|Publication Type:||Journal Article|
|Year of Publication:||2005|
|Authors:||E. Kahan, Gross, S., Cohen, H. A.|
|Journal:||Patient Education and Counseling|
|Pagination:||93 - 97|
|Keywords:||Absenteeism, Administrative Personnel/psychology, adult, animals, Attitude of Health Personnel, child, Child, Preschool, Communicable Disease, consensus, Fever/prevention & control, Guideline Adherence, humans, Israel/epidemiology, Lice Infestations/prevention & control, Morbidity, Organizational Policy, Pediculus, Questionnaires, scalp dermatoses, vomit|
The aim of the study was to examine criteria for ill children in child-care centers. A questionnaire on practices of exclusion/return of children according to specific signs and symptoms was mailed to the directors of care centers in central Israel. Thirty-six of the 60 questionnaires (60%) were returned by mail and the reminded were completed in personal visits to the CCCs achieving a response rate of 100%. About half (51.7%) used "common sense" and "personal feelings" to exclude children and to allow their return, and 29 (48.3%) used the guidelines of the Ministries of Education and Health or other authorities. The percentage of centers excluding children by signs/symptoms was as follows: high fever (>38 degrees C), 100%; low-grade fever, 76.7%; asthma exacerbation, 80.0%; heavy cough, 75.0%; eye discharge or conjunctivitis, 83.3%; diarrhea and vomiting more than twice per day, 100%; rash, 72.3%; otalgia, 46.7%; and infected skin lesion, 66.7%. Only four centers excluded children with head lice. Most centers required a physician's note on return of a child after high fever (76.7%), eye discharge or conjunctivitis (48.3%), and from 75 to 80%, respectively, for frequent vomiting and bloody or mucinous diarrhea. The results show that exclusion practices among child-care centers (CCCs) vary widely, suggesting the need for the establishment of a uniform exclusion and return policy in Israel, with distribution of clear, up-to-date guidelines on the prevention and control of communicable diseases to all day-care centers. In a simple way, this study identified attitudes concerning the exclusion/return of sick children in CCCs and was useful for the discussion of the related policy with CCCs responsible and national health and educational authorities.
Exclusion of ill children from child-care centers in Israel