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Recurring Pediculosis

Geriatric   (2,626 Views | 14 Replies)

vintagemother specializes in Med-Surg, Psych, Geri, LTC,.

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Id like to know if any nurses have experience managing a lice outbreak.

The circumstance is this....we have a pt (let's call this person #1) with a severe rash and it was assumed the rash was due to pediculosis of the body. This was assumed because one of the Pts sex partners was found to have so many lice they were crawling on the Pts body, bed, etc.

Both parties were treated as well as their (known) sexual contacts. Live lice were not found on all contacts, only a rash was found on some.

For months, #1 has continued to have skin sores, c/o pruritis, etc. #1 has been tx with tac cream, permethrin, Benadryl, etc. The pt was was referred to a dermatologist, but refused to see #1 due to the type of insurance.

#1 is very snugly / sexually active with both genders. One partner, let's call this person #2, was discovered to have genital lice and tx. A few days later, #2's roommate who is intimate with no one, was found to have pediculosis of the hair, body and genital region. This person will not comply with the ordered tx.

As an aside, a new person was discovered to have lice covering their whole body. Their (known) sexual partners, as well as their partners, were not found to have any lice, but recvd tx.

Another pt who has no sexual / intimate contact with anyone nor does this person share a room with anyone affected, was found to have genital lice, and tx.

I, as well as the other health care providers, are at a loss as to what is going on and how to stop it.

Any ideas? This is a large, LTC.

I was thinking of suggesting PO lice meds. Or perhaps tx the entire population.

Has anyone ever experienced something like this? And beat it?

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Esme12 has 40 years experience as a ASN, BSN, RN and specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

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Is this a geri psych unit?

I am confused about all the sexual activity....active group aren't they?

You can treat the patient but you need to find out where they are getting it. They need their clothing and bedding all treated. Hair brushes and their personal items have to be de-bugged as well. Cloth furniture, rugs, stuffed animals..... need to be treated as well.

Another pt who has no sexual / intimate contact with anyone nor does this person share a room with anyone affected, was found to have genital lice, and tx.
Being the devils advocate...because of my ER brain is there any possibility that you have a staff member infecting the residents?

Outbreaks in the Nursing Home: Responding Responsibly

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vintagemother specializes in Med-Surg, Psych, Geri, LTC,.

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Thanks for replying ESME. It's not Geri psych. The clients are allowed to have sex, we promote safe sex and provide condoms. It is their "home". The ages range from 20-60. Many are there because they've hurt others (criminally) but were found mentally ill and unable to stand for trial. Some are simply so gravely disabled by their mental illness that they can't take care of themselves without supervision.

I think that treating all of their personal items is appropriate, but our protocol only allows for treating themselves and their bedding and their room. (Not inside of their closets, drawers, etc)

I feel like we're playing hit and miss. Tx 1 person here, 1 person there. Oh there it is again, a few months later on another person. Not sure if they keep getting reinfested due to new admissions or if we just never got rid if it in the first place.

Shoot...I guess it could be a staff member. It could be anyone.

Thanks for the article. It was good reading. (-: I wish I could implement everything in it.

I am trying to learn that I can't fix everything. But I feel sorry for the Pts who are affected. )-: and those at risk- which is the entire population. )-:

So many rashes!!!

Edited by vintagemother

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Esme12 has 40 years experience as a ASN, BSN, RN and specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

6 Followers; 4 Articles; 20,908 Posts; 148,957 Profile Views

I think you need to consult infectious disease or a public health nurse. This can't be allowed to spread unchecked. The facility MUST have some policy about the treatment of parasites. Without these precautions you will continue to have a problem.

CDC - Lice - Head Lice

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Esme12 has 40 years experience as a ASN, BSN, RN and specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

6 Followers; 4 Articles; 20,908 Posts; 148,957 Profile Views

I moved the thread to Long term care...you might find helpful answers here.

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vintagemother specializes in Med-Surg, Psych, Geri, LTC,.

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Thanks! I couldn't decide if I should put it here, in prison nursing or LTC!

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vintagemother specializes in Med-Surg, Psych, Geri, LTC,.

2,708 Posts; 44,729 Profile Views

I think you need to consult infectious disease or a public health nurse. This can't be allowed to spread unchecked. The facility MUST have some policy about the treatment of parasites. Without these precautions you will continue to have a problem.

CDC - Lice - Head Lice

We do have a policy. I just don't feel it addresses how to control an epidemic, I Feel it is helpful for isolated cases.

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123 Posts; 4,988 Profile Views

Ahh the joys of mixed sex forensic psychiatric units.

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vintagemother specializes in Med-Surg, Psych, Geri, LTC,.

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Ahh the joys of mixed sex forensic psychiatric units.

Yup!!!!! (-; lol!!!!'

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xoemmylouox has 13 years experience as a ASN, RN.

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What a mess. Unless there is a mass tx of all residents affected and all of their belongings (closets, dressers, etc) I don't think this will end. Ugh.. Now I'm all itchy! Hopefully you don't bring any critters home on you. :sour:

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heron has 40 years experience as a ASN, RN and specializes in Hospice.

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I wonder if practices in the laundry could play a part. Maybe the water's not hot enough to kill nits shed onto linens? Are patients' clothes all washed together? Or something?

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heron has 40 years experience as a ASN, RN and specializes in Hospice.

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OP - did you ever figure out how the bugs were spreading? I'd love to know, purely out of curiosity.

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