There is a reason the public heads to a hospital when there's a mass emergency. Hospitals are built and staffed to handle just about anything through an all-risk approach to disaster planning.

All-risk approaches work for more than just emergency management systems. They work for pest management as well. An all-risk-ready integrated pest management (IPM) program can protect a health care facility and its patients from all kinds of pests while minimizing the need for chemical treatments.

The IPM approach

Instead of reacting with chemical treatments, IPM takes a proactive approach to facility maintenance and sanitation that can keep infestations from popping up. IPM plans work well in hospitals and health care facilities because they do not rely solely on chemical treatments — chemicals are only used as a last resort, and then only in highly targeted treatments.

The approach is much greener, a feature hospital leaders look for in their pest management programs. In fact, 97 percent of health facilities professionals indicate that sustainability is important in their pest management programs in a survey of Association for the Healthcare Environment members conducted earlier this year by Atlanta-based Orkin LLC and scheduled to be released by Orkin later this year.

But, most importantly, an IPM approach is effective. An IPM program can deter the most common pests — ants, flies, cockroaches and rodents — from getting in and creating problems inside a hospital. These pests are important to keep out because of the diseases and germs they can bring into a facility.

Cockroaches and ants can pick up and transfer harmful bacteria, and cockroaches leave droppings that can cause asthma attacks for some people. Flies spread microorganisms and disease-causing organisms everywhere they land.

Then there are rodents, which tend to be of particular concern in the colder months as they fight to get indoors to regulate their body temperatures. Once inside, they have the potential to cause serious health problems among the sick and healthy alike. According to the Centers for Disease Control and Prevention, rats and mice are known to spread more than 35 diseases worldwide that are related to Salmonella, Hantavirus and even Escherichia coli.

Hot spots

There are several hot spots in hospitals in which these pests will try to establish their presence with authority. But each hot spot has an IPM approach that can keep it under control.

Health facilities professionals should follow these IPM procedures to help prevent pest problems:

Outdoors. While it might not be at the top of a facilities professional's mind during the cold months, winter is the perfect time to review landscaping plans around the building. Fragrant and brightly colored flowers in bloom can entice bees and other flying pests, so planting fewer of them should be considered. Grassy areas and large amounts of mulch should also be avoided because they make for hiding spots that allow pests to nest and multiply before finding a way inside a building. If possible, a two-foot gravel strip should be added between bushes and a facility's walls because this deters rodents that use shrubbery to cover their movements around a building.

Facilities professionals also should regularly inspect parking lots and sidewalks to ensure that they are clean of any trash or standing water that can attract pests to the area. Dumpsters should be cleaned and rotated on a regular basis to keep rodents and insects from making them a home.

Cracks in a building's windows, ceilings, floors and exterior walls should be sealed with weather-resistant sealant and copper mesh should be added around pipes and drains before sealing to prevent rodents from gnawing through the seal. Window screens and weather stripping also can be used as protective barriers to prevent pests like ants from crawling inside.

Entrances. The pest management battle doesn't necessarily begin at the entrance of a hospital, but many pest issues can be ended there with the right defense.

First, automatic doors should be installed at all entrances — and double doors should be installed where possible. Automatic doors keep frequently used doors closed when not in use and give pests fewer opportunities to enter. Door sweeps and weather stripping should be used to minimize any gaps.

Pests also can be blown out the door by making sure air is flowing out through the building entrances. Facilities professionals should work with HVAC experts to make sure they have positive airflow, which can be tested by holding a piece of paper in a doorway to see which way it blows. Air curtains that pests can't fly through also can be created by mounting fans on both sides of a doorway.

Finally, fluorescent bulbs next to entryways should be swapped out with sodium-vapor lights that are less appealing to flying insects. Better yet, facilities professionals may consider placing mercury-vapor lighting in fixtures at least 100 feet from the hospital to help lure pests away.

