CHCCN511A: Establish, manage and monitor the implementation of a safe and healthy environment Coordinate the response to accidents and emergencies Contents Develop, maintain and practise evacuation procedures with all workers and children 4 Reducing the likelihood of fire 4 Developing an evacuation plan 5 Review steps already taken by workers and implement additional actions required Reviewing the actions of the team 8 Seek medical assistance as required 9 When to call an ambulance 9 When to notify parents 9 Coordinating the response to the unwell child 10 Implement a plan to meet the emotional needs of children and others in the situation 11 Supporting the child emotionally 11 Support emotional needs of children and others 12 The role of policy and procedure 12 Allocate tasks to different people and give directions about how to proceed 14 Allocating tasks 14 Coordinating the response 15 Sensitively and calmly provide accurate information to parents 17 Recognising parents’ emotions 17 How to inform parents 18 When parents arrive to pick up their child 19 Use policies and procedures of the organisation to inform people of actions required of them What are policies? 2 8 20 20 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 In light of the incident, review service’s policies and procedures with others and change as required Reviewing policies as a team Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 22 22 3 Develop, maintain and practise evacuation procedures with all workers and children We will look at strategies to control the risk of a fire emergency in the childcare service before we look at the importance of developing a thorough evacuation plan. Reducing the likelihood of fire One of the best ways to prevent an emergency situation is of course to prevent it from occurring. Part of our good planning for an emergency event will involve taking steps to reduce the likelihood of fire occurring in the service. We can make sure the following takes place: • • • • • • Dispose of rubbish in the service quickly and appropriately. Install smoke detectors and regularly test them. Check power cords and electrical equipment regularly. Store flammable chemicals safely and appropriately. Keep the service free of combustible materials, ie wood, paper, etc. Regularly check the heating system for safety—and, if faulty, get it serviced straight away. Being fire-ready It is equally as important to prepare your service for emergency situations. You can do this by following these guidelines: • • • • 4 Have a clear evacuation plan for each room and display it in a prominent position. Ensure that all staff have received training in using fire extinguishers, fire blankets and so on. Ensure all staff are aware of the correct first aid treatment for burns. Ensure that appropriate emergency contact phone numbers are displayed near the phone. Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 • • • Ensure that fire fighting equipment (fire blankets and extinguishers) is checked regularly. Ensure the first aid kit is stocked and accessible to all staff. Have regular discussions and reviews of emergency procedures. Developing an evacuation plan You will probably be familiar with the steps that need to be followed in the event of an emergency evacuation. Any emergency evacuation procedure you develop will be based on the RACE procedure. RACE procedure Do you know what RACE stands for? The RACE procedure, developed by the NSW Fire Brigade Service, involves the following steps: • • • • Remove children and adults from immediate danger. RAise the alarm. Let all staff know about the danger and ring the fire brigade to let them know about the fire. Contain the fire if safe to do so, ie close doors and windows in the service. Without a supply of oxygen the fire will not be able to continue to burn. Evacuate the building to a place of safety. This will be a known assembly point and will be a safe distance from the childcare service. Remember, unless you are confident to fight the fire with a fire blanket or fire extinguisher and have received training to use these fire-fighting devices safely then it is recommended that you concentrate on moving everyone to a point of safety. Once you have reached the assembly point it is important to check that all children have been removed safely and that families and the Department of Community Services (DoCS) are notified of the emergency situation. The team leader will also liaise with the Fire Brigade Service when they arrive to tell them what is known about the fire, ie where is it, if anyone missing and to provide any other information required. These steps will all be happening in the space of a very short time. Each staff member will have responsibilities to fulfil that will see all children and staff in the childcare service moved to a point of safety quickly and smoothly. The emergency response plan should identify who is coordinating the evacuation, who is coordinating first aid, who will check attendance records for the day, who will check individual rooms or areas in the service for children and staff and, finally, who will call the families. Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 5 Evacuating children to safety We mentioned before that the aim of the evacuation plan is to be as smooth and quick as possible. Of course you know when young children are involved that this will require much planning. You will have to ensure that you have practised your fire drills frequently with the children to reduce the likely panic and alarm. You will have developed with the team some fun but organised ways to move the children to safety. It would be helpful to get the children to hold onto a rope, or each other’s waists to make a line, and sing a song that encourages them to be actively involved in the evacuation process. Below is an example of a song that children can sing as they make their way to safety, holding on to each other’s waists. Here we go, here we go, here we go! Little boats one by one, one by one! Across the deep blue sea... We’ll sail to a safe safe place With a whoop and a whoop and a ho! With a whoop whoop ho, off we go! We’ll sail to a safe, safe place Across the deep blue sea! Some services make up songs that will help children move quickly to safety. You might want to make one up yourself. You might also want to read about one service’s Wiggly Worm evacuation technique in the following textbook: Caton S and Roche D (1999) Managing the Risks in Children’s Services: An integrated approach to managing risk for children and staff, Lady Gowrie, Australia. Activity 1 Practising evacuations The Children’s Services Regulation 2004 specifies that fire drills should be carried out at least once every three months. Fire drills can be regular and planned or spontaneous. It is important that any drill is carried out in a realistic way. Sending out a memo that a fire drill will be held on a certain day at a certain time may help staff in the room to be ready for the evacuation drill but will not simulate the stress of an unexpected incident. 6 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 How will staff know what it is like to wake sleeping infants and put them into the fire cot, move hungry toddlers away from the lunch table or get a group of active preschoolers to stop what they are doing and move into their single-file formation unless drills are carried out during play times, during meal times or during sleep routines. A fire will not wait until all children are fed, awake, happy or ready. After the emergency evacuation Evacuation procedures also need to be reviewed regularly. Children, staff and environments change over time. Because of these changes we need to ensure our evacuation procedures change too and that they are regularly practised and reviewed with staff and children. We need to talk about the drill with all staff and check: • • • • • • • • Did staff know what to do? Do staff know how to train new staff on evacuation procedures? Did everyone leave the building quickly and smoothly? Was assistance required in the evacuation of younger children? Were any of the children frightened? How did the staff manage this fear? Do staff know what the legal requirements are for evacuations? Do staff have any ideas for the improvement of the evacuation process? Activity 2 Activity 3 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 7 Review steps already taken by workers and implement additional actions required It is important to thoroughly review the evacuation response to assist with future planning. It is important to complete this review after any emergency situation, ie after a child has been injured or become ill. Reviewing the actions of the team We may not always be in the service at the time of an emergency situation to lead the emergency response. However, we will always have the important role of ensuring that everything that could have been done was done. We need to know answers to the following: • • • • • Were our service procedures followed? Did staff have the knowledge and skills to act swiftly and appropriately? Were staff able to communicate clearly with others in relation to the incident? Were all necessary actions taken? Is any follow up required? For example, does any equipment need repair? Do we need to speak with parents about future action plans? Activity 4 8 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 Seek medical assistance as required In most cases, staff in the childcare service will be able to provide appropriate first aid when accident or injury occurs. However, there will be instances when we need to be able to determine if other professional medical treatment should be sought. Depending on the situation, we may contact the child’s parents first before we take action. In other situations, we will call for an ambulance or make arrangements to get a child to hospital first and then contact the parents. When to call an ambulance We would always call an ambulance when: • • • • • • the child has an anaphylactic reaction. Note: After injecting a child with an EpiPen, you will still need to call the ambulance. Keep the injector to show the hospital. the child has difficulty breathing the child looks particularly unwell and you are worried the child loses consciousness the child has a seizure the child breaks a limb or suffers a burn or any injury that leads to symptoms of shock. When to notify parents Parents would be notified to come and take their child to a medical practitioner when a child: • • • • has a fever of 38º Celsius has increasing asthma is not drinking water or other fluids and has diarrhoea or vomiting has a rash as well as a fever. When a child is mildly unwell, parents should be notified and asked to pick up their child as soon as is possible. Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 9 Coordinating the response to the unwell child There is much to consider when medical assistance is required. What information will the medical staff need? The child’s personal file must be taken to the hospital. Information to be included in this file would include the child’s date of birth, full name, known allergies, contact telephone numbers, language spoken at home, etc. The staff member accompanying the child will need to ensure that this is given to the appropriate medical staff and that any questions they have are answered thoroughly. How do we get the child the medical assistance they need? • • • Will you call an ambulance? How far is it to the nearest hospital? Who will travel with the child to the hospital? How do we ensure the smooth running of the service? • • When a member of staff accompanies the child to hospital, how do we ensure there won’t be disruptions to the service? Who will be best placed to comfort and support the child until the parents arrive? These decisions will be your responsibility as team leader of the service. If you have worked carefully through the development of service polices and procedures before an emergency situation, your response will be that much easier. Clear steps and actions will have already been identified and all you have to do is follow them. You will also need to ensure that your staff are familiar with service procedures and that hey are able to follow them easily. Your immediate concern will be of course ensuring the health and wellbeing of the injured or unwell child, supporting the needs of the child’s parents and supporting the emotional needs of the other children in the service. Activity 5 Activity 6 10 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 Implement a plan to meet the emotional needs of children and others in the situation Just as each individual adult will react differently to an emergency situation, so too will the responses of the children in our services vary tremendously. Some children may be afraid, some may cry, some may go into shock, some may not be overly interested as they are occupied elsewhere. The child’s response to the emergency situation may not be immediate either— something else we need to be aware of. A psychological response to a stressful emergency situation can be delayed by days, weeks, months or even longer. We will need to monitor children carefully after a stressful event to check for signs they may not be coping and plan carefully to support their emotional response. We must also support our staff emotionally, allowing time as a team for thorough debriefing after an emergency situation and accessing counselling services for staff who need this. Supporting the child emotionally Our responsibilities as team leader will involve ensuring the following: • • all staff within the service are aware of the possible impact such an event might have on each of the children each child’s unique emotional needs are supported. How might we know a child could be experiencing an emotional upset or is feeling particularly stressed about an event? Initially children will show alarm. They may stop what they are doing and become fixed on the person or event associated with their stress. They then will adopt a coping strategy they are familiar with; children may cry, seek closeness to a familiar adult, suck their thumb or use some other object for comfort. Children can become distressed if we don’t provide them with the emotional support required at these times. If this distress is not recognised and managed, Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 11 other more long-term problems can emerge, eg sleep disturbances, nightmares and distrust and feelings of fearfulness, anxiety and insecurity. Support emotional needs of children and others As coordinator, we will need to ensure the following actions take place: • • • • • make sure all staff have the skills and knowledge to comfort children and encourage their questions and talk about what they saw, felt or experienced follow up with debriefing meetings with families. Staff need to discuss what happened and why and plan to prevent a similar occurrence from happening again if this is at all possible. access counselling services for staff, families and children who may need extra support after a stressful event facilitate separate debriefing sessions with the children involved if and when appropriate follow up with phone calls to the families of children directly involved in accidents or emergencies to check on their emotional and physical wellbeing. The role of policy and procedure Our emergency policies and procedures must have strategies included in them to guide staff’s response to the needs of all children during an emergency situation. Staff who are not needed to carry out first aid actions or communicate with families or medical professionals could be allocated the role of taking the other children away to a quiet place in the service where they can explain what is happening and answer the children’s questions, in language the children can understand. Staff will also need to provide physical reassurance in the form of hugs and handholding to comfort young children. Families will need to be informed of the incident and of the service’s response to the children’s questions. This will help them to follow up children’s concerns at home and to be alert to signs that their child may be experiencing a delayed emotional reaction to the stressful incident. We will need to follow up with families when we know how the injured or ill child is progressing too. This will help in the emotional healing of staff, children and families. 