Monthly Archives: August 2013

August 30, 2013

fridays

The Group Psychology of Infection Prevention

Have you ever thought about what drives human behavior? Have you ever wondered how extreme groups like the Nazi’s or Al-Qaeda were formed? Or how people make decisions in general? Or why we act one way in one situation and the complete opposite in another?

Are you stumped? That’s okay, when it comes to human behavior there are rarely any simple answers. My Social Psychology professor used to ask us yes or no questions all the time, and it got to be a running joke because the real answer was always, “It depends.”

I’ve heard a lot of ideas about what could be holding us back in infection prevention, and some of the discussions have reminded me of that Social Psychology class. Infection prevention is a group effort, and group dynamics can have a huge impact on behavior and, by extension, the quality of infection prevention. It doesn’t matter if there are infection prevention products and ideas of every size, shape, and cost. In the end, it is humans that using that technology and humans that are implementing those new ideas. And even though that copper table doesn’t care what the UV Flash thinks, the nurse using them both is susceptible to the effects of group dynamics.

Here are 5 Psychological Principles that could be hindering infection prevention in your healthcare facility:

 1. Group Think

Do you remember, in school, when the teacher would randomly assign people to groups and have them create a presentation, paper, or work on some sort of project? It can be stressful.  Everyone wants that group to get along and work well together because you all have a common goal and you’ll be more successful as a unit. “United we stand, divided we fall”, right? So oftentimes, you agree on one of the first ideas that is brought up. Any doubts or misgivings you have you keep to yourself because you don’t want to “rock the boat” or cause problems.

When it comes to infection prevention, workers, obviously, have a common goal: no infections. So if someone has an opinion contrary to what the group thinks, there is a chance they won’t want to risk causing problems and will keep quiet for the sake of group cohesiveness.

 2. Group Polarization

Let’s say you stand outside Comerica Park in downtown Detroit before a Tigers baseball game, pick out 10 people wearing a shirt with Miguel Cabrera’s name on the back, put them in a room together, and tell them to talk baseball. We already know these 10 people like the Tigers. We already know these 10 people like Cabrera (for all the readers not into baseball, he is one of Detroit’s top players).

What the Group Polarization theory claims is when these people are put in a group and told to talk about something that they already agree on, they’re opinion will become polarized. In other words, they’ll feed off each other and come out of that room with a stronger and more extreme opinion than they started with. One person might say, “I think Cabrera is the best player on the team.” And other is going to say, “Yeah he’s the best player on the team. Heck, he’s the best player in the American League!”  And a third will respond, “He’s the best player in the history of baseball!” And everyone will nod their heads and agree that, yes, Miguel Cabrera is the best baseball player in the history of baseball.

The same goes for infection prevention. If you get a group of hand washing advocates in the same room, they might say hand washing prevents the spread of MRSA. No, actually, hand washing is the BEST way to prevent the spread of MRSA. No, hand washing is the ONLY way to really prevent the spread of MRSA. In cohesive groups, members often get so fired up about one agreed-upon idea that they forget to consider alternatives.

 3. Group Conformity

In 1951, Solomon Asch conducted an experiment.  He would tell each participant they were taking a vision test with a group of about 5 other participants. However, the other participants in the group were actually confederates, or actors following the directions of the experimenter. The participants and confederates were then told to look at the line on the left and choose whether line A, B, or C on the right matched it most closely in length. Every time, the actual participant had to answer last, after hearing the confederates’ answers.

Now, I don’t want to influence your opinion, but line C is the correct choice, right? Well, what Asch would do is have every single confederate answer wrong, let’s say with Line A. And, even though Line A was clearly the wrong choice, the real participant almost always answered Line A, conforming with the group opinion.

Whether we admit it or not, we are all somewhat susceptible to the opinion of those around us. And if I’m a nurse in the Intensive Care Unit and every single other nurse appears to agrees that antimicrobial copper is a waste of time, I might bite my tongue to fit in with the group.

 4. Social Loafing

Okay, everyone, admit it. We’ve all slacked off in a group before because we assume someone else will take step up and take responsibility. It’s common, but it’s dangerous, especially when it comes to infection prevention. What if I’m working in a Sterile Processing Department and I don’t scrub an instrument thoroughly enough because I assume it’s someone else’s job to make sure that instrument comes out clean? How do I know that’s not what everyone else is thinking? Then who is actually taking responsibility? Is anyone?

