A critical evaluation of the Hand Hygiene Compliance Procedure of Kookaburra Childcare Centre

Question

Task: Explain why the improvement project is needed. State the problem and the intervention that can help to fix it. Explain how the intervention was evaluated.

Answer

Introduction

Children are prone to various infections and illnesses due to exposure to various materials, surfaces, and body fluids. The maintenance of hand hygiene is considered an important factor that plays an essential role in the overall prevention and spreading of infectious diseases. Kookaburra childcare centreis committed to compliance with hand hygiene procedures that can significantly assist the organization in reducing the likelihood of children becoming ill due to cross-infection factors (Klar et al., 2022). The parents, children, and visitors are always asked to wash their hands on arrival and departure from the centre which can be considered a significant step in preventing the spread of infection among children. This essay provides a detailed analysis of the various factors related to hand hygiene and the overall background and context of the issue. The intervention strategies provided in the assignment will help in the mitigation for redubbing the likelihood of infections in the future for the children. The possible intervention along with the ways to implement the strategic interventions is also provided in the essay. The measurement or evaluation of the strategic interventions is provided with the help of follow-up audits, observations, and feedback from the staff of the childcare centre.

Background and context

The proper implementation of the mitigation strategies related to effective hand washing for children is considered one of the most important factors which can help prevent the spread of infectious diseases among children. The settings of Kookaburra Child care centre promote the continuity of personal health and hygiene aspects of children by sharing the ownership of routines and schedules of children within the families and community. The educators and coordinators of the healthcare settings provide these guidelines for maintaining and preserving the health status of children within the childcare centre. Therefore, the main aim and objective of the project can be attributed to the maintenance of high standards of hygiene in the centre through the promotion of effective hand-washing practices and procedures for all the children and adults who enter the childcare facility. However, the overall compliance rates according to Moment 2 and 3 indicate a poor performance as per the overall national standards. Moment 2 has projected a compliance rate of 91.7% and Moment 3 has indicated a compliance of 93.5% which are considered poor according to the National hand Hygiene initiative directed under the Australian Commission on safety and quality of healthcare. This factor indicates the room for improvement in the overall hand hygiene procedures within the care settings (National Report Data, 2022).

The requirements of child care related to various infectious diseases and medical conditions including allergies are met by the organization. The families of the child require the submission of documents related to the medical conditions of the child. The development of strategic initiatives is a concern for the organization and the management is committed to the development of mitigation strategies for effective control of the spread of infections among children. Management ensures the staff, children, parents, and volunteers have proper access to the hand-washing facilities at the childcare centre. The management should also ensure the proper facilitation of access to hand sanitizers in case the hand washing facilities are not provided or present on the premises. Up-to-date information about the appropriate hand washing procedure is required by the organization for mitigating the instances of infectious diseases. Hand washing is considered an integral part of the overall hygiene aspects of children (Shahrbabaki et al., 2021). The children are susceptible to various illnesses consisting of infectious elements which can create various other complications for the children.

Risk presentation

The prevalence of infections can be reduced to a third if hand-washing techniques are properly implemented in the childcare centers like this. Effective interventions in hand washing can lead to an improved state of overall health for the children in healthcare settings like Kookaburra Childcare centre. The prevalence of the pandemic of Covid 19 presented a great number of risks and threats for the childcare centre as the children were at the most risk of contracting the disease due to the prevalence of lesser immunity as compared to adults. Communicable diseases can be potentially life-threatening for children as the pandemic has already created a global impact on the population (Staniford&Schmidtke, 2020). Early childhood provides a proper time for practicing hand hygiene as children tend to use their hands on various surfaces that can contain germs. The prevalence of lower hand hygiene aspects for children makes them prone to more infections which is the leading cause of developing strategic initiatives by the childcare centre.

