Estrategias para promover la salud física y el control de infecciones del personal

(En inglés)

Strategies to Promote Staff Physical Health and Infection Control

Steve Shuman Now we can begin. Let me introduce today's other speaker, my friend and colleague, Bobbie Rose.

Bobbie Rose: Thank you, Steve. I'm Bobbie Rose. I'm a registered nurse and a health and safety subject matter expert with the National Center on Health, Behavioral Health and Safety. I'm absolutely delighted to be with you today, and also to present with Steve today. Let's get started. Next slide, please. Again, thank you for joining us today, because the health of Head Start staff has never been more important.

Here are our learning outcomes for today. We hope that by the end of today's session, you'll be able to identify elements of the policies, systems, and environments that contribute to staff health, recognize the importance of regular health assessments and adult immunizations, implement appropriate infection control strategies, understand strategies that prevent staff injuries, and develop awareness of the health promotion topics and resources available to you. Next slide, please.

Social determinants of health have a major impact on people's well-being and quality of life. They can also contribute to wide health disparities and inequities. Health begins where people live, learn, work, and play. That includes Head Start Programs. Creating a workplace that prioritizes systems, policies, and environments that support staff health will pay off in all kinds of ways. In staff being, in fewer missed days due to illness or injuries, and in better staff retention.

Furthermore, staff wellness is vital to child well-being and a critical component in the ability to address the diverse and individualized needs of Head Start children and families. Head Start staff spend many hours each week working in Head Start programs. Take a minute to reflect on your programs, policies, systems, and environment. Can you think of something – maybe just one thing – that your program does to make sure that staff members are safe and healthy?

Go ahead and put your ideas into the chat as you have them. It's so exciting to sort of see everyone pop up in the chat. You can see where everyone is today, all over the country, all over tribes and territories. I see some things coming in: sick policies, yearly physicals, yoga classes, wellness programs, morning health checks for all of us, wellness for staff, annual health, and safety wellness programs, COVID screening. So many things.

It sounds like you all are actually very engaged in this already. Thank you. They're still coming in, and that's great to see, OK. Next slide, please. Here are some key elements of a healthy workplace from the aspect of policy systems and environments. Staff has regular health assessments and receive recommended adult immunizations. Staff consistently implement infection control practices, measures to prevent staff injuries are in place, the facility has safety equipment, furnishings, and supplies.

There are opportunities for a physical activity and access to healthy food and healthy drinks. Staff have regular opportunities to learn about mental health, wellness, physical health, and safety. Staff has resources to address stress management. Now, we'll go through each of these elements and give you some strategies on how to implement them in your program. At this point, I'll turn it over to Steve.

Steve: Thanks Bobbie. Head Start Program Performance Standards, 1302.93 reminds all of us of the importance that regular health assessments for staff and precautions to prevent the spread of communicable disease, states, tribes, territories, and other jurisdictions may have additional requirements regarding staff health that programs must follow. Next slide.

Caring For Our Children or some of us call it CFOC also has recommendations and resources to ensure staff are and stay healthy, including items like this sample form. This and all the resources we mentioned today can be found in the handout that Valda has placed in the chat. Next slide.

Caring For Our Children Standard 1701 recommends a comprehensive medical exam initially, including the results and appropriate follow up of a TB screening that just happens once at entering into the early care and education field then any subsequent TB screenings as determined by a health care provider, by history of high risk for TB. Next slide.

Also, a review and certification of up-to-date immunizations per the current CDC recommendations for adults, including an annual flu vaccine. This is the time of the year you want to make sure you have your flu shots and up-to-date tetanus, diphtheria, and pertussis. Next slide.

Since March 2021, the Office of Head Start has prioritized staff getting vaccinated against COVID-19. The U. S. Department of Health and Human Services, the Administration for Children and Families, and the Office of Head Start are currently engaged in activities related to operationalizing the president's action plan for Head Start staff to become fully immunized. In the meantime, you and your staff may find some helpful information on ECLKC and the CDC website. Next slide.