12 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 We will also need to fill in Accident or Incident forms. You might already have seen such a form. If you have not, there are sample forms on the Internet. The information required includes: • • • • • • • • • injured person’s name and other personal details (date of birth, address, etc) names of witnesses name of person reporting it nature of injury, including severity date, time and place of when injury occurred probable causes treatment (eg first aid) action taken for person’s welfare action taken to prevent recurrence. Activity 7 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 13 Allocate tasks to different people and give directions about how to proceed We have mentioned previously that an effective emergency response will involve multiple tasks being carried out simultaneously. Effective planning before an emergency event will mean that staff consider the many aspects of a situation and develop a procedure and policy that meets not only the health and safety needs of the children and the legislative requirements impacting on the service but also supports the emotional needs of staff, children and families. Allocating tasks In any emergency response, each staff member will have a role to play in managing a given situation. As team leader you will be responsible for the allocation of roles. Sometimes this will be dictated by licensing requirements, ie the authorised supervisor has certain responsibilities with an obligation to carry out. Other times you will allocate these roles based on the experience, skills and qualifications of the staff member. On other occasions, roles may be given to a particular staff member because they have volunteered to be responsible for an action. Each individual needs to understand the importance of their role in the response. A successful outcome, after all, depends on everyone fulfilling their responsibilities. Think back to our emergency evacuation plan. Imagine what would happen if the staff member whose responsibility it was to check rooms and areas in the service forgot to do so. Imagine if the staff member whose role was to pick up the evacuation bag which contained among other things the mobile and emergency contact numbers, forgot to bring it out to the assembly area? Consider the likely impact on the safety and wellbeing of children, staff and families created by these gaps in the response plan. 14 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 Coordinating the response Despite your team’s attention to anticipating likely emergency events and planning for these, it is more than likely that your service will face an emergency you had not planned for. An example of this is where a service needed to develop a snake policy after there was an incident where a child picked up a snake that had wandered into the service’s playground. In this type of situation you would need to coordinate the emergency response and direct staff to complete actions without a procedure in place to guide you. Your actions and decisions would be driven by the goal of keeping children and staff safe and healthy. Remember that in a stressful emergency situation, particularly one which your staff have not encountered previously, people can ‘freeze’, and your role will be to prompt staff calmly to complete actions to ensure the safety of all. Activity 8 Guidelines for handling ‘snake’ situations • • • • • • • • • Remain calm. Advise your co-worker to remove the other children to a place of safety. Reassure the children—any sudden change in routine could be stressful for young children. Focus your attention on the child. Call her name and say, ‘Throw what you have in your hands as far as you can. Then come straight to me.’ Once the child does as you had asked her to (hopefully she does), take her to safety. Check her for obvious injury. While you were doing this, ask another staff member to notify the child’s parents. It would probably be wise for the child to be checked out medically. Record the incident. The location of the snake would need to be ascertained. Hopefully it would have slithered its way back into the reserve. If the snake is still in your playground, ask a staff member to contact a professional organisation trained to assist in such situations. At the same time, another staff member needs to keep a watchful eye on the snake— from a safe distance. It is really important that, as caregivers, we educate ourselves about snakes, spiders and other animals and plants that could be poisonous or cause allergies. If our centre backs onto a reserve (or is close to one), it is absolutely critical that we are well-informed. Correct identification will also help medical authorities. Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 15 You and your co-workers would need to discuss how best to talk to the children about what had happened. Some safety rules for picking up wildlife in the environment obviously need to be looked at with the children. Given your location near the reserve, developing a procedure for managing the threat posed by snakes would be a useful tool for the future. This would obviously be done at a team meeting after the emergency. So, another emergency event managed smoothly and calmly. You can see how essential it is to have a calm leader who can think on the spot and provide clear directions even when they are feeling uncertain themselves. While it might seem difficult now, these skills will develop over time as you gain experience in leading staff and emergency situations. 