Facility, room numbers, layout and staffing

The center encourages the families of children to settle them in the centre by staying with them for a period in the rooms which can also enable the parents to discuss various issues related to the education and healthcare aspects of the children. The educators within the care provide an adequate amount of communication and support for the parents which can enable their children to reap the benefits of the childcare centre. The childcare service uses a staffing roster for providing continuous care for the children both during arrival and departure. The children are usually accepted in a combined group for a certain period both in the mornings and evenings (Tantum et al., 2021). The groups are combined for maintaining a proper child ratio which can be integrated into the national regulations related to childcare in the country. The educators within the premises make themselves available to interact and communicate with the parents for ensuring a proper care plan and regime for the overall aspects of health, hygiene, and education. The resources consisting of the staff and educators play an important role in the overall hygiene maintenance of the children. The staff consists of director, assistant director, office manager in the management body. The associates include the clerks, teachers and lead educators who are supported by the various educators at the childcare centre. The aim of the organization can also be attributed to ensuring the attendance of the children by the educators as a primary objective. Ensuring care continuity is also a matter of concern for educators which can be considered an integral duty of the overall resources of the organization. Hand hygiene is one of the most important aspects of childhood healthcare education which is considered an easy practice (Tantum et al., 2021). Workplace readiness consists of the various procedures for ensuring proper hand hygiene in the place. The placing of adequate hygiene measures by the staff like hand sanitizers and hand wash soaps along with the provision of hand wiping wet tissue papers are considered important aspects that can justify the workplace readiness of the organization.

Strategy

Hand hygiene is one of the significant parts of controlling the infection and bringing health improvement. It is the compliance of cleaning hands with water and soap or with antiseptic hand wash to remove the microorganisms from the hands and maintain the skin condition of the hand. It has been identified that most infections or diseases are also transmitted from the hand and is important to maintain hand hygiene. In healthcare practices, it is an essential part of washing hands with soap and water and alcohol-based hand rub (ABHR) to remove the microorganisms that can infect another person (Engdaw et al., 2019). In childcare centres, there is a high risk of getting gastrointestinal and respiratory infections and it is essential to have hand hygiene compliance procedures for mitigating the challenges. There are more possibilities that children do not follow hand wash procedures and this can bring infections to their bodies and make them sick. Therefore, various interventions are taken for helping the child to follow the hand washing procedures with soap and water for removing the microorganisms (Zomer et al., 2016). Kookaburra is a community-based non-profit association that works in providing the best child care to children. For availing of the benefits, one has to enrol their child at the centre which allows the parent to become a member of the association.

Kookaburra child care centre works in various areas for providing real-life experiences to the child for bringing social and cognitive development in them. Hand hygiene is defined as a significant measure for reducing healthcare-associated infection (HCAI) transmission. In children transmission of infections are most likely due to their natural behaviour which infects their respiratory system and due to an immature immune system. The possible interventions to improve their hand hygiene compliance procedures are to help them learn to wash their hands frequently and to let their hand touch their face or mouth when their hand is dirty. Effective education for children and their parents is one of the vital parts to promote hand hygiene compliance procedures to reduce infections in children and the vulnerability of getting infected (Lary et al., 2019). As per the reports, it has been identified that children attending daycare facilities have experienced more infections than home-treated children. Most of the children less than 5 years old are enrolled in a childcare centre for around 35 hours a week. Therefore, there are more possibilities of getting infected due to a lack of hand hygiene which is the most important task in the centre.

The Handwashing intervention strategies in child care centre includes effective training and monitoring of hand washing at times to prevent the risk of getting infected. Practice-based hand washing and education-based hand washing procedures are some of the hand washing compliance procedures that help in reducing the risk of getting infections in children at childcare centres (Agustina et al., 2021). Teaching children about germs and their impacts on human health and instructing them allows for improving hand hygiene compliance procedures.

