The policies and procedures cover a wide range of thing in the nursey we have to follow the policies of walking children up and down the stairs guiding 4 children holding the front child and back child’s hands to support the children in the middle. Also the policy for being out in the garden there should be a member of staff on the hill helping children up and down making sure they use it one way, another near the sand and mud to stop young children may eat it, also someone else on the road to make sure they are using the bikes properly and safely.
As such, the diagnosis and management of AOM has a significant impact on the health of children, cost of providing care, and overall use of antibacterial agents (AAFP, 2004). Watchful waiting can have many benefits for the children and the provider if used properly. Diagnosing AOM can be tricky. The signs and symptoms can also be related to other illnesses such as an upper respiratory virus. Throwing antibiotics at any illness use to be the course of action. However, now that there is evidence that bacteria have become resistant to some antibiotics, clinicians are testing out other means of treating illnesses. If the child presenting with symptoms of AOM has no underlying conditions and has means to follow up with the doctor if the symptoms progress, watchful waiting is an appropriate approach for treating the child. According to the research, placebo controlled trials have shown that children have responded well without antibacterial intervention. Giving the opportunity for the illness to resolve without antibacterial intervention not only benefits the child but, the caregivers and the clinician. It benefits the child by not being exposed to antibiotics that are not needed, therefore creating a potential resistance to that antibiotic. It benefits the caregiver by not spending money on a medication their child does not need. Last, it benefits the clinician by preventing resistance to an antibiotic that may be useful in the near future.
Upper respiratory tract infections (URTI), including acute otitis media (AOM) are the most common cause of ambulatory physician visits and antimicrobial prescriptions in children1,2. The most common bacterial causes of URTI are Streptococcus pneumoniae and Haemophilus influenzae, though the majority of cases are caused by viral pathogens 3–10. Distinguishing between viral and bacterial URTI can be difficult. Reports on quality of antimicrobial prescriptions have shown a 30-50% of all out-patient prescriptions due to (upper) respiratory tract infections to be inappropriate2,10,11. In Europe the quality of prescription is higher in the north of the continent, including Iceland compared to in the south12. Conversely, many factors contribute to the overuse of antimicrobials2,13–15, which in turn results to increase in antimicrobial resistance16,17. Contributing factors cited by by physicians to cause over-prescription include uncertainty of diagnosis, fear of disease complications, lack of perception of harmful effects of antimicrobials, not perceiving their own prescription practices to be a problem, pressure by patients, limited time, fear of damaging doctor-patient relationship in addition to language, cultural and educational barriers2,13–15. Antimicrobials were long a mainstay treatment against AOM in fear of rare, but dangerous complications, which have later been found to be unfounded, asnd
As a childminder you have to make sure that if you have a child with an infectious disease that you don’t let the child get in contact with other children. This sometimes means asking the parents to keep their child at home.
In 1999, there were amendments to the Optician’s Act. The amendments aimed to provide optometrists with a wider scope of practice, which allowed them to have limited clinical management of non- sight-threatening conditions such as allergic and infective conjunctivitis. It was thought that this might have helped to reduce the burden on the National Health Service. (GOC rules and regulations. (2017)).
Everyone within the UK has a set of requirements which must be met by the providers of early years care; in Wales they are known and the Welsh Assembly Government and CSSIW. They must promote the welfare of the children but also promote the good health of the children b taking step to prevent the spread of infection as well as taking appropriate steps when the child is ill. The specific requirement areas are;
The prescribing of antibiotics for AOM can have an impact on the health of the treated children and increases the cost of providing care. Watchful waiting is the recommendation from the AAFP & AAP in cases of uncomplicated AOM that are a result of other illnesses such as an upper respiratory virus. In the past doctors would immediately prescribe antibiotics for the signs and symptoms of an ear infection, however new evidence shows that over time bacteria have become resistant to certain antibiotics and so other means of treatment must be explored. If a child presents with symptoms of AOM and has no other underlying illness or condition, then watchful waiting is an appropriate avenue of treatment for the child. The research showed placebo trials had favorable outcomes and children responded without antibiotic interventions. If watchful waiting is used the child is not exposed to unneeded antibiotics and this reduces the chances of antibiotic resistance in the future. In addition, it also reduces the amount of money spent on health care needs in the form of purchasing medications. It should be noted that watchful waiting should only be considered in cases of uncomplicated AOM and that education should be given to care givers on when to follow up if symptoms do not improve within 48-72 hours. In the even that symptoms do not resolve then antibiotics may become necessary.
When policies and procedures are written they should clearly define what it is meant to ensure that there is good practice but it should also be able to save time as adult will be aware of what is expected of them; if they are not clear enough then staff may be confused on what they are meant to do and this can have severe consequences on either the children/ young people or the staff within the setting. When they are clear it ensures that the setting can work at optimal strength while also ensuring that it operating effectively to ensure that children care is not at risk because staffs are not entirely sure of what they should be doing within the setting. There should also be no misunderstanding if they are written out clearly enough. Policies and procedures are put in place in order to ensure that children are both, safe, and secure, as well as happy while having the best possible learning opportunity; even when the policy applies to adults they have to ensure that children are being given the best care and education possible because they have to impose
* I cannot accept to my setting any child which is suffering from, or has suffered from a contagious illness such as diarrhoea, sickness or conjunctivitis in the last twenty-four hours.
Plan of Care: No laboratory work ordered at this time. Patient prescribed Tobramycin ophthalmic ointment 1/4 to 1/2 inch ribbon to lower conjunctiva every four hours while awake (Medscape, 2014). Patient instructed to keep eye clean using a dilute baby shampoo solution twice daily. The patient is instructed to seek immediate medical intervention for visual changes, fever greater than 100.0, or increasing ocular pain. Return for follow-up appointment in two days (Goolsby & Grubs, 2011). Continue current medication regime as previously prescribed.
How would you encourage parents with children to approach a health professional about over prescribing antibiotics that could potential lead to resistance? How would you educate parents to recognize warning flags with over prescribing habits? You state that health education programs need to have the ability to enable and empower parents, how could empower lead to further complications associated with antibiotics? In your opinion what is a approach that could be taken to encourage health professional to reduce prescribing habits while still empowering parents to have guidance and ownership over their families health status?
In today’s society, the parents have a right to refuse or discontinue treatment. However, when parental decisions are not in the best interest of the child and potentially dangerous to the child’s health, health care practitioners have a responsibility to advocate for the child and challenge those decisions, as is the case with vaccinations.
In taking any medication there are always positives and negative side effects. Overprescribing medication and over diagnosing different disease in children has caused these effects to become increasingly prevent in society today. An increasing number of children and teenagers are being prescribed drugs as a “quick fix” rather than treating the root problem.
Mohan Pammi, MD, PhD (2016) also stated, treatment depended on the diagnostic test results. There are so many types of treatments that can be used for C. Trachomatis induced conjunctivitis and pneumonia, but oral antibiotics are always preferable. The American Academy of Pediatrics (AAP) Committee on Infectious Disease and the Centers for Disease Control and Prevention (CDC) recommend oral erythromycin (50 mg/kg per day given orally in four divided doses) for 14 days for either chlamydial conjunctivitis or