, asthma, and croup) as some of the most common and deadly illnesses of infancy and early childhood. In developing countries, for example, 1 in 4 deaths of children aged under 5 is due to diarrhoea. According to WHO, the main cause for the spread of such infection are: unsanitary conditions, lack of running water, basic toileting facilities and poor hygiene behaviours (www.who.int).

Supporting the ‘social model’ of health, psychologist Jacqueline Barnes (2010) and child health expert Kate Billingham (2010), suggest that the dramatic improvements in children’s health within the UK in the last 100 years are due to public health measures such as: better education, provision of clean water, sanitation and decent housing.

It may seem irrelevant to be discussing the world wide issues in relation to children’s health within developed countries such as the UK, however, 1 in 4 children in the UK are still living in poverty (Sharma 2005); and 25% of young people aged 0-15 are living in housing that is considered non-decent (DCLG 2006).

In addition, the more recent (2009/10) pandemic of swine flu outbreak was a major worldwide public health concern. In comparison with seasonal flu, the government highlighted that many more people could become severely ill, and many more could die (DFES 2007 pg 2).

2 pages, 825 words

The Essay on Engage in Personal Development in Children and Young People’s Settings

Engage in personal development in children and young people’s settings Being a Nursery worker involves a lot of hard work and dedication. We have many roles and responsibilities to follow to help provide a safe and careering environment for the children. They are as followed: * Welcoming the children and liaising with parents * Providing a safe and caring environment by doing safety checks, risk ...

As with many infections, this was a disease that was highly contagious and which was easily spread through bodily and air-borne contact. To try and limit the spread of the infection throughout the UK population, the government launched a media campaign: ‘Catch it, Bin it, Kill it’ in order to promote the social message that hand washing is a predominant factor in helping to reduce the spread. Written information was backed up with TV advertisements which used visual imagery to encourage a change in behaviours within the population.

This was further highlighted as a public concern with the more localised 2009 Surrey farm E-coli outbreak (HPA 2010).

The review into the outbreak concluded ‘that public education on the risks of infection from E. coli O157 and the measures parents can take to protect their families is vitally important for their informed choice’ (pg 122).

Hand Hygiene Compliance.

The UK Health Protection Agency (HPA) states: ‘Hand washing is the single most important means of reducing the risk of transmitting infection’ (HPA, 2009, pg).

In agreement, the International Global Handwashing Campaign (GHC) identifies that in developed countries, hand washing helps to prevent the spread of viral infections, such as norovirus, rotavirus and influenza (www.globalhandwashingday.org.uk)

A more local incident was identified by the Infection Control nurse who visited the setting in early November, who pointed out that an outbreak of Norovirus had been identified in a local high school – the possibility of a school closure had been discussed with the Health Protection Unit (see appendix).

This information was important to the setting as a few children who attend have siblings at the high schools. With the infection spreading easily from person to person, there was a real possibility of cross-contamination within the children’s home environment. As a result, the nurse expressed the importance of hand washing in the fight against infection.

However, research undertaken for the Centre for Disease Control Prevention (CDC), showed that hand washing occurs with varying frequency (CDC 2003).

2 pages, 913 words

The Essay on Health & Hygiene In Islam

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Observational studies within hospitals (CDC, 2003) concluded that the hand hygiene compliance of Health Care Workers (HCW) was often poor, and that a change in attitudes and behaviour towards hand washing was desperately needed: shortage of sinks, lack of soap and paper towels, insufficient time, poor role models, belief there was low risk of acquiring infection as well as scepticism regarding the value of hand hygiene were identified by HCW as reasons for poor compliance (pg 25).

In addition, a 2007 survey sponsored by the antiseptic and disinfection company, Dettol, and conducted by the hygiene council, found that two-thirds of Britons do not follow basic hygiene principles; and one in 10 people do not wash their hands after going to the toilet. (www.hygiene4health.com)

Behaviourist theorist, Albert Bandura, suggests that children frequently learn through observing and imitating role models (Pound 2008).Thus, in relation to the author’s Early Years setting, the above findings may suggest a reason for children’s poor hand washing behaviours may be due to the role models they are observing.

