During an economic downturn, staff training budgets can be the first on the chopping block. If expensive third-party training programs are out of the question this year, health care environmental services (ES) managers might be looking for alternative ways to invest in the pest management knowledge of their staff. After all, when times get tough, it is the employees’ commitment, productivity and ability that adds value to the health care organization and keeps it competitive.
Unfortunately, pests won’t let diminishing markets stop them from seeking food, water and shelter in health care facilities. Carrying disease-causing pathogens like E. coli and salmonella that can threaten the safety of patients and staff, pests have no place in health care environments. The last thing a facility needs is a potential lawsuit or a failed inspection by The Joint Commission that leads to unwanted media attention.
Implementing an integrated pest management (IPM) program can help reduce pest activity at a health care facility. An environmentally friendly approach to pest management, IPM programs focus on preventing pests through a combination of nonchemical solutions, relying on chemical treatments as a last resort, and only then in their least volatile forms.
The IPM solution
Now more than ever, it’s imperative that staff is educated and engaged in an IPM program. It’s up to ES managers to equip them with the knowledge they need to spot pest problems before they grow into full-fledged infestations by enlisting the help of their pest management professional to instruct employees on the pests that are most common in health facilities and the evidence they leave behind. Such in-house training will strengthen a pest management program and staff while keeping the ES budget in check.
While such a training program can be quite detailed and tailored to the specific facility and area of the country, staff will generally be taught how to identify the following types of pests:
Flies. Though often overlooked, flies are a common problem in many of the nation’s health care environments. While these pests might not be commonly visible to patients and visitors, they can spread disease and threaten food safety in facilities with inpatient food service operations. Because flies can be so tiny, it can be challenging for staff to differentiate between the four main species listed below. However, identifying the species and their habits is integral to successful fly management.
 Fruit flies prefer dark and moist breeding spots, such as mop heads, under tables and cabinets and around kitchen appliances. |
• Fruit flies. These pests are about 1/8-inch long and range in color from tan to brownish yellow to black. The distinguishing characteristic of one species is their bright red eyes. Fruit flies get their name because of their fondness for fruits, where they lay eggs and develop. Although they are generally just a nuisance, they can contaminate food with bacteria and other disease-producing organisms. Females lay their eggs near the surface of fermenting fruits and vegetables or in imperfectly sealed containers.
Fruit flies are small and known to penetrate ordinary screens. They prefer dark and moist breeding spots, such as mop heads, under tables and cabinets and around kitchen appliances. Adult fruit flies are attracted to light. Be on the lookout for these pests in cafeterias, employee break areas and in patient rooms.
• Phorid flies. These are commonly referred to as humpbacked flies because of their arched side profile. One of their most distinguishing characteristics is their habit of running in an erratic manner. Ranging from 1/64- to 1/4-inch long, phorid flies vary in color from black to brown to yellowish. Unlike fruit flies, which feed on decaying fruits and vegetables, phorid flies feed on a variety of moist, decaying organic matter, so they can transport disease-causing organisms to food materials and other surfaces. Monitor for this nuisance pest around drains and anywhere food is stored or spilled.
• Fungus gnats. The distinguishing characteristics of these pests are their long, mosquitolike legs and their smoke-colored wings. Black, brown or yellowish in color, adult gnats typically hover on or near decomposing materials. Infestations are often associated with overwatered potted plants or water leaks. Check for activity around utility pipes and in lobby areas of patient rooms containing plants.
• House flies. These are much bigger and louder than the previously discussed species. Their distinctive traits are their dull gray color and the four stripes on their backs. Carrying more than 100 different diseases on their bodies, house flies spread illness when they land, excreting and regurgitating whenever they come to rest. During the day, house flies tend to perch less than 5 feet from the ground on walls, floors and various objects so they can remain close to food. At night, they tend to rest above their food sources, perching on ceilings, walls, electric wires and around light fixtures. Areas likely to attract house flies include kitchens, cafeterias and dumpsters.
 Rodents have poor eyesight and will often travel against a wall, leaving greasy rub marks as a trail to follow. |
Rodents. Rats and mice are constantly gnawing, so staff should be trained to look for chew marks around utility openings and along baseboards and door frames. ES managers will want to catch rodents before they can contaminate surfaces with their urine and feces. Also, rodents have been known to cause fires after gnawing on electrical wiring. These disease-spreading pests have poor eyesight so they often travel against a wall, leaving greasy rub marks as a trail to follow. Droppings are another sign of rodent infestations. Rat droppings are about the size of a raisin while mouse droppings are the size of a rice grain. Signs of rodents can be found in storage rooms as well as shipping and receiving areas.
Bed bugs. Bed bugs can be the most difficult pests to spot and even tougher to control. While they have not been found to transmit diseases, these tiny, blood-feeding pests can leave itchy, red welts on their victims. Bed bugs can “hitchhike” their way into health care facilities with staff, patients, long-term care residents and visitors by hiding in clothing and belongings.
