How safe are our children in nurseries?
We included six common emergencies: choking, poisoning, seizures, drowning, head injuries and simple fractures. We had approached 81 registered nurseries and 42 consented to take part in the study. The most senior teacher from each nursery was approached. They were given six different scenarios and asked to identify the emergency and outline the first aid steps that they would perform to help the child.
The results were not encouraging. Remember that this evaluation was based on the most senior/experienced person in the centre and that 69% of participants had first aid training.
Although the teachers were good in identifying the emergencies, none of them possessed good or average knowledge in managing common emergencies. The majority knew less than 70% of the right steps to take and were often out of sequence. Only four nurseries had first aid algorithms to refer to during an emergency and these teachers tended to fare better in the assessment.
Current policies require registered nurseries to have some minimum safety standards.
These include making available a first aid kit (all but one nursery audited had first aid kits available) and having some training in handling emergencies (69% had first aid training). But our study found that these were insufficient to support our young children.
We would like to thank these nurseries for the courage to allow us to audit them. This offered them opportunities to improve the quality of care at their centre.
The nurseries taking part in the study were given a copy of the algorithms to serve as a reference guide in case of an emergency.
We are certain that teachers working at nurseries would like to have the knowledge and skills to support children when faced with an emergency.
Calling for help, while useful, may take too long to help a child. We recommend that all nurseries:
Display important first aid algorithms to aid action during emergencies (see these links: www.crc.gov.my/publication-crc-ipoh/ or www.crc.gov.my/wp-content/ uploads/2016/11/algorithms2.pdf ).
Have a complete first aid kit that is checked periodically.
Have all teachers trained in first aid. This should include a formal Paediatric Basic Life Support (BLS) course for at least one staff member.
We strongly encourage parents to evaluate the safety profile of nurseries before enrolling their children.
If this study showed the limited safety capacity of registered nurseries, imagine the situation in the numerous unregistered childcare providers and nurseries in our country.
We need to work together as a society to improve the quality and safety of child-care providers and nurseries in our country.
Dr Arvinder Singh HS Research Officer Datuk Dr Amar-Singh HSS Head Clinical Research Centre Perak