Special health care needs include any physical, developmental, mental, sensory, behavioral, cognitive, or emotional impairment, or limiting condition that requires medical management, health care intervention, and/or use of specialized services of programs. The condition may be congenital, developmental, or acquired through disease, trauma, or environmental cause and may impose limitations in performing daily self-maintenance activities or substantial limitations in a major life activity.

Health care for individuals with special needs requires specialized knowledge as well as increased awareness and attention, adaptation, and here's where you all come in, accommodative measures beyond what are considered routine. Under the Americans with Disabilities Act, known as the ADA, employers are expected to make reasonable accommodations for persons with disabilities.

Under ADA, accommodations are based on an individual case by case definition. Undue hardship is also defined on a case-by-case basis. Accommodation requires knowledge of conditions that must be accommodated to ensure competent function of staff and the well-being of children in care. Now, we'll hear more from Bobbie. Next slide, Livia.

Bobbie: Thank you Steve. According to Head Start Program Performance Standard, 1302.47, programs are to implement and enforce procedures to reduce the risk of infectious diseases and also provide professional development for staff on how to reduce the risks of infectious diseases. There are many tried and true ways to prevent spreading illnesses that I'm sure all of you are familiar with.

Thanks to the COVID-19 pandemic, we've learned some new strategies. We'll be going over some of the key infection control practices. Those include hand hygiene, cleaning, and disinfecting, wearing face masks and covering your cough and sneeze, staff health policies and exclusion for illness, healthy routines, standard precautions, managing disease outbreaks and reporting illnesses, and ventilation for healthy air.

Resources for – if you want to take a deeper dive into these topics – will be provided in a handout and also on some slides at the end of the presentation. Again, we're just going over these things sort of briefly and quickly. But there's a lot more information available to you if you feel you need more information later. Next slide, please.

Handwashing. Handwashing never goes out of style. It's simple and effective. Programs can support effective handwashing technique by providing training, by placing posters at sinks, by making sure that there's adequate handwashing supplies – things like liquid soap, paper towels, sinks in child care areas. Be sure to establish and implement policies on when to wash hands and make it part of the daily routine for both children and staff.

Also, provide training on the safe use of hand sanitizer. We're seeing a lot more hand sanitizer being used since the beginning of the pandemic. We want to make sure that it's used safely and stored safely and used properly and honestly just used in situations where running water is not available. Running water and soap is going to be your first choice every time. Next slide, please.

Cleaning means to physically remove dirt and grime from a surface by washing, scrubbing, and wiping with soap or detergent and water. Always focus on cleaning first. It's the important first step in the process of disinfecting as well. You will need to always clean surfaces before applying any disinfectant. Next slide, please.

Some surfaces will need the added step of killing germs. Disinfecting means to apply a product to a clean surface that will kill almost all of the germs. Disinfectants are called antimicrobial pesticides. That means that they kill antimicrobials. The EPA is the government agency that regulates pesticides. Make sure you use only EPA-registered disinfectants and use them according to the label instructions. The label is the law.

Products on EPA's list N are either known to kill the virus that causes COVID-19 or are expected to kill the virus because they kill other viruses that are similar to SARS-CoV-2. Whenever possible, choose products with ingredients that are safer for human health and for the environment. Limit the use of disinfectants to surfaces soiled with body fluids and high-touch surfaces. Keep all disinfectants out of children's reach.

Unfortunately, we've seen a lot of overuse and misuse of disinfecting products during the COVID-19 pandemic. It's really time to take a look at our safe and effective use of disinfecting products. Next slide, please. Face masks are one of the most effective strategies to reduce the risk of illness like COVID-19 from spreading through the air. Facilitate the use of face masks for children and for staff during the COVID-19 pandemic.

Masks are especially important indoors until young children can be vaccinated. Ensure that everyone aged two years and older wears a properly fitted mask indoors. It's possible that this new health habit could also be utilized during future cold and flu seasons. It's a new tool for us. Another way to keep germs out of the air is by safely covering your coughs and sneezes, either by coughing into your sleeve, or into a tissue and then washing your hands after disposing of the tissue. Next slide, please.

Keeping people who might spread communicable disease out of the program is another strategy to reduce infectious diseases. Generally, staff should take a sick day if the illness limits their ability to provide an acceptable level of teaching and learning for the children, or the illness compromises the health and safety of children and others, including a risk of spreading a harmful disease. Follow the advice of your local health jurisdiction for when a child or staff member should stay home or go home if they develop symptoms of COVID-19 during the day.