The staff and management need to implement the various strategies required to ensure the strategic implementation of the initiatives related to the mitigation of infections. Hand hygiene is one of the most important considerations for the organization that can be implemented through the proper integration of staff, management, and parents. The practice of effective hand washing can be implemented by the staff of the childcare centre by setting up various points of hand wash and sanitizers for the effective mitigation and control of infectious diseases within the premises (Jamaluddin et al., 2020). The proper mitigation of infectious diseases can be done by using hand washing for the parents and staff before entering and after leaving the premises. The children should also use hand sanitizers and soaps after using the toilets, wiping their noses, or eating food. The implementation of these interventions can help in reducing the occurrence of infections that can negatively affect the children at the care centre. The various aspects of hand washing can be attributed to the rigorous rubbing of palms and fingers including the back of hands for cleaning the dirt accumulated in the hands. The children within the care centre should be provided the training required to properly implement the hand washing technique as an effective mitigation strategy for infection control.

The implementation of the strategic interventions within the premises of the childcare facility can be attributed to a few variables and factors. Stakeholder engagement is considered one of the most important aspects of the strategic implementation of the intervention. The centre can adopt various training and guidance practices for the parents which can effectively help in distributing messages of awareness related to hand washing care. Awareness campaigns consisting of proper ways to utilize hand washing with soaps and sanitizers can also be considered an important factor in involving stakeholders within the organization (Jamaluddin et al., 2020). The collaboration of the centre along with various other government or private healthcare initiatives can also help in communication with the communities and societies for facilitating a better reach of the awareness plans and campaigns related to the importance of hand hygiene. Communication strategies can be implemented by the medium of social media and mass electronic media campaigns related to the effectiveness of hand washing as an infection prevention matter for children within childcare facilities.

There are some barriers associated with the proper application of interventional strategies related to the prevention of disease by using hand washing techniques. The social and cultural aspects of the communities can be considered as significant barriers which can affect the overall implementation of the intervention strategies related to hand washing benefits. The facilitation of language as a significant indicator of effective measurement of success can be considered important for the centre. The children belonging to the Aboriginal community and Torres Strait islanders can face difficulties in accessing the child care centre due to the various inequities in the overall; healthcare services in the country (Younie et al., 2020). Lack of proper knowledge of the healthcare and community workers along with the educators at the child care centre can also be considered a significant obstacle or barrier in the effective mitigation of infectious diseases among the children in the facility. The improper attitude of the staff and educators and lack of proper communication with the parents can also be considered as potential barriers that can cause a hindrance in the mitigation of infections among children.

Evaluation

Most of the children below the age of 5 years old are enrolled in a childcare centre for taking care of them and educating them in various areas. Providing education to children helps in bringing improvement and progress in them which helps them learn the significance of hand hygiene and its related benefits. In the Kookaburra child care centre, various interventions are being implemented for allowing and educating children to know the benefits of hand hygiene and the impacts of germs on them. Furthermore, they have implemented other strategies in guiding and monitoring them to identify the procedures followed by them and help them learn new things. In a childcare centre, it is essential to understand that volunteers and other staff have to provide education on hand hygiene compliance procedures so they can teach those practices to children effectively. Hand hygiene is important in the child care centre as children have a less immune system and easily get infected and is important to help them learn hand hygiene procedures (Azor-Martínez et al., 2018). The measurement of the effectiveness of hand hygiene compliance procedures is followed using direct observation, and indirect and self-report hand hygiene measurement product usage. The hand hygiene audit was done to identify the measures taken by the Kookaburra child care centre for improving hand hygiene in children in their centre. The audit was followed after six months of interventions were asked to implement in the centre. The volunteers and children were asked to show the measures that have been taken or implemented in the centre as a part of hand hygiene. From the evaluation, it has been identified that the interventions were followed or implemented effectively by the Kookaburra child care centre regarding hand hygiene for reducing the risk of getting infected to children. Educating children and guiding them on hand hygiene allows in bringing improvement in their health by reducing the risk of getting infected (Mohamed et al., 2016).