The author has observed poor hand hygiene practices within the setting (see appendix 1).

For example, a parent told a child who had just used the toilet: “be quick, we will wash your hands when we get home”. Staff observation of 25 children’s toileting routines showed that, when not prompted by an adult, 56% (14 children) left the bathroom without washing their hands. This was a great cause of concern, not only for the medical health and wellbeing of the children, but of the impact this would have on their education in terms of inability to maintain both full interactivity and/or attendance during times of illness. It was decided, therefore, that staff would be more vigilant in their own hygiene practices to make sure they were positive role models for children.

There is little research about hand hygiene compliance in Early Years settings, however, whilst discussing hygiene routines with staff throughout the promotion (see appendix 4), staff identified that making sure all children had washed their hands correctly was difficult due to issues such as: time restriction, the possibility that paper towel dispensers could become ‘jammed’; and that some children had difficulty turning taps on. While the author does not attempt to make universal claims about hand hygiene practices in Early Years settings, the observations and staff comments allowed the author to see a link between the factors identified by HCW, and the staff within the setting.

4 pages, 1987 words

The Review on Evaluate the Effectiveness of Repeated Oral Health Education Programme on Oral Health Knowledge and Hygiene of Visually Impaired Individuals

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Research Rosen et al (2007), highlights that the environment must be enabling to children to promote good hand hygiene practices. In addition the EYFS acknowledges the importance of environment on children’s learning and development. This was a motivating factor that prompted further discussion about how the team could make the toilet environment more user friendly for the children. Thus, further observation would be needed to identify if the difficulty some children had turning on the taps was due to the taps not being appropriate for children’s use.

Evaluation of Resource pack

The aim of the promotion within the setting is to help children develop the skills of effective hand washing and to develop appropriate hand washing habits. A resource pack was compiled for the children along with an arranged visit arranged from the Infection Prevention Nurse.

The resource pack fits the educational and behaviour change approaches to health promotion identified by Naidoo and Wills (2000) (Cited in Dryden et al 2005 pg 35).

It is designed to educate children about how infections are spread, and to encourage behaviours that will reduce the spread of infection. This, then, supports the social model of health.

Educational approaches are generally viewed as a way of providing individuals with knowledge and understanding which allows them to make informed choices about their health and behavioural approaches. In contrast, however, as decisions are being made by people other than the individual, it could be argued as being behaviour modification. In this context the health behaviours are determined by staff within the setting, for example: making sure children have washed their hands before lunch or after using the toilet. Thus, how much is really the choice of the children is difficult to assess.

The main resource within the pack is a Story Book “Oliver Odd Sock”, which was part of a resource pack for pre-school children, retrieved from the Global Handwashing day website (www.globalhandwashing.org.uk).

The benefit of using this website to source the story book was the flexibility to download and reproduce the book numerous times and at a lower cost than buying traditional story books. Although the book was aimed at pre-school children, in relation to the setting’s campaign, staff felt the need to adapt some of text in order make it more appropriate for the children’s developmental stage.

While the pack was designed for children’s usage, the author was initially aware that that there would need to be planning put in place to enable a consistent approach of reading the story. On this basis, it was decided that staff would read the story to children at ‘circle time’, where time could better be dedicated to answering potential questions. This supported the EYFS’ belief that children learn best when there is a mix of adult-led and child-initiated play activities (DFES 2008).

To facilitate children’s learning within their spontaneous play activities, copies of the books were put in various areas within the nursery, including the bathroom. To reinforce the messages received from circle time, a snakes and ladders game (see resource pack) was available for children to use.