Make sure that your policies for when to stay home if sick are clear and well communicated to staff and families. Keep a substitute staff roster for when staff members cannot work due to illness. Provide adequate sick leave for staff. Next slide, please. Healthy routines. Diapering and toileting of young children can potentially spread infectious diseases through the fecal-oral route. Some diseases like CMV can spread through urine.

Carefully plan your programs' diapering and toileting areas and procedures to reduce the risk of spreading illnesses. Things like providing barriers to prevent contact with body fluids. That includes moisture-resistant disposable diaper table paper, disposable gloves, eye protection. About gloves … Gloves are not required for the feeding of human milk, cleaning up spills of human milk, or for diapering. Disposable gloves are optional unless your hands may have contact with blood or bloody body fluids.

Provide diapering tables that are at a comfortable height for staff and have all the necessary supplies within an arm's reach so that staff can always keep one hand on the child. Never leave a child alone on a diapering surface or in a toileting area. Then, provide adequate ventilation. Ideally, bathrooms and diapering areas will have a fan that vents to the outdoors or an open window. Air fresheners are discouraged because they add chemicals to the air rather than providing fresh air. Next slide, please.

Standard precautions. We use standard precautions because germs can spread from person to person through blood and body fluids. Standard precautions are primarily designed to prevent the spread of blood-borne diseases such as hepatitis and HIV. But they also protect against the spread of other kinds of infectious diseases. Use standard precautions when handling blood or body fluids.

That includes avoiding direct contact with potentially contaminated materials without protection-- and by protection we mean, wearing gloves. Clean and disinfect soiled surfaces. Protect against getting contaminants into your eyes, nose, or mouth. Dispose blood-contaminated material, for example, tissues and bandages in a secured plastic bag, and of course, always wash your hands after handling body fluids and removing gloves. Next slide, please.

The same steps that you take to keep children and families healthy keep staff healthy too. You might be familiar with this cute poster with seven steps to stay healthy during the COVID-19 pandemic. It's available on the ECLKC website with the messages “Wash your hands,” “Wear a mask,” “Stay physically distanced but socially connected,” “Increase fresh air,” “Clean and disinfect,” “Check for symptoms daily and stay home if sick,” and “Get vaccinated.” Again, there are lots of great posters available for you to put up in your program. Next slide, please.

Some infectious diseases need to be reported to local public health authorities. Each state or territory sets local laws and rules for which diseases must be reported. Local health jurisdictions, in turn, report to the federal health authorities. The Head Start Program Performance Standards include making appropriate notifications of any reportable illnesses. Your licensing agency may also have regulations or rules for reporting illnesses.

Contact your local health jurisdiction if a child, staff member, or family member has a reportable disease, or your program has an outbreak of an infectious disease. Report to your licensor as required by local laws and regulations. Next slide, please.

Now, let's take a minute to consider staff members who may be pregnant. Some diseases could affect their unborn baby, like CMV and fits disease or possibly a vaccine-preventable disease like rubella or varicella. To keep pregnant staff safe, limit their exposure to infectious diseases by implementing proper infectious disease control measures like we just talked about. Take measures to prevent trips, falls, and back injuries. Encourage regular prenatal health care for pregnant staff and encourage vaccination as advised.

Encourage pregnant staff to discuss their employment-related activities and their exposures at work with their health care provider. Be flexible with breaks and medical appointments for pregnant staff. Share the CMV posters available on the National CMV and CDC websites. I'm going to put the links to these posters in the chat now and turn it over to Steve, who's going to talk a little bit about safety equipment, furnishings, and supplies.

Steve: Thanks, Bobbie. It strikes me that so many of the strategies that we have been talking about to keep children safe are really the same strategies that we want to make sure that all of the staff are kept safe and healthy too. Thanks for sharing all that.

Bobbie: Thanks, yeah.