5. Obedience

During WWII, the Nazis killed millions of people and carried out unimaginable acts of cruelty. On trial after the war, the most common defense was, “I was just following orders.” Obedience. Stanley Milgram tested this idea of obedience in one of the most famous psychological studies ever. I won’t into the details (read more about the experiment here), but he found that your average citizen was willing to administer dangerously high levels of electric voltage to another “participant” (actually a confederate following Milgram’s directions) just because a figure of authority told them to. Obedience.

If my supervisor tells me not to worry about cleaning that Operating Room, wouldn’t I assume that they know best since they’re in authority over me? If my boss tells me that new technology doesn’t actually work, wouldn’t I believe they know what they’re talking about? Blind obedience can be a huge obstacle to effective infection prevention.

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Infection prevention still has to be a group effort, there’s no way to avoid it. But we do need to be aware of some of the possible negative effects that come from working in groups and how that could negatively impact infection prevention. But, as we always say, knowledge is power. And the more aware you are of these group dynamics, the less susceptible you are to them.

Sources: allpsych.com, spring.org.uk, simplypsychology.org, psychology.about.com

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Filed under Daily Blog Posts, Gimme Five Friday

August 29, 2013

Thursday

Infection Prevention- “And” is Better

Have you seen the new Ford commercials?

It’s a pretty ridiculous ad, but do you see their point? Why would we choose between two options when having both is better? In the case of Ford, a foot activated lift gate AND great gas mileage is better than one or the other. And what about these other duos?

Macaroni AND cheese, Bert AND Ernie, Twist AND Shout…

Better together, right?

It reminds me of the sentiment that I’ve seen reiterated over and over in LinkedIn discussions, news articles, and success stories: infection prevention needs an all-hands-on-deck and it doesn’t have just one solution. When it comes to infection prevention, “and” is better.

In a patient’s room:

  • Hand hygiene: cuts down on the spread of germs and bacteria, but it’s impossible to ensure 100% compliance
  • Antimicrobial copper: kills 99.9% of surface bacteria within 2 hours, but it’s not financially possible for most hospitals to copperize every single surface in a hospital
  • Hand hygiene AND Antimicrobial copper: eliminating more germs and bacteria through hand hygiene and copper high touch surfaces

In an instrument washer:

  • Ultrasonic bath: breaks up bioburden on instrument surface
  • Ozonated water: world’s most effective bacteria-killer
  • Ultrasonic bath AND Ozonated water: elimination of bioburden and bacteria leading to instruments that consistently pass AAMI standards

In disinfection:

  • UVC full room disinfection machine: disinfects rooms, but only the surfaces facing the machine
  • UV Flash: 360° disinfection of hard to clean objects at a high risk for cross-contamination such as stethoscopes, laptops, and more
  • UVC full room disinfection machine AND UV Flash: ability to disinfect rooms as well as the entire surface area of commonly used objects; both of which cuts down on cross-contamination

Creating standards:

  • Standardized processes: ensures everyone is following the best proven procedures while cleaning instruments in sterile processing departments, preparing a room for a new patients, etc.
  • Standardized results: ensures that each healthcare facility is aiming for an objective and measurable level of clean
  • Standardized processes AND results: no more articles with tips on which hospitals to choose and which to avoid because everyone is following the same procedures and achieving the same high level of clean

Yup, “and” is definitely better.

What are some other infection prevention combinations you can think of?

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Filed under Anti microbial copper alloys, Daily Blog Posts, Thursday Thought of the Day, Ultraviolet light to fight bacteria

August 28, 2013

Wednesday

How do you know your hospital is clean? The MediCount ATP Testing Device provides an objective way to determine the cleanliness of a counter, surgical instrument, desk, and more.

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Filed under Daily Blog Posts, Healthcare Acquired Infections, Watch it on Wednesday

August 27, 2013

trivia

Did you know?

Most of you know Charles Darwin for his work on the theory of evolution. But did you know this 19th century scientist also took advantage of the antimicrobial properties of copper? Darwin’s ship, The H.M.S. Beagle, had a copper covering on the submerged section of the ship’s hull. This covering kept barnacles and other microorganisms from attaching to the ship, keeping The H.M.S. Beagle in shipshape (pun intended) condition.

source: copper.org

And here’s the answer to yesterday’s Mash Up!