According to language and literacy expert, Marion Whitehead (2010), oral story-telling is a powerful way of sharing and passing on the knowledge, experiences and beliefs of a community. In agreement, staff observations showed the story book had an impact on children understanding of why they should was their hands.

However, it was the visits from the Health Protection Nurse, Dirty Bertie (see video in resource pack), and the children’s interaction with the ultra violet light which had the most positive impact on the childrens’ actual hand washing behaviours. Observation taken after the visit (see appendix 5) show that 100% of the children independently washed their hands after using the toilet compared with the initial 56%. In addition, whilst in the bathroom, for example, a child told another child: “Don’t forget what Dirty Bertie said: you got to wash your hands and don’t forget your thumbs”. Children were also observed spending longer washing their hands. Thus, this supports Whitehead’s views that connections between a book and the childrens’ world need to be built upon with sensitive talk at appropriate times, and that the use of puppets and visual aids can enrich and extend children’s understanding and learning (2010).

It may also suggest that the visual nature of presentation suited the children’s learning styles.

Every Child Matters (2004) highlights the importance of multi-agency working as a way of improving health outcomes for children (DFES 2004).

Shared knowledge and expertise from the Infection Prevention nurse helped strengthen and support children’s understanding of the importance of hand washing. The nurse also helped the setting to limit the spread of infection by identifying that the swing bins in the toilet area were a possible source for cross-contamination between children within the setting.

When attempting to bring about a change in behaviour, motivation is a key factor to consider. The resource pack contains items aimed to foster motivation in children, for example: reward stickers and certificates. To reinforce her visit, the Health Protection nurse also provided children with a bag of resources (see resource pack).

Bandura suggests that when reinforcement follows behaviour, that behaviour is likely to be repeated.

Parents were informed about the health promotion and a leaflet was given for their information (see appendix 6), however parental participation was limited due to the resource pack being targeted at the children. As discussed earlier in the report, hand hygiene practice amongst adults can vary and good role models are essential to children’s learning and development. Thus to support children in their home environment, the setting would need to extend the health promotion to encourage parents to become more involved in their child’s hygiene. Along with this is the need to find an appropriate way to approach the issue that, whilst benefitting the children, would not inadvertently be seen as criticism by some of the parents. Thus, the team have decided to make up a resource pack similar to the ones used in the setting and, using a library system, allow the children to borrow the resource pack to use in their home environment.

Conclusion

In conclusion good hand hygiene is seen as an essential element to protect children from infectious disease (HPA 2009, Global handwshing campaign 2010,) worldwide, nationally and at local level.

Immunisation and the ‘medical model’ of health support the control of serious infections. However, as identified by Lalonde’s social model of health it is the complex web of factors such as, genetics, environment, lifestyles and medical services that impact on children’s health outcomes. Thus, Practitioners need to consider these when undertaking health promotion work within the setting.

As shown within the report Hand hygiene compliance within the adult population is varied. As Bandura suggested, children often learn through observing and imitating role models (Pound, 2008).

To become positive role models, therefore, staff within the setting need to be vigilant of their own hygiene practices.

The Observation show that more children independently washed their hands after using the toilet after the promotion than before, thus the Author would suggest that the health promotion had a positive impact on children’s hand hygiene practices. However, as parents were not targeted within this promotion, the health promotion may need to be extended to fully support children’s development and understanding of children’s hand washing behaviours.

Recommendations.

• Extend the promotion to develop parent participation

• Further observations are needed to identify issues that children have using the taps.