Steve: Thanks for the link to the posters. Facilities and equipment must be made and kept safe through regular maintenance. Here are some strategies to consider related to safe equipment, furnishing and supplies that support staff health. You want to think about providing adult-sized furniture for staff and installing touchless sinks and soap dispensers. Provide appropriate protective equipment in several sizes. You heard Bobbie talk about gloves, and there's been a conversation about smocks during the pandemic.

Face masks, eye protection, and so forth. You want to reduce exposure to all kinds of hazardous chemicals. You heard about the problem using air freshener and overuse of some disinfectants. You want to really choose safer cleaning and disinfecting products and practicing integrated pest management, and Bobbie is going to talk about IPM shortly. I saw that we had a question about disinfectants in the Q&A, and we'll try to get to that.

You want to provide shade so that there isn't overexposure to the sun. That could be trees, umbrellas, sun sails, awnings, anything that really creates an opportunity for sun safety. Consider hiring a ventilation consultant to assess your heating, ventilation … Not yet. Please go back. Thank you. Hiring a ventilation consultant to assess heating, ventilation, and air conditioning to make sure the air in your program is healthy to breathe for everyone.

We know that many of our Head Start staff are also people with asthma and other respiratory conditions. It's a good idea for everyone to have clean, healthy air to breathe. Next slide now, Livia. Thank you.

In 2015, a study of early care and education providers found that 58% – so considerably more than half – reported musculoskeletal symptoms such as pain and injury to bones, muscles, tendons, ligaments, and soft tissues.

That very same study determined that these types of symptoms contributed to worker burnout. You know how crummy you feel when your back is hurting, or you've hurt yourself. It contributes to going, “You know, I'm not sure I want to do this anymore.” We have created a new poster. This is now on ECLKC which is part of what you see on the slide that can help teach and remind staff how to prevent back injuries. Next slide.

This slide illustrates how holding heavy objects close to your chest and higher up can significantly reduce back strain. I'll let you take a look at that for just a moment. We hope to get this on ECLKC soon. You want to talk about it?

Bobbie: Yeah. I really like this poster mostly because I think that the source of a lot of back injuries is just not using proper lifting techniques. The simple strategy of holding objects close to your body really does help. The heavier the object, the more important that is. Just to keep that in, mind all those things you're lifting each day and during your work to make sure that you're holding that close and you're holding your back straight. Yeah. OK.

Steve: Thanks, Bobbie. That's so helpful. Again, this post was not available yet, but it will be soon, and we'll let everyone know when it's there. Next slide, please. It's not always having staff remember how to avoid injuries. Some of our program equipment can make a difference too.

For instance, if you have a toddler room, consider purchasing step up changing tables for your older toddlers. That way, staff don't have to lift a toddler who hasn't been toilet-trained yet but may be able to walk up those stairs with supervision. Bobbie is going to let us know what are some other things programs can do. Next slide.

Bobbie: Thank you. I really do love the new poster and those new images because I think it puts the focus on staff health in a refreshing way. Just the things you can do to your environment to make it a better place to work, a healthier place to work, and to reduce injuries. Yeah. Here are some other tips to keep staff safe from getting hurt or being harmed at work.

Consider reducing exposure to hazardous chemicals by choosing safer cleaning and disinfecting products and using them safely. There are a lot of fumes associated with these products, and as Steve mentioned, a lot of staff members may have asthma or allergies, and that could be a trigger for them.

Also practicing Integrated Pest Management. Integrated Pest Management or IPM is a process that you can use to solve pest problems while minimizing the use of pesticides. The idea behind IPM is to create an environment where pests are not able to get in and are not welcome. They don't have a source of food or water. The result of that is that fewer pesticides and fewer pesticides exposures occur. I could talk probably a couple of hours on IPM. But just quickly in a bullet, that's what it's about. Maybe you can get some more information on that for your program after this.

Other things you can do. Keep the breakroom clean and comfortable for your staff members. As Steve mentioned, consider your outside area, provide shade, utilize areas under trees, umbrellas, sun sails or awnings for sun safety. OK, next slide, please.

We now know that COVID-19 spreads mainly through the air. This realization has prompted a new focus on indoor air quality and ventilation. That's the good news because we can really start making some investments in making sure that the area that everyone is breathing is healthy to breathe.