The Medici Effect wordsearch full answers

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Filed under Anti microbial copper alloys, Daily Blog Posts, Tuesday Trivia

August 26, 2013

Monday Mash-up

Happy Monday! Find all the Medici Effect terms in the word search below…

The Medici Effect wordsearch full

Download the printable version here.

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Filed under Daily Blog Posts, Monday Mash Up

August 23, 2013

fridays

5 Examples of the Medici Effect at Midbrook Medical

On Wednesday, we learned about The Medici Effect, an idea that is changing the way we look at innovation. In case you missed it, watch this short video to learn about this phenomenon in the words of Frans Johansson, the author of the book The Medici Effect.

Crazy stuff, right? And it’s true. If you mentally scroll through the most innovative ideas you’ve heard lately, I’d be willing to bet they are all examples of this Medici Effect, all examples of taking an out-of-the-box approach to creating ideas. At Midbrook Medical, we work to take this approach every single day. Here are 5 of our Medici Effects:

 1. “Clean as a Result, Not a Process”

  • Automotive Industry + Healthcare

Before the creation of Midbrook Medical, we were simply Midbrook Inc. Instead of manufacturing washers for surgical instruments and carts, we manufactured washers for automotive parts. We are located 70 miles west of Detroit, aka the “Motor City”, so we worked with the best of the best and became the supplier of choice for the Big 3 domestic automotive companies as well as their largest tier 1 and tier 2 suppliers. We don’t come from a background in healthcare. We come from a background in clean.

And this is exactly what set us apart when we transitioned into the medical world in 2007. The “Motor City” was struggling, and we knew we couldn’t depend on them to keep us going. We decided to take what we had learned about clean in the automotive industry and apply it to a world where the difference between clean and dirty is literally a matter of life or death: healthcare.

When a car part is being washed, that part has to hit a certain cleanliness level every single step of the way before it can move forward. Companies in the automotive industry are sticklers for results, not processes, because the result is what sells. And if an automotive company refuses to put a part in your minivan unless it achieves a specific level of clean, shouldn’t we make sure a surgical instrument being put in a living, breathing human body also hits a specific level of clean? With that thought, the automotive industry and healthcare industry collided, and we settled in nicely at the intersection, promoting “clean as a result, not a process”.

2. MediCount ATP Testing Device

  • “Clean as a Result, Not a Process” + Food Industry + Healthcare

You just learned about the belief that clean should be a measurable and objective result. But how do we objectively measure clean? The results from instrument washers such as The Tempest have been tested repeatedly, and we can hold up those statistics as objective proof. And we can prove the effectiveness of the UV Flash or antimicrobial copper (both of which you’ll hear about in a minute) with lab tests and studies. But, in the real world, on a day to day basis, how do YOU objectively measure clean?

Once again, the answer was found outside the healthcare world. For years, the Food Service Industry has used ATP testing on a daily basis to ensure their facilities are sanitary. ATP (Adenosine Triphosphate) is a high energy molecule required for cellular activity, so wherever you find ATP you’ll find life. In the case of the Food Service Industry and now the Healthcare Industry, wherever you find ATP you’ll find bacteria or germs. The Midbrook ATP Testing Device detects the presence of ATP on counters, instruments, and more according to measurable and customizable standards.

 3. Ozonated Water

  • Water Bottling Industry + Healthcare

Midbrook Medical isn’t the only division of Midbrook Inc. One of our other sectors is CapSnap Equipment, the leading provider of high-quality water bottling equipment and services. One of the reasons CapSnap is so renowned is because of their attention to detail. When a 5 gallon jug is being cleaned for reuse, it has to follow a specific process. It is washed, rinsed, sanitized, refilled, and, finally, capped. Before the plastic cap is automatically placed on the jug it is shot with a blast of ozonated water to kill any final bacteria that might have formed inside the cap. Ozone is the world’s most effective bacteria-killer, more than 3,000 times as effective as chlorine, the 2nd most effective.

Well, we thought, if ozone is so effective, why not use it to clean surgical instruments more effectively? So we created the Tempest. The Midbrook Tempest Washer combines the traditional ultrasonic washing process with the use of ozonated water, ensuring that results consistently meet AAMI standards.

 4. UV Flash

  • Barber Shops + Water Disinfection + Healthcare

When you think UV light, what do you picture? Tanning beds? Wrinkles? Skin Cancer? UV light gets a bad reputation from the media, but when used on surfaces other than the human body, it can be extremely beneficial. When UV light has a C wavelength, it breaks apart molecular bonds of DNA, essentially destroying any germs present.