Measuring about 3/16-inch long, bed bugs resemble apple seeds with their oval shape and reddish-brown color. Since they are nocturnal, bed bugs are most often identified by the evidence they leave behind rather than by sightings of the pest themselves. They generally live within three to six feet of their food sources, so signs of their presence, such as tiny brown blood excretions, are usually first discovered on bed sheets or mattress seams and tags. But in addition to inhabiting an actual bed, the pests also can live near baseboards, in cracks and crevices, on furniture, or in lighting fixtures. When large numbers of bed bugs are present, a sweet odor like soda syrup may be detected.
 Bed bugs resemble apple seeds because of their oval shape and reddish-brown color. |
ES managers should make sure employees are well versed in bed bug management efforts. They should be able to recognize the signs of bed bugs and know the facility’s protocol if an infestation is discovered. Many reputable pest management providers offer staff training as well as proactive services to help protect a facility from bed bugs.
Ants. Ants can quickly become an overwhelming nuisance—their colonies can number in the millions, with individuals traveling hundreds of feet to find food for the colony. Species to look for include the two listed below. With a constant supply of food and water, health care environments are vulnerable.
• Pharaoh ants. These ants can be a big concern to hospitals, where they’ve been known to enter wounds and in-use IV bottles, as well as seek moisture from sleeping infants’ mouths. ES staff should look for these yellow- to red-colored pests indoors around shipments and in patient rooms around IV bags.
• Fire ants. Fire ant attacks in health care facilities have garnered much media attention, illustrating how devastating a fire ant infestation can be and how hard they sometimes can be to prevent. Because of the threat to health, watchful prevention is essential. Facilities are at the highest risk for fire ants during the summer months. Wet conditions can amplify populations, so staff should monitor around entrances and along the facility’s facade after it rains.
Birds. In addition to annoying patients and visitors, birds pose a health hazard and can cause expensive damage to the building and grounds. When monitoring for birds, employees should be on the lookout for droppings and nests. Over time, the corrosive acid in bird droppings can compromise a building’s structural integrity, resulting in expensive damage, while debris from nests can clog drains and gutters. Even more alarming, birds have been known to pick up lit cigarettes, which can set the nest and subsequently the building on fire.
Birds can carry more than 60 diseases, including histoplasmosis, a sometimes fatal acute respiratory disease. In addition, birds’ molted feathers can result in human respiratory problems and bird droppings can cause serious infections. Staff members should monitor for the three most common pest birds—pigeons, sparrows and starlings—around roofs, ledges or outdoor courtyards, where they tend to socialize, feed, sleep and nest.
Cockroaches. Cockroaches’ bodies are coated in bacteria from the decaying organic matter they seek for feeding and breeding, which means that these pests can pose a serious threat to patient and staff safety. They can carry up to 25 different disease-producing bacteria that can cause illnesses such as diarrhea, food poisoning and pneumonia. In addition, research from the American Allergy Institute indicates that cockroach excrement and cast skins contain proteins that can aggravate allergies and asthma. ES staff should monitor for cockroaches in storage areas, around shipping and receiving docks and along the edge of the facility.
Invest now
ES staff should be walked through this article and become well-versed with these pests of concern. Staff should also be taught the pests’ biology and the evidence they leave behind. Investing in these skills now will put a health care facility in a strong position as the economy recovers.
| Sidebar - Getting staff up to speed on IPM |
An environmentally friendly approach to pest management, integrated pest management (IPM) focuses on preventing pests through a combination of nonchemical solutions, relying on chemical treatments as a last resort. One key to successfully implementing IPM is getting environmental services (ES) staff involved through the following measures: Educate staff on IPM. ES staff can’t do the job if they don’t know what IPM is or how it impacts patients and the environment. They should be educated on the importance of IPM and the role staff play in its success. Use training resources. Encourage ES staff members to visit www.HealthcarePestControl.com, an interactive online handbook that provides free training resources on smarter pest control practices. The site offers an interactive self-assessment that visitors can use to score their pest control programs against best practices recommended by Atlanta-based Orkin Inc., the American Society for Healthcare Environmental Services (ASHES) and Practice Greenhealth. All participants in the self-assessment survey can request a free copy of ASHES’ “Recommended Practice: Integrated Pest Management,” co-authored by Orkin experts. The recommended practice is a how-to guide to implement and maintain an effective IPM program in a health care facility. Encourage cooperation. Rigorous sanitation and facility maintenance efforts are the most important components of effective IPM and they require ES staff to play an active role. Good sanitation helps eliminate pests’ basic needs, such as food, water and shelter, while maintenance helps keep pests outside where they belong. Even the smallest improvements to a facility’s sanitation and maintenance efforts can help avert pest infestations. ES managers should work with pest management professionals to train staff on basic sanitation and facility maintenance tips for pest prevention success. |
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Ron Harrison is an entomologist and director of technical services for Orkin Inc., Atlanta. He can be contacted at ronharrison@rollins.com. |