Caregiver must never leave a child alone on a table or countertop, even for an instant. If an emergency arises, caregivers should put the child on the floor or take the child with them.
The teacher will follow these steps:
Step 1: Wash your hands, gather and bring what you need to the diaper changing table/area:
- Fresh diaper, clean clothes (if you need them).
- Wipes for cleaning the child's genitalia and buttocks removed from the container or dispensed so the container will not be touched during diaper changing.
- A plastic bag for any soiled clothes.
- Disposable gloves, if you plan to use them (put gloves on before handling soiled clothing or diapers).
- Diaper cream (labelled individually).
Step 2: Carry the child to the changing table, keeping soiled clothing away from you and any surfaces you cannot easily clean and sanitize after the change:
- Always keep a hand on the child.
- Remove the child's shoes and socks so the child does not contaminate these surfaces with stool or urine during the diaper changing.
- Put soiled clothes in a plastic bag and securely tie the plastic bag to send the soiled clothes home.
Step 3: Clean the child's diaper area.
- If safety pins are used, close each pin immediately once it is removed and keep pins out of the child's reach. Never hold pins in your mouth.
- Lift the child's legs as needed to use disposable wipes to clean the skin on the child's genitalia and buttocks. Remove stool and urine from front to back and use a fresh wipe each time. Put the soiled wipes into the soiled diaper or directly into a plastic-lined, hands-free covered can.
Step 4: Remove the soiled diaper without contaminating any surface not already in contact with stool or urine.
- Fold the soiled surface of the diaper inward.
- Put soiled disposable diapers in a covered, plastic-lined, hands-free covered can. If reusable cloth diapers are used, put the soiled cloth, diaper and its contents (without emptying or rinsing) in a plastic bag or into a plastic-lined, hands-free covered can to give to parents or laundry service.
- If gloves were used, remove them using the proper technique (see: “Gloving” Poster) and put them into a plastic-lined, hands-free covered can.
- Whether or not gloves were used, use a disposable wipe to clean the surfaces of the caregiver's hands and another to clean the child's hands, and put the wipes into the plastic-lined, hands-free covered can.
- Check for spills under the child. Clean if necessary.
Note: Gloves must be worn when blood or bodily fluids containing blood are present.
Step 5: Put on a clean diaper and dress the child.
- Slide a fresh diaper under the child.
- Apply any necessary diaper creams. Note and plan to report any skin problems such as redness, skin cracks, or bleeding.
- Fasten the diaper. If pins are used, place your hand between the child and the diaper when inserting the pin.
Step 6: Wash the child's hands and return the child to a supervised area.
- Use soap and water at a sink to wash the child's hands.
- If a child is too heavy to hold for hand washing or cannot stand at the sink, use commercial disposable diaper wipes or follow this procedure:
- Wipe the child's hands with a damp paper towel moistened with a drop of liquid soap and then with a paper towel wet with clear water.
Step 7: Clean and sanitize the diaper-changing surface.
- Dispose of the disposable paper liner used on the diaper changing surface in a plastic-lined, hands-free covered can.
- Clean any visible soil from the changing surface with detergent and water; rinse with water.
- Wet the entire changing surface with the bleach solution (2 tsp for 1 ltr of water, mixed fresh daily), and leave for 2 minutes.
- Put away the spray bottle of sanitizer. The surface can be left to air dry or can be wiped dry.
Step 8: Wash your hands and record the diaper change in the child's daily log.
- In the daily log, record what was in the diaper and any problems (such as a loose stool, an unusual odour, blood in the stool, or any skin irritation). Report as necessary.
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