Some common sources of indoor air pollution include bacteria and viruses, mold, dust mites, pet dander, pollen, cleaning and disinfecting products, air fresheners, cosmetics, personal care products and perfume, pests and pesticides, lead from lead dust or lead paint, or art supplies.

Controlling these sources include measures like having people stay home when they're sick or wear a face mask, cleaning up garbage, cleaning up standing water, mold, and pests, not using air freshener sprays, and choosing low-fume art supplies. You can balance the source control by improving your ventilation. By improving ventilation, you can do things like safely opening windows and doors, operating, and maintaining your heating, ventilation, and air conditioning system to circulate and filter air, using portable air cleaners with a HEPA filter as needed.

Here's an added tip. You can use your COVID funds, your relief funds to make repairs or upgrades to your heating, ventilation, and air conditioning system and purchase portable air cleaners, or even purchase window guards so that you can open your windows safely. Next slide, please.

Now, let's consider a couple of additional ways to support kind of the overall health of staff in their workplace. Next slide, please. OK. Let's start with opportunities for physical activity. Regular physical activity is one of the most important things that people can do to improve their health.

Why not do it at work? People who work in Head Start programs actually have wonderful opportunities for being more physically active. Exercise increases your quality of life. It improves your mood. It reduces your risk of heart disease, stroke, cancer, diabetes, and blood pressure. Moving more and sitting less have tremendous benefits for everyone, regardless of age, sex, race, ethnicity, or current fitness level. Here are some tips and strategies for providing opportunities for physical activity for your staff in your program.

Encourage staff to join children in physical activity such as dancing and playing running games. You might look into resources from "I Am Moving, I Am Learning" to get ideas for integrating more physical activity into your teaching and into your children's learning activities. Place posters of physical activity – things like stretches, exercises, or yoga poses – in child care areas and also in the staff break room.

Plan exercise breaks for staff. That could be maybe you have a walking meeting where everyone is walking while they're talking instead of just sitting. Plan healthy, active, and sustainable events. Encourage active commuting by providing bike racks for your staff who might like to bike to work. Consider an exercise bike for your staff room that they could use while taking their breaks at work. A lot of the staff might work two jobs or have family responsibilities that keep them from exercising in their off hours. Also a great stress reliever to get some exercise during the day. Next slide, please.

OK. Staying hydrated keeps every system in the body working properly. On the other hand, regular consumption of sugary beverages has been linked to obesity, heart disease, type 2 diabetes, and dental decay. Healthy beverages include drinks without added sugars like water, probably mostly water or tea or coffee.

Remind everyone to stay hydrated, provide and maintain hydration stations – indoors and outdoors – serve healthy food and beverages at meetings and events. If you're giving away water bottles, you might want to consider giving away BPA-free reusable water bottles. If you have vending machines on-site, you might replace the sugary drink options with healthier choices. Remember a diet that's rich in fruits and vegetables can prevent or lower the risk of many chronic health conditions. Just think about your meetings and the opportunities that you have to provide food or drinks and make sure that those are going to be healthy for staff. OK. Next slide, please.

Steve: Thanks. Much great information, Bobbie. I don't know if you've got a chance to see, but people have begun to share ideas that they use in their own programs, which is my favorite part of these national webinars. We have over 500 people. I know you all have good ideas. Just make sure that you're sharing it with everyone and use that Everyone button in their dropdown menu and everyone will get to see your suggestions. Thank you for doing that.

Program Performance Standard 1302.93 also obligates programs to provide regular opportunities for staff to learn about a full array of health, mental health wellness, and safety programs, some of which you heard mentioned in the strategies that Bobbie just talked about. We're going to look at some others as we move forward. Next slide.

However, on September 27, 2021, so just a few weeks ago, the Office of Head Start reiterated its commitment to promoting and prioritizing needed supports for staff with an IM describing the importance of and requirements and recommendations for building a culture of wellness across all Head Start Programs. If you haven't read this IM, pleased do and share it with your colleagues.

The past 19 months have brought significant changes and challenges to the Head Start workforce. The COVID-19 pandemic has had a disparate impact on our under-resourced communities. There has also been a heightened attention to racial injustice in our country, which has led to calls for major reforms, long overdue, to address these longstanding societal inequities.