16 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 Sensitively and calmly provide accurate information to parents Have you ever had to contact a family member to let them know their child had been injured? Did you find it difficult? Bad news is never easy to share. Even the parent who is normally rational and easy to get along with can challenge us when their child has been injured. Recognising that this response is driven by emotion is useful. Rather than becoming irritated or defensive, we can support parents’ emotional needs. Recognising parents’ emotions Parents are likely to be experiencing anger. Parents can often question the supervision skills and abilities of the staff and might want to know what you were doing when the accident happened. They may imply that you were not looking after the children properly. Over time, some parents may also feel one or more of the following emotions: • • • • • Guilt—remember, parents may be in two minds about being a working parent. They may blame themselves and feel that this would not have happened if they were at home looking after the child. Jealousy—parents can feel jealous that other adults and carers have provided their child with comfort and support—they wish they themselves could have provided this. Annoyance—parents can feel torn between their work obligations and their parental responsibilities. For many parents, it is not easy to take time off from work to pick up their child and seek medical attention. Many employers are not as supportive as they could be. For a busy, tired parent who is juggling family and work commitments, the dreaded call from the childcare service can be the last straw! Fear—parents can be afraid that their child has been seriously injured and the symptoms aren’t immediately obvious. Relief—parents can feel relief that at least the accident has occurred in the service where calm, confident staff know exactly how to comfort and care for their child. Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 17 How to inform parents However experienced you are, responding to any of the emotions we have identified will not be easy. Can you prepare for such situations? You cannot really fully prepare. However, it is worth our while to practise possible responses. In thinking up possible responses, remember how we ourselves would like to be informed of an incident. What information would you expect to be told? It is important to remember the following: • • • • • When their child has been injured, families will want to know. It’s important to provide clear, concise, calm information about what has happened. Provide parents with an honest and realistic description of the child’s physical injury or symptoms. Even if their child is not alright, be honest. Make sure the child is receiving appropriate care. Most of all families want to feel reassured that the situation is being responded to by calm, professional, caring and competent staff. Below are some guidelines on dealing with parents who get angry. How to deal with anger and blame We have said that it is not uncommon for parents to feel angry when their child is injured at the centre. How do you deal with his anger? Below are some guidelines. • • • 18 Inform the parents right away. If it is a serious injury where the child had to be rushed to hospital, you will, of course, need to ring the parents. If it is not serious, wait until they come to collect the child. If you delay talking to the parents, they are likely to get angry when they find out later, when they notice the bruise or if the child tells them. If you tell them right away, the parents will feel that you care. It helps build trust and their anger would not have time to fester. If the parents get very angry when you tell them, you might request that you talk with them later, when hopefully they would not be quite as angry. State the facts clearly and concisely. Remain calm. Do not add your interpretation to the facts and avoid blaming anyone. Instead of apportioning blame, state what happened and what measures you have put in place to prevent such incidents recurring. Treat the parents’ concerns seriously. Do not be patronising. Acknowledge their feelings, including anger. Also, make sure you meet in a private place—where other staff and children cannot see you. Listen to the angry parent without interrupting them. If you interrupt and start being defensive, the parent might get angrier. Let the parent vent all their Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 • • • • feelings—just listen and show that you are listening. What do you do if the parent does make threatening or violent statements? In this case, you would need to interrupt in a very calm manner, excusing yourself from the situation. It is important for a carer to identify whether the centre director needs to intervene. It is also very important for you and your director to be able to know when you may need legal advice. If there are details a parents needs to recall such as the names of staff, hospital, times etc then recommend that the parent write them down, & then have the parent re-read them back to you. Finish off by clarifying if there is anything else the parent would like you to do. Remind the parent to pick up the ‘incident form’. Activity 9 When parents arrive to pick up their child When parents come to pick up their child, we will need to answer other questions and provide them with a copy of the incident report to take to the doctor or hospital. We must make time to talk over the incident with the family and will follow up in the days after the event to check on their child’s recovery. The same approach will be used for handling emergency situations—though in these instances we may find ourselves discussing events with all parents. Our response will always be factual, calm, supportive and informative. Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 19 Use policies and procedures of the organisation to inform people of actions required of them What are policies? Basically when we refer to policies we are referring to a written document which outlines principles or guidelines specific to our service. Policies are helpful to us in many ways: they can protect us against personal litigation, they provide guidelines so all staff are consistent in the handling of a variety of aspects of running a service and they can be used to refer families to when they are making enquiries at enrolment. A policy is basically writing down what we already do! Why do we need policies? In children’s services it is a requirement of DoCS for licensing for a service to have policies. These are outlined in the Children’s Services Regulation 2004. When a centre is going through the accreditation process, policy documents are also required as evidence to support the practises of the service. Policies should not be developed only for these reasons. Policies and procedures make life so much easier in centres by guiding the decision-making process and promoting consistency of staff actions. This is especially important when managing emergency situations. A hastily made decision can breach best practise, regulations or other legislative requirements faced by the childcare service and endanger the safety of children and staff. Using polices to guide staff Policies are what we rely on to help us monitor the care of others—both the care that we give to the children in our care and the care our colleagues are giving to children at the service. 20 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 All staff must be made aware of their service’s policies and procedures so they can provide care of a high quality to children. Our role as team leader will be to promote and explain policies to all staff in our endeavours to ensure our staff are familiar with their roles and responsibilities in an emergency situation. There are a number of ways we can familiarise staff with the actions they need to perform. We can: • • • • • • organise a brief individual induction for new staff members where critical policies are explained ensure each staff member receives a copy of our service polices and procedures on commencement of service. Also make sure they sign, say, a cover page to indicate that they have read these policies and procedures. ensure that we regularly discuss policies at our team meetings ensure that all policies be audited/reviewed each year to ensure that the roles and responsibilities in relation to procedures are current and relevant, and are signed off by the employer use incidents and events that occur in the service to discuss and review policies and procedures. We can use this opportunity to check our team’s understanding of, and ability to, perform their roles and how staff have responded to an accident or emergency situation. as new laws/regulations come into effect, take time to reflect on the wording and inclusions of your policies Activity 10 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 21 In light of the incident, review service’s policies and procedures with others and change as required We have spoken previously about the importance of using emergency incidents that have occurred in the service to review our response to a situation of illness, accident or emergency. This is best done with all members of the work team. Reviewing polices, procedures and practices need not be time consuming. It is essential that the policy document is a living document and that the practices used in the service actually follow the guidelines we have put into our paper policies and procedures. Our policies and procedures must be updated in line with new health and safety information that may become available to us and then signed and dated by the employee. Reviewing policies as a team All staff have an important role in identifying where and why policies and procedures are inadequate and in suggesting changes that enable all staff to provide a flexible, responsive and safe service. You will initiate this review process at a suitable time after an event or incident. You must allow sufficient time to carefully analyse the response, looking closely at: • • • • • what happened why it happened what actions were taken and who carried them out whether those actions were appropriate, timely and effective how those actions fitted with the set policies and procedures of our service. When is it time to change procedures? Change is essential if you find that procedures: • • 22 are not working are too complicated for staff to understand Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 • • take too long to implement are based on outdated information. All staff must be involved in the review and development of a workable model to manage emergency situations. Procedures for managing accidents and emergencies and responding to sick children are critical. Having commitment and understanding from all staff will ensure a consistent and safe response to any emergency situation. Activity 11 Diploma of Children’s Services: CHCCN511A: Reader LO 9295 © NSW DET 2010 23