Pest control
Fighting against hospital infestation In some of the latest facilities, pest control appears to have fallen down the gap between the management company and the trust in question. In light of this, Health Business looks at the importance of regular pest control in all parts of the hospital to keep infectious diseases at bay Health bosses are considering legal action approaching £900 million, including hundreds against the contractors who built the £842 of outstanding maintenance jobs at the million Queen Elizabeth Hospital in Glasgow Queen Elizabeth University Hospital alone. where there have been a number Alongside the pigeon droppingof infection-related deaths. related deaths, an investigation into Hospitals are vulnerable the water supply at the Queen Audit to infestation. The Elizabeth University Hospital in Scotlan modern hospital Glasgow found ‘widespread d has clai functions on a contamination’ in taps and the tota med that 24-hour, 365-day drains, after an infection l b a basis, with several outbreak in two cancer c k mainte log of n thousand staff, wards at the neighbouring a n c e acros Scotlan patients and other Royal Hospital for Children s d’s visitors, supported (RHC) last year. In total, is appro hospitals by a wide range of 23 children contracted £900 maching services. As such it bloodstream infections in illion resembles a small city, the cancer wards between creating a very attractive January and September last year. habitat for a range of pests. In England, there are many Much has been made of hospitals that formerly had deeply the events at Glasgow’s Queen Elizabeth entrenched infestations that have now not Hospital, where a series of issues with had a significant infestation for several years. infections where found at a Scottish hospital. There is, however, no room for treading water. Holyrood’s health committee has since set up The issues around infestation and its control an inquiry and has written to Scottish Health do not stand still. We know that infestations Secretary Jeane Freeman noting concerns of cockroaches, bed bugs and other pests about cleaning, maintenance and testing. in hospitals are still all too common. Freeman herself has commissioned a In some of the latest facilities, pest control review into infections in Glasgow and what appears to have fallen down the gap between can be learned across the NHS as a whole, the management company and insisting that ‘robust measures’ are in place the trust in question. Pest across the country to tackle infections. control, Three deaths at the Queen Elizabeth where this has been University Hospital remain under investigation considered at all, has from prosecutors, with 63-year-old Mito sometimes gone Kaur’s death found to be the result of a out to tender fungal infection related to two previous along with deaths at the hospital after patients contracted a separate fungal infection linked to pigeon droppings. A 10-year-old boy and 73-year-old woman had contracted cryptococcus, a fungus linked to pigeon faeces, with the Healthcare Environment Inspectorate (HEI) first asked to examine the cleanliness of the hospital in January. The Scottish Health Secretary has since ordered a full independent investigation into the design, maintenance and construction of the hospital, after the HEI reported that some areas of Scotland’s biggest hospital could not be cleaned properly because they were awaiting repair work. In fact, Audit Scotland has claimed that the total backlog of maintenance across Scotland’s hospitals is
catering, cleaning, security, and car parking, with no consideration of existing arrangements or of the specific requirements of the site. Old buildings can also bring their own problems. On numerous sites, redundant buildings sit empty prior to demolition, and some hospitals have removed these from the pest control contract in order to save costs, which can lead to several problems. Sometimes, significant questions have subsequently come to light about the design of details in new buildings, with the topical issue of pigeon roosting sites located close to air intakes and clinical facilities serving as a prime example. Where can they have come from? Faced with these and other issues, those with responsibility for the management of pest control within trusts and hospitals need to actively maintain a broad professional competence in this area. Upon finding an infestation this is normally the first question to be asked, but often the last to be answered, if at all. We can normally identify which factors are conducive to infestation, but it is often very difficult to look at a particular current infestation, and work out its origin with any degree of certainty. Of course we know that feral pigeons visit the site at intervals, and may become established if they find regular food (particularly if it is deliberately placed out for them), and sheltered roosting sites. Rats, squirrels, foxes, and feral cats are all likely to respond similarly. At the other end of the scale, we presume that most stored food pests such as beetles, moths, mites etc, normally arrive within food products. However some storage insects are also associated with bird’s nests, which may provide an alternative route into a building. Pests such as pharaohs ants, cockroaches and bed bugs do not normally colonise buildings very rapidly under current UK conditions, and the actual infestation routes are often difficult to identify. An infestation that re-appears some months after a treatment programme is much more likely to be based on survivors of the old infestation, rather than on newly arrived pests. Once a hospital is truly free of cockroaches, ants, or other infestations of this type, years can easily pass before a new infestation appears. E
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