These are particularly important concerns for everyone involved in Head Start. All staff have been impacted by COVID-19, but 60% of Head Start teaching staff are Black, Indigenous, and people of color. Thirty percent have a primary language other than English. These are people who have been identified – these groups of people, rather – have been identified as at higher risk for getting infected with COVID-19, and so we need to take even stronger efforts to protect everyone.

As such, the Office of Head Start is committed to a culture of wellness that includes holistic support for the entire Head Start workforce. Again, if you haven't looked at the IM, it's relatively new. The link is there, the link is on the handout. It's with the other information memorandum on our ECLKC. Please make sure you read it and share it. Next slide.

All of this – the performance standard and the IM – are opportunities for programs to take the necessary steps to help build health literacy and health awareness for staff. You can call on your health services advisory committee to recommend speakers and health experts, maybe even themselves from your community to provide staff development workshops on health promotion. If you have child care health consultants – and hopefully you have mental health consultants – they too can share their knowledge and expertise with staff.

Consider scheduling workshops on in-service days, pre-service days, and during staff meetings. Share information in newsletters, bulletin boards, on social media – however you communicate with staff. When I was a program director, we would put tips in paychecks. In those days, there wasn't direct deposit. We used to put them in the same envelope with their paycheck. Think about whatever creative ways you have with communicating with staff. Now, I've told you how old I am. Next slide, please.

Early care and education staff are amongst the lowest paid workers, especially considering the demands of the job. As I mentioned earlier, studies have shown that these workers disproportionately suffer from chronic conditions and higher risky health behaviors. Here are some examples of health promotion topics to integrate into health education for staff.

It could be increasing physical activity, eating more fruits and vegetables, the benefits of adult vaccines, prevention and control of infectious diseases, safe lifting and ergonomics, getting a good night sleep, the dangers of smoking and secondhand smoke, good oral health practices, and even maintaining positive mental health, team building, and social connections.

Whether these health topics apply inside or outside your program, providing health education on these and other topics can help staff stay healthy and even improve their health status and possibly address some of the health equity concerns among Head Start staff. Next slide. I think this is Bobbie.

Bobbie: Thank you Steve. You know, it really is so important that there's an overall agreement that we take very good care of the people who work in the Head Start Programs. I'm just going to take the opportunity to take a little deeper dive into a few of the topics that Steve just mentioned. These are examples of potential workshops that you could have. The reason that these were chosen is because they're important to the overall health of your staff.

Consider a tobacco cessation for your workplace program. Cigarette smoking kills almost 500,000 Americans each year. According to the American Lung Association, helping smokers quit saves lives. It is hard to quit. You know, cigarettes are very addictive, and if there's a way to bring in all the tools that are available to help people quit, we want to make sure that those resources are available.

Smoking can also save a lot of money. The savings come from lowered health care costs, increased workplace productivity, and prevented premature deaths. The Office of Head Start Smoke-Free Environment Suite is available to you. It has several videos and it's mainly intended for families but also could be used for staff. I just want to point you toward that resource. You can also check with your local public health department for smoking cessation programs in your local area. Next slide, please.

OK. Rest and relaxation. Another very important topic for people. Why is sleep important? A good night sleep can have a big impact on how well you function the next day. We need sleep to heal, to refresh, and restore. Not getting enough sleep is linked to many chronic diseases and conditions – again, like type 2 diabetes, heart disease, and obesity.

Not getting enough sleep can also lead to increased risk of injuries and mistakes at work. People who regularly lack sleep are prone to being irritable and are more likely to become depressed as well. We need sleep to think clearly, to react quickly, and for memory. It sounds like all the things that we need are our Head Start staff to have. In addition, when we rest and relax, the flow of blood increases around our body giving us more energy.

It helps us to have a calmer, clearer mind, which aids positive thinking, concentration, memory, and decision making. Relaxation slows our heart rate, reduces our blood pressure, and relieves tension. The ECLKC website, of course, has lots of great resources and one set of resources is a series of relaxation exercise recordings. They are available in English and Spanish. These are things that you can share with Head Start families and staff to help reduce stress. OK. Next slide, please.

