A guide for keeping your residents-and your busines-safe from ants, rodents, and other harmful invaders
BY ZIA SIDDIQI, PHD, BCE, AND FRANK MEEK, BCE Nursing home administrators agree that providing a healthy environment for residents is a top priority. Keeping insects, rodents, and other pests out, of course, is part of that mission. Lethal fire ant attacks in long-term care facilities in recent years have made the public and industry insiders all too aware that pests can pose a very real threat to residents. Pests also threaten nursing homes themselves. Negative publicity from an infestation can ruin a facility's reputation, and multimillion-dollar lawsuits can put the business on the line. Last April, for example, a Houston nursing home was hit with a $1.5 million judgment after a resident died as a result of more than 2,000 fire ant stings.
Unfortunately, long-term care facilities are inviting targets for many pests. Heavy traffic in and out of multiple entries, combined with busy food service, laundry and storage areas, make effective pest prevention daunting. Making the task even harder, pesticides must be used sparingly, if at all. Overexposure to certain pesticides can cause adverse health effects, especially among older or immunocompromised residents.
An administrator must know which pests to prevent, and where the facility's vulnerabilities are. Typically, five types of pests cause the most trouble, and certain areas within nursing homes are more susceptible to infestation.
Ants. Pharaoh ants have been known to climb into open wounds, IV bags, or used bandages. Because they nest in walls, pharaoh ants can be difficult to find and control once they become established in a facility. The wrong control procedures can lead to disaster.
Fire ants, particularly the red imported variety, can be an even greater health threat. They have attacked residents and patients in healthcare facilities in more than 10 documented cases, several of them fatal. (For more on fire ants, see Nursing Homes/Long Term Care Management, September 2001)
Flies. Flies are more than a nuisance; they also can spread germs rapidly. Covering distances quickly, they might feed on garbage one minute and a resident's food the next. Flies carry Staphylococcus, E. coli, and Salmonella, and can drop bacteria wherever they land. They reproduce rapidly and are hard to control once they gain entry.
Cockroaches. The mere sight of a cockroach is enough to startle and disgust residents and families. But more alarming to nursing home administrators is that roaches carry germs that can cause pneumonia, diarrhea, and food poisoning. Cockroach droppings can also inflame allergies or asthmatic conditions.
Rodents. Rodents are keenly aware of and attracted to the food served throughout long-term care facilities. In the Middle Ages, rats carried the black plague through their fleas. Today, rodents carry diseases with perhaps less menacing names-Hantavirus and typhus-but with dangerous symptoms. Most recently, scientists found that rats in Hong Kong were transmitting SARS. In addition to threatening residents' health, rodents can also cause property damage by chewing and burrowing in walls or other structures.
Birds. While often not regarded as pests, birds can infect humans with up to 40 viruses and 60 transmutable diseases, including salmonellosis, a form of food poisoning, and encephalitis, or inflammation of the brain. If left unchecked, dried bird droppings can enter a building's ventilation system and be inhaled by residents and employees. Inhalation of these airborne particles can cause histoplasmosis, a potentially fatal respiratory infection.
Pests will infest any location where they can find food and moisture. Many nursing homes, unfortunately, offer both in abundance.
The residential setting within a long-term care facility is the first "hot spot." Depending on the housekeeper's vigilance, a room or apartment might become attractive to pests. If residents leave food out or otherwise fail to keep a clean living space, pests will likely appear.
Many nursing homes have multiple dining areas serviced by one or two full kitchens, a situation which presents the same pest challenges that restaurants face. Because of regular food deliveries, pests can hitch a ride into the kitchen on incoming parcels or can invade the premises through open doors, cracks, and crevices. Care must be taken to limit chemical applications in food-preparation areas when planning a control strategy.
Employees, too, can create an attractive environment for pests. Locker rooms or break areas can be inviting to pest invaders if employees bring their own food to work. Pests will find food that is left in a locker or closet. In addition, employees might bring bags, jackets, extra shoes, or other accessories on which pests can sneak into nursing homes.
Ironically, areas dedicated to cleanliness can pose problems. A janitor's supply closet might stay locked most of the time, preventing regular treatment by a pest management professional. Wet mops or buckets of water provide a moist haven for many insects. In the laundry room, stacks of dirty clothes provide shelter and warmth for pests. And if the room is used heavily, finding time to treat it might be difficult.
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