Food service. Pests love a free meal, and food service and storage areas — along with employee break rooms — are full of them. Health facilities professionals should vacuum, sweep and mop public multiuse areas on a daily basis to eliminate potential food and water sources for cockroaches. Trash cans should be emptied frequently, especially if they contain food waste. Liners should be used and all trash cans should be covered with tight-fitting lids to restrict odors from escaping and attracting flies.

Since certain species of flies see decaying organic matter as an ideal dinner, an organic, enzymatic cleaner should be used to scrub away residue around sink and floor drains in food preparation and storage areas.

Pests only need a small amount of water to survive in a space, so a leaking faucet, dishwasher or ice machine can be enough to provide nourishment. A plumber or appliance professional should be called to repair any leaks. Kitchens should be cleaned thoroughly at the end of each day, and staff should sweep or mop under appliances and counters.

Facilities professionals must make sure that hospital employees are on the same page when it comes to getting rid of food sources. They should be instructed to quickly dispose of food waste left on in-room dining trays. Spills must be cleaned immediately and floor mats and spill trays should be sanitized daily.

Receiving and storage. Loading docks are prime pest targets in health care facilities because they typically are more accessible than other entrances. Sometimes pests come in through the receiving doors, but they also can catch a ride on shipments, so inspect incoming shipments as well.

Facilities professionals must make sure receiving areas are clean, well-lit and uncluttered — clutter gives pests places to hide. They should ensure that exterior doors form a tight seal when closed — mice can squeeze through an opening the size of a dime, while cockroaches only need a one-eighth-inch opening to get inside.

Staff should keep all containers closed with airtight lids and stored at least six inches off the floor and 18 inches away from walls. This decreases the chances of pests accessing their contents. Also, cardboard boxes should be thrown away whenever possible because cockroaches will eat the glue and hide within the ridges of the corrugation.

A team effort

For an IPM program to work, everyone needs to be on board. The more hospital staff members buy into the plan, the more effective it will be.

It's imperative that staff members understand the key components of IPM and how implementation can reduce pest activity in a health care facility. Once they understand how this approach protects them, the patients and the environment, they will be more likely to put it into practice.

Hospital staff should be educated not only on the importance of the IPM program, but also the crucial role they play in its success. Even the most sophisticated prevention and control techniques will go to waste if a health care facility's employees aren't supporting the pest management efforts.

Staff should be equipped with the knowledge they need to carry out IPM initiatives, such as detailed documentation, pest-sighting protocols and environmentally friendly treatment methods. Some pest management professionals will provide educational resources to aid in the employee training process.

A health facility's staff should be more than the front line of the pest management program; they should be the most valuable players in the facility's efforts. For this reason, it's critical that staff members be well-versed in the facility's areas of vulnerability, including patient rooms; laundry, vending and dining areas; storage closets; and waste disposal zones.

Keeping pests out of a hospital requires the commitment of everybody in the facility. With an ongoing team effort, existing and potential pest control problems easily can be overcome.

Greg Baumann is vice president of training and technical services for Orkin LLC. He can be reached at

Sidebar - Alternative treatments for pest problems

If an indoor pest problem requires treatment, there are several alternatives to chemical applications.

Nonchemical traps, such as sticky boards, can be used to catch and monitor crawling pests in a health care facility. Fly lights, which are available in styles that will blend with a hospital's dacor, can be installed near entrances to food preparation or other sensitive areas.

In some cases, a pest's own biology can be used against it. Pheromone traps incorporate a synthetically reproduced version of natural pest pheromones, another way to lure and trap pests. Likewise, insect growth regulators employ man-made hormones to stunt insect growth and prevent reproduction and population growth without posing a threat to people.

If health facilities professionals have to use chemical treatments, they can do so without spraying the entire facility. Non-volatile gel baits can be applied directly to cracks and crevices where pests can feed on them and take them back to the colony. Unlike sprays, gel formulations will not become airborne, so they won't be inhaled or contaminate sterile surfaces. Another less-volatile option is the bait puck or containerized baits, which can be used in damp, dark areas.


Sidebar - Resources on the Web

Need more information on integrated pest management? Free resources such as white papers, checklists, recommended practices, guides and a self-assessment survey are available at