UVC light technology has been used for decades in barber shops to sterilize tools, and is also used in water disinfection to kill various microorganisms. The UV Flash Disinfectant Station uses this same technology to sterilize hard-to-clean objects such as cellphones, stethoscopes, or stuffed animals in only 60 seconds.

5. Antimicrobial Copper

  • Ancient Egyptians + Shipping Industry + Environmentalists + Healthcare + Custom Fabrication

Ancient Egyptians used copper drinking vessels to keep their water clean. Ships often have a copper covering on their hull to prevent buildup of barnacles and other microorganisms. With antimicrobial copper, it wasn’t a matter of coming up with a brand new idea. It was a matter of realizing what the rest of the world has known since ancient times and applying it to the healthcare world.

We manufacture copper IV poles, carts, Mayo stands, and really anything else that can be made out of stainless steel. Custom fabrication has been a huge part of Midbrook’s services since we began, and now we’ve added Cuverro® Antimicrobial Copper the ever-growing list of material options. And to top it all off, since copper’s antimicrobial properties are completely natural, it appeases environmentalists and those concerned about toxins in many high-tech cleaning supplies. Antimicrobial copper has the potential to dramatically cut down on infections and cross-contamination.

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Wow. Who would’ve thought we’d use the same sterilization methods as Ancient Egyptians? Or take cleaning tips from the automotive industry? But, as Frans Johansson discussed, we can come up with far more groundbreaking ideas when we combine fields, cultures, and ideas. So let’s continue to use the idea that “diversity drives innovation” and create intersections of improved healthcare products and technologies everywhere.

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Filed under Daily Blog Posts, Gimme Five Friday

August 22, 2013

Thursday_rabbit

Infection Prevention: Seeing Isn’t Believing

I have a weak spot for magic tricks. When I was little, my best friend’s dad used to perform for us when I was at her house. I remember begging and pleading for the secrets behind the tricks because, even at age 5, I needed things to be logical and make sense.

And that’s why those tricks drove me up the wall. First of all, there’s no way a quarter could stay put behind my ear. Second, even if it could, there’s no way I wouldn’t notice it. Or what about that trick where a magician saws his assistant in half? How can I see her feet sticking out of one half, her head sticking out of the other half, and both halves still alive and kicking (one half literally kicking…)? You just can’t survive if your body is in two different places. It doesn’t make sense.

But sometimes, what you see isn’t what you should believe. Sometimes appearance isn’t reality, and reality isn’t appearance. Sometimes we have to look past appearances to really “see” clearly.

That sounds pretty twisted and cryptic doesn’t it? It’s confusing to explain on paper and even more confusing to adopt as a mindset.

My point is that we all struggle with separating appearance from reality, and that’s one of the obstacles holding us back in infection prevention.

If we don’t SEE any superbugs or bacteria, how do we know they are there?

Or if we SEE a nurse wipe the counter down, then it should be clean right?

And if we can’t SEE a difference between objects before and after UVC light disinfection or a difference between stainless steel and antimicrobial copper, how do we know they work?

If we base our logic on appearances, the rising rate of HAIs (Healthcare-Acquired Infections) doesn’t make sense at all. And if we base our logic on appearances, there’s no reason to change our current infection prevention practices

But, whether it makes sense or not, HAI rates ARE rising, and we DO need to change our current infection prevention practices.

So maybe we need to take a page out of the magician’s handbook and look past appearances.

Then we can SEE that just because it looks like the magician pulled a quarter from behind my ear doesn’t mean it actually happened. Then we can SEE that just because it looks like that assistant was sawed in half doesn’t mean she actually was.

Then we can SEE that just because it looks like there aren’t any superbugs or bacteria present doesn’t mean they aren’t there. Then we can SEE that just because something looks clean doesn’t mean it is. Then we can SEE the difference that using UVC light or antimicrobial copper makes.

Now let’s get one thing straight. I’m not trying to say infection prevention is a magic trick. Preventing the spread of germs and bacteria requires more effort and technology than could ever be pulled out of a top hat. But, like magic, it does require us to look past appearances to “see” the truth. And, in infection prevention, the truth is worth a whole lot more than a hidden quarter behind my ear.

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Filed under Daily Blog Posts, Healthcare Acquired Infections, Thursday Thought of the Day