Healthy Practices Changing Pull ups and Soiled UnderwearR


(music) Learning to use the toilet is a big step for young children and learning takes practice. Let’s face the facts. There will be times when young children are involved and excited about what they are doing and oops! Accidents happen. Just like changing diapers, it’s important to follow proper safe procedures when changing soiled pull-ups and underwear to reduce the spread of germs that could make children and staff sick. Here’s the big question: When a child is wearing pull-ups or underwear, should you make the change while the child is standing up or lying down? Let’s weigh the pros and cons. A “standing change” may be preferred for children who need reinforcement for being a “big” boy or a “big” girl.
You’re a big boy now, you’re learning to use the potty and you don’t need to wear diapers.
Lying down for a change makes it easier to clean a child’s bottom and it’s a little easier to avoid the spread of germs when a child is lying down versus standing. Also, consider accessibility. Does the changing area have steps so you can assist a child to climb up the steps and lie down or will you need to lift a heavy child from the floor onto a changing table? It’s your choice to change while the child is standing or lying down, based on what works best for you and the child. Let’s get started!
Gather all your supplies and get organized before you bring the child to the changing area. If this will be a standing change, you need a surface on the floor that will be easy to clean and disinfect, such as a vinyl covered mat, a sheet of plastic, or even a piece of seamless vinyl flooring. It’s a good idea to cover the surface of the changing area, floor, or table with a piece of nonabsorbent disposable paper. The paper will help to keep the work area clean. You will also need a clean pull-up or clean underwear, clean clothes if a child’s clothes are soiled, and a plastic bag where you place the soiled clothes, wipes removed from the container or wet paper towels, and disposable gloves if you choose to use them. There should also be a plastic lined trash can with a lid that can be opened without using your hands, such as a can with a foot pedal near the changing area. A hands-free trash can makes it easy to toss the dirty pull up and used supplies when you’re finished. Start by removing the child’s shoes and socks. Remember, germs can be spread to anything touched by soiled underwear. If soiled underwear touches a child’s shoes, the shoes will need to be cleaned and sanitized before the child can wear them again or you run the risk of spreading germs as the child walks around the room. If this is a standing change, ask the child to hold up her shirt, sweater, or other clothing above the waist. Asking for the child’s help gets her involved. Her hands are busy and her upper clothing is held away from soiled clothing. An alternative is to use plastic clothespins to hold the child’s upper clothing out of the way. Just remember the clothespins will need to be washed and sanitized when you’re finished. Remove the child’s pants, tights, or any other clothing from the waist down. If the clothes are wet or soiled, place them in a plastic bag that will be sent home to be washed. If the child is wearing a pull-up, pull the sides apart to remove, instead of sliding it down the child’s legs. Drop the pull-up in the trash can. Soiled underwear will need to be pulled down the child’s legs. Do your best to keep soiled underwear from touching the child’s legs or other surfaces as you remove it. Place soiled underwear in the plastic bag with the child’s wet or soiled clothing. Use wipes or wet paper towels to clean the child’s genital area and bottom. Wipe from from to back one time, then toss the wipe or paper towel in the trash. If more cleaning is needed, pick up a new wipe to continue. The rule for using wipes is one swipe and done. Check to see if any soil or urine fell onto the changing surface or floor during removal of the child’s pull-up or underwear or while you were cleaning the child’s skin. This is when the nonabsorbent paper covering is handy. If you see some soil, simply pick up an end of the paper and fold it over to cover the soil or urine. You now have a clean work area and you don’t have to worry about the child walking or rolling in soil or urine. If you are wearing disposable gloves, now is the time to remove them. Pinch the first glove at the wrist and pull down, touching only the outside of the glove. Ball up the dirty glove in the palm of your gloved hand. Now, slide two fingers under the glove at the wrist. Pull the glove toward your fingers, turning the glove inside out as you’re taking it off. The germs and soil are contained inside the gloves which are ready to drop into the trash can. Use a wipe to clean your hands and give the child a clean wipe to clean his hands. Throw the wipes into the trash can when finished. Time to get dressed!
Assist the child as needed to put on a clean pull-up or underwear, clean clothes, shoes, and socks. (music) Take the child to the sink to wash his or her hands with liquid soap and water for twenty seconds. Try singing “Happy Birthday” twice or one verse of “Twinkle, Twinkle, Little Star” to make sure you are washing for a full 20 seconds. Give the child a paper towel to dry his or her hands and use the towel to turn off the faucet. (Music) This child is clean and ready to return to play in a supervised area. Fold the paper liner and throw it in the trash. If the changing area looks clean, the next step is to disinfect. If you see stool or urine on the floor or changing surface, clean the area first with a mixture of dish detergent and water. It’s handy to have a spray bottle with a mixture of dish detergent and water next to the changing area for this purpose. You’ll also need a bottle of plain water or a wet paper towel to rinse after washing. Now disinfect. Spray the changing surface with the disinfecting solution and allow the required standing time for the solution to do its job. Check the label for the correct amount of standing time. A disinfecting solution made from household bleach and water needs five minutes of standing time. You may want to set a timer to make sure you allow the proper amount of standing time. Be sure to read the labels of commercial disinfectants carefully. Some may require rinsing with plain water after standing time. If other children aren’t waiting to use the changing area, you could leave the disinfecting spray on the changing surface to air dry. Otherwise, allow for standing time and then wipe the surface dry with a clean paper towel. You’re ready for the next change. It’s your turn to wash your hands with liquid soap and warm water, twenty seconds for you too! Dry your hands with a clean paper towel, then use the towel to turn off the faucet. Make note of the change in the daily log, recording the contents in the pull-up or underwear, and any special notes such as loose stool or skin irritation. Put the plastic bag with the child’s soiled clothing in the child’s cubby to go home to be washed. Congratulations!
When the next accident happens, you’re ready to safely change soiled pull-ups or underwear. (music)

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