Mental health and team building. The pandemic has created unprecedented staff shortages in communities across the country. Steve has already mentioned that. It's more important than ever to provide a strong workforce for young children and their families. In fact, a strong and healthy staff is essential to delivering high quality comprehensive services to children and families. Over 20% of Head Start staff are former parents and they are an incredible asset. It's important to talk about staff wellness and to destigmatize mental health issues – such as depression, anxiety, burnout, or emotional issues – so that people can seek out the help they need.

Things you can do are to share local resources for therapy, counseling, coping, and crisis intervention. Encourage self-care, encourage healthy relationships, spiritual connection, and community involvement, and conduct team building exercises. Next slide, please.

Providing care and education to young children is an intense and demanding job. Consider how to support staff with the day-to-day stresses of the job. A workplace that is built around mutual respect where staff members feel understood and appreciated creates a pleasant atmosphere where teachers can enjoy their work. Effective stress management for staff may also have the added benefit of better staff retention. Dedicate times for staff to share their experiences in a safe and non-judgmental environment with supervisors or with peers.

Here are just a few more tips for stress management for staff: Show appreciation, provide regularly scheduled breaks, support staff to feel comfortable to request and receive a brief unscheduled wellness break – in addition to their regularly scheduled breaks to cool down or regroup. If for some reason, they're feeling overwhelmed at the moment, programs can use floaters to cover these short breaks. Post stress-reduction techniques. I would turn your attention to some very nice posters with simple techniques on ECLKC website. This is one of them. This is from head to toe. In fact, there are 12 of them. You could post a new one every month and rotate them again next year and always be keeping it fresh. Plan professional development workshops about stress reduction. Again, you might call your mental health consultant for help with these workshops. Do everything you can to foster adult relationships among your staff and provide adequate vacation time. Next slide, please.

The next two slides actually have a long list of resources that you can turn to for a deeper dive into the topics that we just went over. They're also on this beautiful handout that Steve put together that has all of these links in addition to more resources and a link to the slides. Make sure you get that handout. That's a wonderful resource. OK, next slide. Again, this is just the continued list of resources that are available to you after this workshop is over. Next slide.

You can also continue this conversation on MyPeers. I really would encourage all of you to sign up for MyPeers. There are lots of different communities that you can join, depending upon your interest or your focus. For those of you who aren't aware of MyPeers, it's a social network where early childhood professionals can brainstorm, and exchange ideas, and share resources with colleagues from all across the country, tribes, territories. I mean, everyone can be on this, and just great ideas are shared in a very nonjudgmental way.

You can join MyPeers by visiting the ECLKC website, and there are instructions there if you look at the bottom footer, you can go to the page. I hope to see more of you on MyPeers. I'm going to turn it back to Steve to wrap it up.

Steve: Bobbie, there's so much information. There's so much we can do to keep staff healthy. We do have time for a few questions. Some I've answered by typing in. I know a lot of people had questions about the vaccine mandate. Information about that will be released from Head Start later this month. You can expect your questions to be answered then. Right now, just go to ECLKC and CDC to get more information about the vaccine.

A few minutes ago, I put a set of new posters – Bobbie reminded me that I think last night or the day before – new posters that we've created from the national center about vaccines are available on ECLKC, along with our posters that we've created earlier this year. That link is there on your handout, but I also put it into the chat as well.

Bobbie, we do have some other questions that I think you are best prepared to answer. They are about disinfecting. Two people asked about nonbleach alternatives to disinfectants. Are there any solutions that you would recommend that are effective disinfectants?

Bobbie: Yes. I mean, there are definitely alternatives to bleach. To be honest, they are a little more expensive, but depending on the product you choose, there are definitely some that are safer for human health and for the environment. I would suggest going to the … Or one thing you can do is you can go to the EPA website, and you can go to … It's called Design for the Environment. Design for the Environment is the only program that certifies disinfectants that are both EPA-registered and safer for people and the environment.

I'm going to see if I can find that link to put it in the chat. The program is Design for the Environment and they have quite a few that are certified. Also, really any EPA-registered disinfectant will do – if used according to the label instructions – will be a disinfectant that's appropriate to use in an Early Care and Education Program.