In the data collection from the Kookaburra child care centre, the goal-based evaluation method was followed to bring improvement in the hand hygiene compliance procedures in a child care centre. The main objective of following this method was to reduce the risk of getting infected in a child as more children get infected from childcare centres than the home-treated centres. Early childhood is the vital period where they develop healthy and effective habits that also include hand hygiene practices. Children mostly use their hands and put their hand in their mouth frequently and there are most chances they inhale microorganisms that infect them and makes them sick (Suen& Cheung, 2020). Therefore, it is also the main reason to choose the goal-based evaluation method as it helps in identifying the progress in the Kookaburra child care centre.

From the evaluation, it has been identified that most children and the volunteers and other staff were following the procedures of hand hygiene and guiding children and parents to use the strategy to bring improvement in them. Lack of hand hygiene can bring various infections which also kill children and are very important for the child care centre and families to help and guide them to learn and implement the hand hygiene compliance procedures effectively. Kookaburra child care centre effectively follows hygiene standards including hand washing procedures for children and members who enter the service. Hand washing is considered an effective measure in Kookaburra child care centre and is compulsory for the management, staff and parents to follow the regulations. They have the procedures of hand washing and when to wash hands which have to be effectively followed by all Kookaburra child care centre members. From the overall evaluation, it has been identified that every member of the Kookaburra child care centre is following the procedures and is bringing improvement in their centre to educate others.

Hand hygiene is defined as a cornerstone in preventing children from getting infected. The report also suggests that most of the infections in children are from the childcare centre and is important to educate and provide guidelines to childcare centres to follow hand hygiene and other hygiene standards (Klar et al., 2022). The Kookaburra child care centre is following the hand hygiene compliance procedures effectively and other health hygiene standards that are relevant in child care facilities. However, they can further work in educating the children and families on hand hygiene and other hygiene standards that could be used at their homes. This allows them to make their habit of living healthily and follow healthy procedures. Further, educating children and families to have alcohol-based hand wash gels or liquids in their place could be followed in the Kookaburra child care centre for bringing improvement and progress in children.

Conclusion

Hand hygiene is one of the significant parts that have to be followed by children and child care centres for preventing children from infections and reducing the risk of getting infected. Children at an early age have a weak immune system and they receive more infections. In childcare centres, most children get infected due to a lack of hand hygiene compliance procedures following. Therefore, it is essential for the childcare centre to follow hand hygiene to prevent children from getting infected. Kookaburra child care centre is a non-profit community-based child care centre where people can enrol their child in the place and can become a member of the centre. The centre offers various effective and beneficial education to children and parents on guiding children and helping them follow hand hygiene and other hygiene standards. Practice-based learning and education-based learning are effective intervention strategies to implement hand hygiene in a childcare centre for preventing infection spread. In the childcare centre age of fewer than 5 years old are getting infected mostly and is identified due to a lack of hand hygiene compliance procedures followed in the centre. In Kookaburra child care centre effective hand hygiene compliance is being followed for all management staff members and the children for preventing the spread of infections and bringing improvement in the child care centre.

References

Agustina, W., Haryanto, J., &Indarwati, R. (2021).Child Hand Washing Intervention (Age < 5 Years) Against The Risk of Infection in Child Care: Systematic Review. Https://Sjik.org/. https://sjik.org/index.php/sjik/article/download/622/452/

Azor-Martínez, E., Yui-Hifume, R., Vico, F. J. M., & Jimenez-Noguera, E. (2018).Effectiveness of a Hand Hygiene Program at Child Care Centers: A Cluster Randomized Trial. Www.researchgate.net. https://www.researchgate.net/publication/328148756_Effectiveness_of_a_Hand_Hygiene_Program_at_Child_Care_Centers_A_Cluster_Randomized_Trial

Engdaw, G. T., Gebrehiwot, M., &Andualem, Z. (2019).Hand hygiene compliance and associated factors among health care providers in Central Gondar zone public primary hospitals, Northwest Ethiopia. https://d-nb.info/1206847417/34

