Head Lice Procedures

Granite Falls School District

Pediculosis Procedures

Purpose: To limit infestation, provide appropriate health information for prevention, referral and treatment, prevent over exposure to potentially hazardous chemicals, and minimize school absence that can impact academic performance.

Objectives:

  1. The District Nurse or HHHealth Room Attendant (HRA) will provide education to all constituencies about pediculosis; dispelling myths and stigmas regarding lice infestation.
  2. The District Nurse or HRA as student advocate and nursing expert will provide anticipatory guidance to the school community regarding medical “best practices” of pediculosis management, practices that are based on scientific evidence.
  3. The management of pediculosis should not significantly disrupt the education process.

Referrals

  1. Any concerns, reports or requests regarding head lice will be reported directly to the HRA or the District Nurse.
  2. When parent(s) call to report head lice, the HRA or District Nurse should be notified.
  3. If three or more students in a classroom are found to have live lice, an informational letter will be sent home to the parents in this classroom to notify and educate them about the control and spread of head lice (see Head Lice Letter).

Identification of new cases:

  1. If live lice, defined as live bugs OR nits within one cm of the scalp are found, the parent or guardian will be notified. If possible the student should be picked up immediately for proper treatment at home.
  2. All students identified as having lice, will be given a parental notification letter and will be provided evidenced based information on care options for treatment of head lice, methods to eliminate infestation, and directions to examine household contacts for lice and nits (see Lice Aren’t Nice Brochure, Snohomish Health District). If the parent/guardian is unable to afford treatment, referral must be made to the District Nurse.
  3. When no one can be reached to take the student home, the student will remain in a designated office area until someone is reached or until the end of the day.
  4. The teacher involved will be notified if the student will be going home, and will take preventative measures in the classroom. Staff will maintain the privacy of students identified as having head lice. Due to privacy and confidentiality issues, the person (outside of staff members) making the referral will not necessarily get a report back.
  5. Siblings and close contacts of a student with live lice should be examined. The HRA will notify the other HRA at school within the district to perform check on students of concern.
  6. The decision to screen an entire classroom and/or close contacts of the student will be made by the District Nurse.
  7. The student may return to school when the parent/guardian reports having treated the student and on inspection the student has no live lice found.
  8. Follow up checks will be performed by the HRA and/or the District Nurse.

Process for Re-Entry:

  1. Student needs to check in with the HRA on the day of re-entry so the HRA and/or District Nurse can check for evidence of adequate treatment and live lice. The student will be screened individually and privately.
  2. Proper treatment is evidenced by no live lice, and removal of most of the nits.
  3. Students will be re-checked within one week after re-entry. The parent/guardian will be instructed to continue to check at home and continue to remove nits thoroughly once a day for three weeks.
  4. If live lice or nits within one cm of the scalp are detected, the parent/guardian will be notified by HRA and/or District Nurse to review proper treatment strategies, protocol will be implemented.

Process for assisting students who are chronically or repeatedly infested:

  1. District Nurse must be notified.
  2. Meeting coordinated with Principal, District Nurse, HRA, Parent/Guardian and student if appropriate to review proper treatment strategies and perform education as necessary.
  3. District Nurse to complete a home visit to review proper treatment strategies.
  4. Referrals for support in completing treatments.
  5. Referrals to primary care provider for possible resistant cases.
  6. District Nurse to conduct environmental inspection of affected classrooms to review prevention strategies.

Screening:

  1. Screening will be performed by the HRA and/or the District Nurse.
  2. When head lice is reported by a parent or suspected by school personnel, the HRA will be notified. The student will be screened individually and privately. Pediculosis Procedure will be implemented as needed.
  3. When there is evidence of an outbreak in a classroom (three students identified to have live lice or nits within one cm. of the scalp on the same day), the District Nurse will determine if the entire class should be screened. Classroom screening will be done by the District Nurse and/or the HRA. This screening can be done while children are seated or standing at their desk.
  4. During screening to avoid transmission from one student to another, the examiner must either wash hands between each examination or use objects such as tongue depressors, disposable gloves, or the wooden pediculosis sticks to examine each child. These items will be disposed of after use. During screening, measures should be taken to assure that those students with head lice are not identified to other students.
  5. Students suspected of having head lice will be called down to the health room discretely to be examined individually and privately for a more thorough inspection
  6. Due to lack of evidence of efficacy, school wide screenings will not be done.

The above guidelines are based on OSPI’s Infectious Disease Control Guide, April 2004, p61-65. Please see guidelines for additional information and American Academy of Pediatrics, 2002.


 HEAD LICE

Granite Falls School District

Dear Parent/Guardian:

We are currently finding cases of head lice at your child’s school and classroom. Head lice themselves are not a health hazard or a sign of uncleanliness, and are not responsible for the spread of any disease. They don’t fly, hop, or jump. Lice are spread most often, by head-to-head contact with another person who has lice, but also by wearing another person’s hat or clothing, or by using another person’s comb, brush, or bedding. Please encourage your child not to share these personal items. Lice outbreaks are common among school children. You can prevent outbreaks by checking your children’s hair weekly for lice or nits. Currently, it is important to check daily for the next three weeks or if your child has been scratching his/her head.

INSPECTION PROCESS:

  1. Use a bright direct light.
  2. Separate the hair into small areas and check the strands for nits. Nits (the eggs) are usually located in the hair close to the scalp and may be more visible behind the ears and the back of the neck. Nits appear as flecks of dandruff. What differentiates nits from dandruff, however, is that nits are unable to be flicked away. Nits firmly attach themselves to the hair shaft.
  3. Head lice may be suspected when there is intense itching and scratching of the scalp, particularly at the nape of the neck. Scratching can lead to skin sores and skin infections. It is important to check for head lice even though itching may not be present.

WHAT TO DO: If you find lice, please:

  1. Check all family members, in bright light, to see who needs to be treated. Lice/nits are most effectively removed by using a combination of thorough combing and manually picking out nits at least daily for three weeks and lice treatments. There are both insecticidal and non-toxic treatments available over the counter.
  2. Be sure to use clean and effective nit-removal comb such as Lice Out or Licemeister until all lice and nits have been removed. An immobilizing gel may be used. If nits remain attached, comb through the hair strands again or use fingernails to slide nits off the hair. Pesticides (insecticidal) are recommended only as a last resort, with a one-time use. Use only as directed! Lice sprays for your home are not recommended.
  3. Refer to the Snohomish Health District’s web site for further retreatment information at http://www.snohd.org/snoLiceArentNice/index.htm# or call the Snohomish Health District “Lice Line” for a recorded message at 425.319.5269.

If you have further questions, please contact your Health Room Attendant, District Nurse, or Health Care Provider. The District Nurse, Colette Dahl, can be contacted at: 425.231.0469 or cdahl@gfalls.wednet.edu.