Head Lice

[jonnysangel777, LPN, LVN]

What are your school policies on head lice? Students at my school can stay in school as long as there aren't live knits. 

[k1p1ssk, BSN, RN]

Our policy is that students found with live lice are sent home to get treated and may return the next day and should be treated again 1 week later. I do a head check daily for evidence of live lice for 2 weeks after the initial treatment. 

It is incredibly difficult to get someone to be "nit" free, especially if the infestation goes un-noticed for a long time. 

[arlingtonnurse]

Policy is student may stay in school through the end of the day but 'should' be treated before returning.  We do not exclude however nor do we do rechecks.

[Supernrse01, BSN]

Our students are sent home for live lice only. We do not have a no-nit policy and I don't typically do a recheck once they have been treated.  

[Keeperofbandages, LPN]

We have a no-nit policy.  If a student is discovered to have lice during the school day, they must be sent home and treated.  Students returning after having lice are to be brought in by a parent/guardian for evaluation from the nurse before returning to class.  If nits are found, the student is sent back home.  If there is a sibling in the school when the lice is discovered, the sibling is also checked for lice as well.  7-10 days after student returns to class, the student is rechecked by the nurse.

[CommunityRNBSN, BSN, RN]

My school nursing handbook/textbook  says: “There are few things that take as much of a nurse’s time unnecessarily, and cause more anxiety and panic among teachers, than lice.” Made me chuckle to read it because boy is it true!  A child gets lice and the principal is acting like they’ve got Ebola. 
 

We do not have a no-nit policy. The child has to go home and get treated and that’s all. 

[k1p1ssk, BSN, RN]

From the American Academy of Pediatrics, https://publications.aap.org/pediatrics/article/135/5/e1355/33653/Head-Lice

Quote

 

"Criteria for Return to School

A child should not be restricted from school attendance because of lice, because head lice have low contagion within classrooms.79 “No-nit” policies that exclude children until all nits are removed may violate a child’s civil liberties and are best addressed with legal counsel for schools. However, most health care professionals who care for children agree that no-nit policies should be abandoned.85 International guidelines established in 2007 for the effective control of head lice infestations stated that no-nit policies are unjust and should be discontinued, because they are based on misinformation rather than objective science.86 The American Academy of Pediatrics and the National Association of School Nurses87 discourage no-nit policies that exclude children from school. However, nit removal may decrease diagnostic confusion, decrease the possibility of unnecessary retreatment, and help to decrease the small risk of self-reinfestation and social stigmatization.

A school nurse familiar with lice infestations, if present, can perform a valuable service by rechecking a child’s head if requested to do so by a parent. In addition, the school nurse can offer extra help to families of children who are repeatedly or chronically infested. In rare instances, it may be helpful to make home visits or involve public health nurses if there is concern about whether treatment is being conducted effectively. Parent education by school health professionals can reinforce similar goals for the medical home."

 

It sounds like most of us should be reconsidering our protocols/policies if we are hoping to follow best practice 

[jonnysangel777, LPN, LVN]

Thank you all for replying to this post. Very helpful.

[RatherBHiking, BSN, RN]

On 10/14/2022 at 7:55 AM, arlingtonnurse said:

Policy is student may stay in school through the end of the day but 'should' be treated before returning.  We do not exclude however nor do we do rechecks.

Same!

[JenTheSchoolRN, BSN, RN]

If live lice are found, call home, work with parent on plan for treatment. If parent would like to pick up student, they can, but if they can't, student can remain in school.  As the CDC states, lice are a nuisance, but they haven't been show to spread disease. 

NASN also supports that "no-nit" polices should be discontinued. However, I still remember mentioning to my first (non-nurse) boss and she gasped at the idea of it. I won after presenting the research, though, and we currently don't exclude for lice.