Reference List

Billingham,K. and Barnes,J. (2010) The Role of Health in Early Years Services. In: Pugh,G. And Duffy,B., eds. Contemporary issues in the Early Years 5th edition.London:Sage pp 137-150

CDC (2002) Morbidity and Mortality Weekly Report, Guideline for Hand Hygiene in Health- Care Settings. US: US Government Printing office

Department for communities and local government (DCLG) 2004 English House Condition Survey 2004 Annual report. DCLG:Wetherby

DFES (2004) Every Child Matters:Change for Children London:HMSO

DFES (2007) Planning for a human influenza pandemic, Infection Control – How to reduce the spread of pandemic flu. Guidance for schools and early years or childcare setting London: Dfes publications

DFES(2008) The Early Years Foundation Stage Nottingham:DCSF

Department of health (2008) Catch it, Bin it, Kill it – Respiratory and hand hygiene campaign [online] Available at: [Accessed on 11/11/2010]

Dryden,L. Forbes,R. Mukherji,P. and Pound,L. Essential Early Years London:Hodder Arnold

Health Protection Agency (2009) Communicable Disease Control Manual for Schools and other Childcare Settings in West Yorkshire Unknown :HPA

Health Protection Agency (2009) Review of the major outbreak of E.Coil 0157 in surrey, 2009 Unknown:HPA

Health Protection Agency (2010) Guidance on infection control in schools and other childcare settings. Unknown:HPA

Hall, D. and Elliman, D., eds (2006) Health for all Children revised fourth edition Oxford: University Press

Global Handwashing Day [online] Available at:http://www.globalhandwashingday.org.uk/index.html [accessed on 9/11/10]

Kearns, K. (2008) The public health landscape:challenges and opportunities [online] Available at: http://www.sph.unc.edu/nutrition_news/the_public_health_landscape_challenges_and_opportunities_934

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MacLeod-Brudnell,I. ,ed. (2004) Advanced Early Years Care and Education .Oxford:Heinemann

Pound,L(2008) How children Learn from Montessori to Vygotsky- educational teories and approaches made easy.London:Step Forward Publishing

Pugh,G. And Duffy, B., eds (2010) Contemporary Issues in the Early Years 5th ed. London:Sage Publications

Rossen, L. Zucker, D. Brody,D. Engethard,D. and Manor, O. ‘The effect of a hand washing intervention on pre-school educators beliefs, attitudes, knowledge and self-efficacy’ Health Education Research 24,(4) pp. 686-698

Sharma.M.D. (2005) Breaking the cycle of child poverty [online] Available at:Http;//news.bbc.co.uk/1/hi/business/4123678.stm[Accessed 21/11/09]

Whitehead,M.(2010) Language and Literacy in the Early Years 3rd Edition London:Sage

Whiting, L. And Miller,S.(2009) ‘Traditional, alternative and innovative approaches to health promotion for children and young people’ Paediatric Nursing, 21, (2) pp. 45-50.

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Billingham,K. and Barnes,J. (2010) The Role of Health in Early Years Services. In: Pugh,G. And Duffy,B., eds. Contemporary issues in the Early Years 5th edition.London:Sage pp 137-150

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Department for communities and local government (DCLG) 2004 English House Condition Survey 2004 Annual report. DCLG:Wetherby

Dfes (2007) Planning for a human influenza pandemic, Infection Control – How to reduce the spread of pandemic flu. Guidance for schools and early years or childcare setting London: Dfes publications

Dowler, E. And Spencer, N, eds (2007) Challenging health inequalities from Acheson to ‘Choosing Health’. Bristol: The Policy Press

Dryden,L. Forbes,R. Mukherji,P. and Pound,L. Essential Early Years London:Hodder Arnold

Health Protection Agency (2010) Guidance on infection control in schools and other childcare settings. HPA

Hall, D. and Elliman, D., eds (2006) Health for all Children revised fourth edition Oxford: University Press

Hupley, J. And Copeman, J.(2008) Practical Health Promotion. Cambridge:Polity Press

http://www.who.int/mediacentre/factsheets/fs330/en/index.html

Kearns, K. (2008) The public health landscape:challenges and opportunities [online] Available at: http://www.sph.unc.edu/nutrition_news/the_public_health_landscape_challenges_and_opportunities_934

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Pugh,G. And Duffy, B., eds (2010) Contemporary Issues in the Early Years 5th ed. London:Sage Publications.