bugs & infestations
Dialysis facilities offer a great environment for some bugs, including roaches, flies, and gnats. These are typically controlled and managed with regular extermination services and good facility maintenance practices.
Roaches, fleas, and lice are other bugs with which patients are known to present. This can be more difficult to address because it is an environment outside of the facility. However, they are fairly easy and inexpensive to eradicate.
Involuntary discharge is not an appropriate response to patients who present with bugs. Instead, the following steps are recommended:
- The Medical Director should be advised and involved
- Confirm what the insect is. An entomologist confirmation is recommended.
- Review policy regarding items patients are bringing in/out or storing in the clinic. Does the unit allow patients to store personal items in lockers, racks, or closets between treatments? What happens to the coats, blankets, bags of patients when patients are hospitalized, or leave the clinic?
- Does the clinic have a pest control policy or resource?
- Does the clinic have an agreement with the landlord or owners of the building to attend to any places adjacent to, but outside of the clinic area, that entice visiting vermin to set up residence? Any boxes unsealed and long forgotten? Any damp or damaged walls or floors (bicarb/acid storage/use areas)? Any leaky door or window seals? Places where food items are not sealed and waste containers not secured? Storage or cleaning closets that are not clean?
- Assess whether the patient is safe. Is s/he mobile and independent? Is s/he clean, well-cared for, and living in a safe environment? Does s/he live in an area where the bugs in question are prevalent? Has s/he undergone functional, financial, support or housing changes recently?
- BE COMPASSIONATE. Anyone would be mortified to be in this situation. It is possible that they are also suffering physically from itching and loss of sleep. Address the issue with as much delicacy, privacy, and expression of care as possible.