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Good evening,
There are a few questions I would ask.
Are residents sharing slings for lifting equipment or other equipment that may be in direct contact with their skin?
( Our residents each have their own and there are back ups for when those are being laundered).
Have any skin scrapings identified scabies on any of your residents?( Keeping in mind it may be difficult to get a conclusive result).
Is this in a memory support unit or a particular part of the facility?
Have any family members of residents been diagnosed with scabies?
Have any staff members been diagnosed with scabies?
Whilst I was working at Eastern Health in Victoria, our Infectious Disease Consultants would treat all Residents with Ivermectin instead of using Ivermectin.This way residents are treated systematically. This is dosed individually by weight.
The issue with Lyclear is often staff do not apply enough or apply it correctly. Some residents due to behaviour issues make it impossible to do so. Also, if they do not leave it on the prescribed amount of time before showering, it may not be effective.
If it is Norwegian crusted scabies, Lyclear may also be ineffective.
24 hours after treatment, we would do a terminal clean.
We bagged fomites for 7-10 days.
We laundered all clothes and linen in a hot wash cycled then dried.
This was repeated in 7-10 days.
We did not prophylactically treat staff. Lyclear can have toxic side effects and you can build resistance. You need to generally have prolonged skin to skin contact to be at risk of acquiring scabies.
Soft furnishings were vacuumed and steam cleaned.
We did not generally use insecticide. Though in large clusters it was considered.
Kind regards,
Lisa Campbell
Infection Prevention & Control Manager
Bolton Clarke
Sent from my iPhone
On 3 Mar 2021, at 6:50 pm, Sarah Gaines Hill wrote:
Good Afternoon Aged Care colleagues,
We have a very perplexing situation at one of our sites where we seem to get a regular visit from scabies mites. The occurrence is too far apart for it to be an ongoing infestation.
We have implemented multiple changes as follows:
Treat any undiagnosed rash as potentially infectious until proven otherwise using contact precautions and isolation
Treat suspected or confirmed cases with lyclear including all staff who have had prolonged skin-to-skin contact or with laundry and linen
Simultaneously treat environment remove and launder bed clothes, clothes, towels, vacuum carpet and mattress, steam clean same.
Bag up other fomites for 72 hours post treatment
Educate staff on scabies rash identification
Do any of you treat the environment with insecticides? I have never done this and what I have read is not indicated.
Any other ideas??? I am at a loss for how to eradicate this from this particular home.
Any pearls of wisdom would be greatly appreciated.
Thanks
Sarah
Sarah Gaines Hill
Infection Control Nurse Coordinator
P: +61 3 9828 1705 | M: +61 429 480 183
Level 1, 117 Camberwell Road, Hawthorn East, VIC 3123
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