School-aged children occasionally have accidents. Once you know an accident has happened, prepare yourself to help the child clean up and change clothes. Follow these steps:

1. Wash your hands.
2. Bring supplies over. You will need: clean clothing, wipes, plastic bags, paper liner or paper towels for the child to lay on, wet cloth or paper towel, and disposable gloves.
3. Then follow these steps from Caring for Our Children (2019).

Step 1: Get Organized

• If needed, discreetly block off the area where the accident occurred, so that you or another staff member can clean it after the child is changed.
• Although the child will do as much of the change as possible by him or herself, provide guidance in the process to limit the spread of contamination to other items or surfaces.
• If the child is standing, it may cause the clothing, shoes and socks to become soiled. Ask the child to remove any clothing that may become soiled in the cleaning process.  Provide paper liner or paper towels for the child to sit on.
• To avoid contaminating the child’s clothes, have the child secure their shirt, sweater, etc. up above their waist during the change.
• Ask the child to remove the soiled underwear and any soiled clothing, asking them to do their best to avoid contaminating surfaces.
• To avoid contaminating the environment and spreading germs to the other children in the room, do not rinse the soiled clothing in the toilet or elsewhere. Place all soiled garments in a plastic-lined, hands-free plastic bag to be cleaned at the child’s home.
• If the child’s shoes are soiled, wash and sanitize them before putting them back on the child. If the child is prone to accidents, it is a good idea to request a few extra pair of socks and shoes from the parent/caregiver to be kept at the facility in case these items become soiled.
• Check for spills under the child. If there are any, use the paper that extends under the child’s feet to fold over the soiled area so a fresh, unsoiled paper surface is now under the child’s buttocks.

Step 2: Avoid Contact with Soiled Items and Put them in an Individual Plastic Bag.

• Ask the child to use disposable wipes or moistened paper towels to clean their legs, genitalia and buttocks as needed. They should remove stool and urine from front to back and use a fresh wipe each time. Put the soiled wipes into a plastic-lined, hands-free covered can.
• If gloves were used, remove them using the proper technique (see Learn Section) and put them into a plastic-lined, hands-free covered can.
• Whether or not gloves were used, use a disposable antibacterial wipe or alcohol-based hand sanitizer to clean the surfaces of your hands if you are helping, and another one to clean the child’s hands, and put the wipes, if used, into the plastic-lined, hands-free covered can. Allow sanitized hands to dry completely before proceeding.

Step 3: Put on a clean pull-up or underwear and clothing, if necessary.

• Assist the child, as needed, in putting on clean underwear and in re-dressing.  Most school-age children will do this relatively independently.

Step 4: Wash your hands and the child’s hands and return the child to a supervised area.

Step 5: Clean and disinfect the changing surface and the area where the accident occured. 

• Dispose of the disposable paper liner or paper towels used on the changing surface in a plastic-lined, hands-free covered can.
• If clothing was soiled, securely tie the plastic bag used to store the clothing and send home.
• Clean the surface used during changing with soapy water.
• Disinfect the changing surface with bleach water, allowing to air dry for 2 minutes.  
• Put away the disinfectant. Some types of disinfectants may require rinsing the changing surface with fresh water afterwards.
• Return to where the accident occurred and clean the surface with soapy water and then disinfect.  Put the disinfectant away when finished. (Another staff member can also do this part while you help the child change).

Step 6: Perform hand hygiene 

• Hand washing is the final and most important step of toilet hygiene. Be sure to wash your hands after you use the toilet or help any child with changing their soiled clothes.