1. Updated KISD Procedure Yvonne Clarke, RN August 2013

2. Myths Head Lice are transmitted easily Head lice spread disease People with poor hygiene attract lice Head lice can live on the carpet and furniture Enforcing a “no nit” policy reduces lice transmission School is a common place for lice transmission

3. Why change the former practice? Department of State Health Services rule revision Negative impact on attendance Life cycle of the louse Not based on current evidence based research No disease transmittal Social Stigma Pesticide Exposure

4. 2010-2011 Klein ISD Data # Index Cases# Index Classes/ Close Contact Classes Checked Total # of Students Checked # Positive Cases Index/Close Contact Classes Lost Instructional Time 89115/20241624/1146.05 13 Index cases (14.6%) had repeat infestations 1.4% of total students screened showed signs of infestation 4 students were siblings or cousins of index case 4 students had the same babysitter 1 was a new student who self reported enrolling with lice

5. New KISD Practice When to refer students to the clinic: Tickling feeling on scalp or hair Itchy head/scalp Sores on the head School clinic personnel will no longer perform whole classroom screenings. Violates confidentiality Loss of instructional time

6. For students found to have live adult lice infestation, school clinic personnel will: I. Exclude students at the end of the day and readmit after assessment finds no live adult lice. II. School clinic personnel will check students excluded for live adult lice upon return to school to determine effective treatment, and again one week later (based on life cycle of louse). III. The school nurse retains authority to exclude a child with repeated infestations where there is evidence of inadequate treatment. IV. Students found to have nits within ¼ inch of the scalp but no live adult lice will not be excluded and will be monitored weekly by the school nurse.

7. Moving Forward Regular in depth head checks by parents Provide parent education Minimize school absence.

9. References Centers for Disease Control and Prevention (CDC). Parasites: Lice: Head Lice Information for Schools. ttp://www.cdc.gov/parasites/lice/head/schools.html. Accessed August 15 2013. Frankowski BL, Bocchini JA, Jr, Council on School Health and Committee on Infectious Diseases, American Academy of Pediatrics. Clinical report – head lice. Pediatrics. 2010;126(2):392-403. National Association of School Nurses. Lice Lessons Head Lice 101 An Overview for Parents, Teachers and Communities. [Power Point Slides]. Retrieved from http://www.nasn.org/ToolsResources/HeadLicePediculosisCapitis http://www.nasn.org/ToolsResources/HeadLicePediculosisCapitis Pontius, D. 2011. Hats Off to Success: Changing Head Lice Policy. NASN School Nurse. Nov. DOI: 10.1177/1942602x11421349 Weisberg, L. 2009. The Goal of Evidence-Based Pediculosis Guidelines. NASN School Nurse, July. DOI: 10.1177/1942602x09337516