Steve: People are asking for that link, Bobbie. If you could do that, while I ... We still have little time here. I see other people are putting in the disinfectants that they use. They want to make sure that they are EPA-registered and approved. I also want to say this about bleach. One of the reasons why bleach is so commonly used is because it's so universally available and inexpensive.

The trick is using the right solution. If you're using a solution that's too strong, you're going to find that your clothes are bleached, your tabletops, your countertops wear away faster and there's more residue in the air. Make sure you're using the right recipe, if you will, for the purpose that you're using it for. Bobbie, there are a number of other questions about disinfectants. One is about vinegar. Then while I have you there, the other is about hydrogen peroxide. Maybe you could talk about that.

Bobbie: Yes. I wish I was a little better at double-tasking but I'm not. It might take me a minute to come up with that design to be ...

Steve: While you're talking, I will get the link and put it in.

Bobbie: OK. Thank you. I appreciate that. The question … Sorry. The question was about vinegar.

Steve: Vinegar and hydrogen peroxide.

Bobbie: OK. Vinegar is not an EPA-certified or registered disinfectant. I know a lot of people use it to clean but it is not a disinfectant. It is not EPA-registered. You cannot reliably use it in a Head Start Program to disinfect surfaces. OK. Also, never mix vinegar with other things like bleach because it can create really strong fumes.

What you do in your own home, you can do …I know a lot of people use it in their own home for various forms of cleaning, but it isn't appropriate for the program level, for disinfecting. Hydrogen peroxide – so straight up hydrogen peroxide – is not like the brown bottle that you get at the pharmacy. That's not a registered EPA disinfectant either. There are many disinfecting products that are EPA-registered that have hydrogen peroxide as an active ingredient.

Those actual products have been tested and have been vetted. If used according to the label instructions, we know that we can count on them to clean the germs on the surfaces. Yeah, that's a little bit of a tricky question.

Steve: Yes, it is. We have a few other questions still about disinfectants. Lysol wipes and UV light purifiers. I'll ask them both, and you can answer them. This will be our last question for tonight. Go ahead.

Bobbie: Yeah. I'm not an expert on UV light, air purifiers, but I do know that at this point, they're not recommended because there are some potential health effects from the UV lights that are not well understood or tested in child care environments. Basically, those are not recommended. The other question was … Help me out, Steve.

Steve: Lysol sprays and Lysol wipes.

Bobbie: Oh, great. You really need to actually take a look at the active ingredient and the label of the product. If you find that EPA registered the number on there. It's very small. You might need to put on your reading glasses to see it. If you use it according to the label instructions, those things, those products are going to be OK to use. Yeah.

Of course you don't want to let children use them though. Be careful. I think some people think that wipes are less of a problem for children to use. But really children should never be using any of these products or have access to them.

Steve: Right and baby wipes aren't disinfectant. They're just some cleaning materials, ingredients.

Bobbie: Exactly, exactly. Yeah. Yeah, so thank you for putting that Design for the Environment up there.

Steve: Mm-hmm. Yeah, no problem. I'm glad we were able to do that, and we put a lot of other things in the chat. Well, this has been great. Olivia, next slide. We're going to wrap things up here for sure. There is an evaluation. It is on your handout. It will also pop up if you don't close the Zoom webinar, the Zoom platform. Please don't close the platform. Kate will do that when we're all finished, and the evaluation will pop up.

Remember, when you submit the evaluation, you're going to get a new URL and that will lead you to your certificate that you can download, save, and print. Next slide. We also have a mailing list if you're interested. Valda has put that link in the chat a number of times. Next slide.

I want to thank everyone for your incredible participation. Valda, Olivia, Kate, and of course, Bobbie, Martin, and Laura, our interpreters. All of our materials are on ECLKC. We've put the website here. You can always go to ECLKC. If you need to reach us for any reason, please write to health@ecetta.info. We also have a toll-free phone number.

With that, it's the top of the hour. We really ended on time. I thank you all very, very much. Bobbie, we'll talk later. Kate, you can take down the Zoom platform and open up the evaluation. Thanks, everyone.

Bobbie: Thank you everyone. Have a good day.

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