Klar, K., Knaack, D., Kampmeier, S., Hein, A. K., Görlich, D., Steltenkamp, S., Weyland, U., & Becker, K. (2022).Knowledge about Hand Hygiene and Related Infectious Disease Awareness among Primary School Children in Germany.Children, 9(2), 190.https://doi.org/10.3390/children9020190

Lary, D., Calvert, A., Nerlich, B., & Segal, J. (2019).Improving children’s and their visitors’ hand hygiene compliance. Www.researchgate.net. https://www.researchgate.net/publication/337957640_Improving_children’s_and_their_visitors’_hand_hygiene_compliance

Mohamed, N. A., Amin, N. N. Z., Ramli, S., Salleh, N. M., &Isahak, I. (2016). Knowledge, attitudes and practices of hand hygiene among parents of preschool children.Journal of Scientific and Innovative Research JSIR, 5(51), 1–6.http://www.jsirjournal.com/Vol5_Issue1_01.pdf

National Report Data.(2022). National Report Data. Doi1e3eo0i66y.cloudfront.net. https://doi1e3eo0i66y.cloudfront.net/static-resources/national_report/47375e14-9376-41a3-9e61-de74987508bd/index.html?95f4440e

Shahrbabaki, P. M., Dehghan, M., Ahmadinejad, M., Jabarpour, M., &Mazallahi, M. (2021). Barriers to Hand Hygiene Compliance in Intensive Care Units From the Perspective of Healthcare Workers: A Qualitative Study. Barriers to Hand Hygiene Compliance in Intensive Care Units from the Perspective of Healthcare Workers: A Qualitative Study, 27(15). https://doi.org/10.21203/rs.3.rs-258249/v1

Staniford, L. J., &Schmidtke, K. A. (2020).A systematic review of hand-hygiene and environmental disinfection interventions in settings with children.BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-8301-0

Suen, L. K. P., & Cheung, J. P. L. (2020). Effectiveness of “Hand Hygiene Fun Month” for Kindergarten Children: A Pilot Quasi-Experimental Study. International Journal of Environmental Research and Public Health, 17(19), 7264.https://www.mdpi.com/1660-4601/17/19/7264/htm

Tantum, L. K., Gilstad, J. R., Bolay, F. K., Horng, L. M., Simpson, A. D., Letizia, A. G., Styczynski, A. R., Luby, S. P., & Arthur, R. F. (2021). Barriers and Opportunities for Sustainable Hand Hygiene Interventions in Rural Liberian Hospitals.International Journal of Environmental Research and Public Health, 18(16). https://doi.org/10.3390/ijerph18168588

Jamaluddin, T. Z. M., Mohamed, N. A., Mohd Rani, M. D., Ismail, Z., Ramli, S., Faroque, H., AbdSamad, F. N., Ariffien, A. R., Che Amir Farid, A. A. R., &Isahak, I. (2020). Assessment on Hand Hygiene Knowledge and Practices Among Pre-school Children in Klang Valley. Global Pediatric Health, 7(12), 2333794X2097636. https://doi.org/10.1177/2333794x20976369

Younie, S., Mitchell, C., Bisson, M.-J., Crosby, S., Kukona, A., & Laird, K. (2020). Improving young children’s handwashingbehaviour and understanding of germs: The impact of A Germ’s Journey educational resources in schools and public spaces. PLOS ONE, 15(11), e0242134. https://doi.org/10.1371/journal.pone.0242134

ZOMER, T. P., ERASMUS, V., LOOMAN, C. W., VAN BEECK, E. F., TJON-A-TSIEN, A., RICHARDUS, J. H., & VOETEN, H. A. C. M. (2016). Improving hand hygiene compliance in child daycare centres: a randomized controlled trial. Epidemiology and Infection, 144(12), 2552–2560. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4988269/