Practice Management Alert

Few structures are immune to pests, but these strategies can nip problems in the bud.

Regardless of whether your practice is located in a high-rise, a strip mall, or is the sole occupant of a building, you probably have had to confront an unwelcome pest. Keeping your practice pest-free is important for health and safety — as well as patient peace of mind.

Plus, in today’s increasingly mobile, global society, parasites that used to be relatively rare in the United States are reappearing in epidemic proportions. If your practice sees a patient who is battling fleas or lice or bedbugs — even if that isn’t the reason for the encounter — you may be wondering about your responsibility in treating that patient, protecting other patients from infestation, and maintaining the cleanliness and safety of your office.

If you have a pest problem — or want to make sure you’re utilizing all of the possibilities available to avoid one — these strategies can go a long way in making sure that no unsavory populations move in.

Know Treatment Options Available

While traditional pest-control options, such as spraying, are available, exterminators have developed newer, safer means of controlling pest populations by focusing on prevention and a multipronged strategy. While there are options for controlling an infestation situation, prevention is the safest and easiest route to make sure your practice and its environs remain pest-free.

Experts in pest control recommend an integrated pest management (IPM) strategy, which they say is safer for everyone involved.

“There is no question that IPM is the system of choice particularly in sensitive environments. IPM methodologies used to mitigate pest populations include tactics such as mechanical, physical, and cultural control strategies. These are called ‘nonchemical’ pest-management actions,” says Michael Deutsch M.S., BCE, technical director at Arrow Exterminating Company Inc. in Lynbrook, New York.

“Routine pesticide applications are not IPM. IPM is a six-step program including: inspection, accurate identification of the pest(s), evaluation of the pest issue, recommendations, actions to mitigate the pest, and monitoring and follow-up,” Deutsch says. “IPM results in long-term pest population suppression and environmental conservation.”

However, if you know you have a pest problem — you’ve seen cockroaches, you’ve found mouse droppings, you see a wasp’s nest under the eaves outside the front door — you may need to employ more traditional extermination methods. Don’t wait, because the risk of a sting or bite, or an increased population, mounts as time passes.

“Clearly, there are instances where a pesticide is necessary to quickly remove a nest of, for instance, stinging insects like bees and wasps to reduce the risk of exposure. However, even with this type of threat, IPM dictates that the product chosen to be the least toxic material available that will result in eliminating the risk of exposure,” Deutsch says.

Prioritize Building Maintenance

Doors and windows are obvious entryways for flying insects, but other means of access exist. Kitchens and employee breakrooms are hotspots for pests because of accessibility to food, Arrow Exterminating says.

Watch your plumbing for issues too — many pests, including some types of flies, cockroaches, and rodents, seek water.

“Clogged drains and leaky pipes are targets for these pests as are damp basements, plumbing closets, and laundry rooms,” Arrow Exterminating says. Prioritize mending leaky faucets or pipes, utilize drain covers where appropriate, and make sure that any and all caulk around water fixtures is in good condition. Maintaining the integrity of your structure and infrastructure helps maintain a barrier against these unwanted pests.

If your practice is in a building where someone else makes the decisions about pest prevention and control, check out your lease or other pertinent contracts to illuminate your options.

Mitigate High-Risk Areas

Areas of your practice that have a lot of patient traffic can present a greater risk for the presence and transmission of some pests. Fleas, lice, and bed bugs can accompany a patient to your practice and potentially put others at risk. For more information on bed bugs and the particular challenges they present, see story, “Keep These Bed Bug Protocols Handy,” page 69.

Keep an eye on the surfaces patients touch or utilize, like waiting room or exam room furniture and high-traffic carpets. If you’re designing or renovating your practice’s space, think about how some materials, like fabric, carpet, or wood, can be harder to deep clean than smooth surfaces like tile or plastic.

“Plastic rather than fabric should also be used in all other furniture pieces, such as chairs, sofas, and curtains, with special attention to limit potential hiding places within seams. As an adjunctive measure, vacuuming can markedly reduce the load of insects; however, care should be undertaken to quickly seal and dispose of the vacuuming bag,” say L. Silvia Munoz-Price, M.D., Nasia Safdar, M.D., Ph.D., John C. Beier, Sc.D., and Stephen L. Doggett, in “Bed Bugs in Healthcare Settings,” published in Infection Control and Hospital Epidemiology, Vol. 33, No. 11.

Make sure staff are trained in spotting these parasites, and establish procedures within your practice for reporting them. If your front-desk staff are reporting itchy ankles and see a flea, make sure they know who to tell — and that that person has the authority to call the pest management company that your practice and/or building manager uses. Otherwise, you may find that reports aren’t attended to and a pest situation quickly gets out of hand.