Publication Date

Fall 11-15-2023

Item Type


Executive Summary

Youth Shelter Bed Bugs & Lice Education
Allie Mechtel, Maddy Rettenmier, Elvina Kuzubov, Megan Joseph, Kevin Phan
School of Health Sciences, Seattle Pacific University
NUR 4153: Nursing Leadership in Community Engagement
Leah Ngoche DNP, MPH, ARNP-BC
8 November 2023

Youth Shelter Bed Bugs & Lice Education


Seattle Pacific University Nursing students were assigned a fifth quarter leadership project in the greater Seattle area. Our group was assigned to a youth shelter located in Belltown, Seattle Washington. It is a thirty-bed, animal friendly shelter for young individuals looking for a safe place to stay. They offer long-term housing for those in transition to more stable housing, night-by-night arrangements and day programs as well. Day programs provide clients with lunch and dinner, hygiene supplies, clothing, computers, laundry, areas to nap/rest, activities to engage with the community, and connect with case management as well as health care providers. They partner with a local coffee shop that offers a 4-month paid job experience to clients who experience barriers to receiving employment within the community. The shelter employs several staff on site who look after the clients and support them with their daily needs the best they can. We met the site director and determined that not all of the staff are knowledgeable about pest infestations or up to date on current pest control protocols. Our project further assisted the staff with the prevention and education of bed bugs and lice. The goal for our project was for the staff at the Seattle youth shelter to show an increase in knowledge regarding bed bugs and lice and how to best support the clients that walk through their doors by November 1st, 2023.


As a group, we worked with the Director of Day Programming at the youth shelter. After meeting with the director and discussing the needs of the community, education regarding bed bugs and lice took precedence. The director mentioned in our meeting that individuals who contract bed bugs or lice are asked to leave the facility for three days. This is an issue as many of the individuals who must leave go right back to their unsafe environment and do not have the means to treat the issue and end up back at the youth shelter, likely having to leave again for the very same reason. Pest infestations typically occur in individuals living in unsheltered areas, which reiterates the importance of providing education to the youth shelter to be able to treat the infestation otherwise the issue will continue to persist (Seattle Public Health, 2019). During one of our meetings with the site director, she informed us she had to contact pest control when they were concerned about a possible infestation. After the area was searched and treated, they had only found a single bed bug. This pest control visit was extremely costly for the shelter. Another concern with the elimination of pests is the use of chemicals that can be bad for clients and the environment. If there is not a full bed bug or lice infestation, it is more cost-efficient and safer for the staff to assist with the prevention and treatment on their own (Seattle Public Health, 2019). With that being said, we collectively came up with the plan to put together an educational poster for the clients and handbook for the staff that provided education on bed bugs and lice. The handbook targeted specific health needs of our assigned population that were addressed in our nursing diagnosis. The nursing diagnosis for the Seattle youth shelter was a knowledge deficit regarding bed bugs and lice in a communal living setting among support staff.

Activities and Rational

In order to create the educational poster and handbook for the clients and staff at the youth homeless shelter, we first had to determine the baseline knowledge the staff had regarding bed bugs and lice. Our assessment was done through an electronic survey sent to staff as well as having an in-person meeting with the site director. During the meeting we discussed areas to focus on in our education. The surveys were not sent out to the clients as many of them stay at the shelter night-to-night or occasionally attend the day program. The educational flyers developed for the clients focused on prevention, signs and symptoms of bed bugs and lice as well as the importance of letting a staff member know of possible infestation. The educational handbook highlights general information regarding bed bugs and lice, prevention, signs and symptoms, and treatment. Ensuring our educational material best fit the needs of the clients and staff, we sent drafts of each to the site director as well as our clinical instructor for approval. Upon approval, we held an in-person meeting to present our final material to the site director and provided education in areas of growth based on the outcomes of the pre-survey.


The use of a survey allowed our group time to customize our project to fit the needs of our site and assist us with the evaluation of our goal. Our initial survey was given to the staff during week three and consisted of six questions that centered around lice and bed bugs. Out of twenty-five staff members, eleven responded to our survey. Significant results included 55% of staff did not know how to prevent bed bugs and lice. Staff had only a moderate amount of general knowledge regarding bed bugs and lice. The survey also showed 65% of staff did not know how to treat bed bugs, 55% did not know what bed bugs look like and 72% did not know the signs and symptoms of bed bugs. After implementing our educational handbook and posters, we had the staff take a feedback survey during week seven. The survey was completed by thirteen out of twenty-five staff members and significant results showed a 100% improvement in staff knowledge of bed bugs and lice. These results showed a remarkable increase in the staff’s knowledge and indicated that our project goal was met. Our group utilized critical thinking during each step of the project to ensure all education included in the handbook and posters would be specific to our site’s needs. To assist with meeting the standards of the site and director, we kept close communication to facilitate those needs. A few barriers we encountered during our project included limited on-site time and the inability to interact with the clients. We could not be on-site without an appointment with the site director. Due to the nature of her job, she did not have time to meet with us more than twice during our time working with the shelter. Our survey allowed us to properly evaluate our project, but we would have preferred an in-person evaluation of the staff’s educational knowledge. Although our on-site time and interactions were limited, our group managed to use the survey and close communication with the site director via email to ensure our project was successful.


The goal for our project was for the staff at the Seattle youth shelter to show an increase in knowledge regarding bed bugs and lice and how to best support the clients that walk through their doors by November 1st, 2023. Our project offered solutions and provided education to the clients and staff at the youth homeless shelter regarding bed bugs and lice. Bed bugs and lice infestation are a substantial problem for shelters because of how easily they can spread. Therefore, education regarding instructions on the correct steps to take is important for both clients and staff. It was greatly important that we found a solution to these issues in order for the clients to be able to stay at the shelter without having to be asked to leave due to a pest infestation. Recommendations for the staff on how to keep education up to date included an annual review of policies and procedures and an annual education refresher for the staff. Repetition is an important part of education, so implementing these recommendations will ensure continuity of educational knowledge on bed bugs and lice. We were encouraged by the staff’s receptiveness to our project and hope the education will continue to benefit the shelter.


Seattle Public Health & King County’s Environmental Health Services Division, Communicable Disease Epidemiology and Immunizations, Health Care for the Homeless Network, King County Department of Community and Health Services, Seattle Human Services Department. (2019, December). ember). Sanitation-hygiene-guidance-for-homeless-service-providers Food Safety. Sanitation & Hygiene Guide for Homeless Service Providers.

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