Self-report of child care directors regarding return-to-care

Andrew N. Hashikawa, Martha Wood Stevens, Young J. Juhn, Mark Nimmer, Kristen Copeland, Pippa Simpson, David C. Brousseau

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The American Academy of Pediatrics (AAP) introduced revised return-to-care recommendations for mildly ill children in 2009 that were added to national standards in 2011. Child care directors'practices in a state without clear emphasis on return-to-care guidelines are unknown. We investigated director return-to-care practices just before the release of recently revised AAP guidelines. METHODS: A telephone survey with 5 vignettes of mild illness (cold symptoms, conjunctivitis, vomiting/diarrhea, fever, and ringworm) was administered to randomly sampled directors in metropolitan Milwaukee, Wisconsin. Directors were asked about return-to-care criteria for each illness. Questions for return-to-care criteria were open-ended; multiple responses were allowed. Answers were compared with AAP return-to-care recommendations. RESULTS: A total of 305 directors participated. Based on director responses to vignettes, the percentage of correct responses regarding return-to-child care management compared with AAP return-to-care recommendations was low: fever (0%); conjunctivitis (0%); diarrhea (1.6%); cold symptoms (12%); ringworm (21%); and vomiting (80%). Two illnesses (conjunctivitis and cold symptoms) would require the child to have an urgent medical evaluation or treatment not recommended by the AAP, as follows: Conjunctivitis - antibiotics for 24 hours (62%), physician visit (49%), any antibiotic treatment (6%), and symptom resolution (4%); and Cold Symptoms - physician visit (45.6%), antibiotics (10%), and symptom resolution (25%). CONCLUSIONS: Directors' self-reported return-to-child care practices differed substantially before the release of revised AAP return-to-care recommendations. Active adoption of AAP return-to-child care guidelines would decrease the need for unnecessary urgent medical evaluation and treatment as well as unnecessary exclusion of a child from child care.

Original languageEnglish (US)
Pages (from-to)1046-1052
Number of pages7
JournalPediatrics
Volume130
Issue number6
DOIs
StatePublished - Dec 2012

Fingerprint

Child Care
Self Report
Pediatrics
Conjunctivitis
Tinea
Guidelines
Anti-Bacterial Agents
Vomiting
Diarrhea
Fever
Physicians
Self-report
Telephone
Therapeutics
Cold
Illness
Antibiotics

Keywords

  • Child care
  • Mild illness
  • Readmission

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Hashikawa, A. N., Stevens, M. W., Juhn, Y. J., Nimmer, M., Copeland, K., Simpson, P., & Brousseau, D. C. (2012). Self-report of child care directors regarding return-to-care. Pediatrics, 130(6), 1046-1052. https://doi.org/10.1542/peds.2012-1184

Self-report of child care directors regarding return-to-care. / Hashikawa, Andrew N.; Stevens, Martha Wood; Juhn, Young J.; Nimmer, Mark; Copeland, Kristen; Simpson, Pippa; Brousseau, David C.

In: Pediatrics, Vol. 130, No. 6, 12.2012, p. 1046-1052.

Research output: Contribution to journalArticle

Hashikawa, AN, Stevens, MW, Juhn, YJ, Nimmer, M, Copeland, K, Simpson, P & Brousseau, DC 2012, 'Self-report of child care directors regarding return-to-care', Pediatrics, vol. 130, no. 6, pp. 1046-1052. https://doi.org/10.1542/peds.2012-1184
Hashikawa AN, Stevens MW, Juhn YJ, Nimmer M, Copeland K, Simpson P et al. Self-report of child care directors regarding return-to-care. Pediatrics. 2012 Dec;130(6):1046-1052. https://doi.org/10.1542/peds.2012-1184
Hashikawa, Andrew N. ; Stevens, Martha Wood ; Juhn, Young J. ; Nimmer, Mark ; Copeland, Kristen ; Simpson, Pippa ; Brousseau, David C. / Self-report of child care directors regarding return-to-care. In: Pediatrics. 2012 ; Vol. 130, No. 6. pp. 1046-1052.
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abstract = "BACKGROUND: The American Academy of Pediatrics (AAP) introduced revised return-to-care recommendations for mildly ill children in 2009 that were added to national standards in 2011. Child care directors'practices in a state without clear emphasis on return-to-care guidelines are unknown. We investigated director return-to-care practices just before the release of recently revised AAP guidelines. METHODS: A telephone survey with 5 vignettes of mild illness (cold symptoms, conjunctivitis, vomiting/diarrhea, fever, and ringworm) was administered to randomly sampled directors in metropolitan Milwaukee, Wisconsin. Directors were asked about return-to-care criteria for each illness. Questions for return-to-care criteria were open-ended; multiple responses were allowed. Answers were compared with AAP return-to-care recommendations. RESULTS: A total of 305 directors participated. Based on director responses to vignettes, the percentage of correct responses regarding return-to-child care management compared with AAP return-to-care recommendations was low: fever (0{\%}); conjunctivitis (0{\%}); diarrhea (1.6{\%}); cold symptoms (12{\%}); ringworm (21{\%}); and vomiting (80{\%}). Two illnesses (conjunctivitis and cold symptoms) would require the child to have an urgent medical evaluation or treatment not recommended by the AAP, as follows: Conjunctivitis - antibiotics for 24 hours (62{\%}), physician visit (49{\%}), any antibiotic treatment (6{\%}), and symptom resolution (4{\%}); and Cold Symptoms - physician visit (45.6{\%}), antibiotics (10{\%}), and symptom resolution (25{\%}). CONCLUSIONS: Directors' self-reported return-to-child care practices differed substantially before the release of revised AAP return-to-care recommendations. Active adoption of AAP return-to-child care guidelines would decrease the need for unnecessary urgent medical evaluation and treatment as well as unnecessary exclusion of a child from child care.",
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