Saturday, July 14, 2007
This presentation is part of : Leading Toward EBN
Evidence based management of head lice in the school setting
Joan Edelstein, MSN, DrPH, RN, Health Services, Oakland Unified School District ACPHD, Oakland, CA, USA
Learning Objective #1: Accurately describe the facts pertaining to management of head lice in the school setting.
Learning Objective #2: Describe the process to create and implement policy that changes management of head lice in the school setting using evidence based practice.

Managing cases of head lice in the schools by nurses should be based on scientifically and medically justified evidence. Head lice are rarely a medical problem, and they do not pose a public health threat yet most schools exclude students identified as having nits or lice, resulting in unnecessary absence and subsequent risk of academic failure, stygmatizing, and bullying. Head lice cause unnecessary absence from school and work, millions of dollars misspent on remedies, and unnecessary treatment of misdiagnosed infestations. Studies demonstrate that screening for head lice in schools does not decrease the incidence of head lice and are not cost effective. Results of studies suggest that education of parents in identifying and managing head lice is more effective and that class wide or school wide screening should be discouraged. The American Academy of Pediatrics, the National Association of School Nurses, the Centers for Disease Control, the California State Department of Health, and the Harvard School of Public Health have all recommended that students with nits and/or head lice infestations need not be excluded from school. Adopting an evidence based approach to head louse infestations will improve attendance, reduce screenings that neither are cost-effective nor an efficient use of staff and student time. This presentation provides facts about head lice; evidence based management of head lice for nurses in the school setting; how nurses can change policy in the schools to address head lice; and implementation, including education, of staff, students, and the community, of new and appropriate policies.