Little Pests, Big Problem

Bed Bug Detection and Prevention in Nursing Homes

They creep. They bite. They hide in dark places. And no, that isn’t the tagline from the latest horror film. But for nursing home administrators across the country, these tiny troublemakers are no doubt just as terrifying.

“They” are bed bugs, and you may have heard a thing or two about them in the news recently. Chomping their way across the U.S. in big cities and small towns alike, swarms of Cimex lectularius have left experts baffled as to what triggered the sudden invasion and scrambling to contain it. Scrambling, because bed bugs tend to spread like the proverbial wildfire.

So what exactly is a Bed Bug?
Bed bugs are small, parasitic insects that favor human blood as their main source of sustenance. Members of the family Cimicidae, they are commonly referred to as “bed bugs” because of their preferred dwelling places—in beds, mattresses, sheets, and tucked away in the nooks and crannies of dark bedrooms.

A typical bed bug is about the size of an apple seed and can be seen easily with the naked eye. Its oval-shaped body is flat, wingless and light brown to reddish brown in color. Although essentially harmless—bed bugs are relatively clean and don’t transmit any known diseases—they present a significant challenge for nursing homes and the people who work and live in them.

Why are Nursing Homes at Risk?
Aside from the obvious stigma associated with an infestation of any kind, bed bugs can wreak havoc on nursing homes and other healthcare facilities, plaguing occupants with itchy, annoying bites and symptoms ranging from skin rashes and bacterial infections to psychological trauma and in some cases even asthma or gastrointestinal disorders.

Not only that, but the staying power of bed bugs is nothing short of legendary, and nursing homes are particularly vulnerable because of the high traffic of staff, residents and guests who may transport the bugs in infested clothing, bedding, luggage and even furniture. However, initiating effective identification and control measures can go a long way toward winning the battle against bed bugs, and educating employees about what to look for, what to do, and what not to do is often the best place to begin.

First Things First: Education is Key
It is imperative that nursing home staff receive training about the risks involved with bed bugs, as well as how to identify and control an infestation. In addition to individual research, employees may be encouraged to take courses to increase their knowledge about bed bugs and be better prepared for a possible infestation.

While prevention is difficult, it is not impossible. Begin by keeping linens clean and rooms free of clutter, and if you suspect bed bugs are present do a thorough inspection of all bedding, mattresses and furniture. Performing a mock bed bug inspection may also be a beneficial exercise; make a list of potential hiding places, and if you find a suspected bed bug, collect a sample for identification.

To reduce the risk of exposure many facilities will also inspect new patients upon admission to assess, including an examination of luggage and personal belongings. At the very least, speaking with residents and families about the potential threat of a bed bug infestation is necessary for increasing awareness and promoting a risk-free environment.

Recognizing the Warning Signs
Signs your facility may have bed bugs include blood and fecal stains on sheets, pillowcases, and blankets, as well as the tiny brown exoskeletons left behind when bed bugs shed their skin. Another obvious indication is the appearance of bites on residents or staff. These will be slightly swollen, reddish areas of varying size, often arranged in a line or cluster and typically found on the face, neck, arms and hands (parts of the body usually exposed while sleeping).

Implementing Control Measures
If and when a bed bug infestation has been discovered, control measures must be implemented immediately. Control requires ongoing action, since bed bugs are rarely, if ever, eradicated. Integrated pest management (IPM) is the recommended approach to controlling bed bug infestations in healthcare facilities. IPM is a comprehensive and multi-faceted approach to pest control that uses a variety of prevention and treatment measures, including:

• Routine inspections/removing clutter
• Cleaning linens frequently and thoroughly
• Applying heat treatments (20-30 minutes at high heat kills all stages)
• Vacuuming (powerful vacuums pull bed bugs out of hiding places)
• Discarding heavily infested items (including mattresses/furniture)
• Non-chemical pesticide application
• Chemical treatment (if necessary) 

When chemical treatment is necessary, as is the case often with severe bed bug infestations, it is important to work with a licensed, insured and reputable company to ensure effective eradication as well as the safety and well being of nursing home occupants and workers.

Documentation is Crucial
Finally, nursing homes and other healthcare facilities should keep a detailed record of bed bug infestations and treatment methods. This will help administrators and staff distinguish between new outbreaks and previous ones. It will also help identify which control measures are effective and may reveal patterns that can aid in overall control efforts.

The bottom line? By approaching the bed bug problem with education, awareness, and a well-planned course of action, facilities can do their part to keep bed bugs at bay and continue to provide optimal care for their patients.