Category Archives: Gimme Five Friday

5 Ways To Save Time In Sterile Processing

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One of the complaints we hear most often from Central Sterile Processing Departments is that there are too many instruments to clean and not enough time. Surgeries are delayed, instruments pass through unclean and SPD workers get frustrated. Too much responsibility falls on this department to have them feeling this way. This is what it looks like when technicians don’t have proper time and tools to properly clean each instrument.

Dirty Surgical Tools

Interior Lumen AFTER Sterilization

1.) Flush and Brush Station

The daVinci instruments used in robotic surgeries do phenomenal things but they also create a lot of hassle for technicians. Instruments get lost, they are hard to clean and difficult to keep altogether. This station from Midbrook Medical sits in the base of the sink and helps technicians keep track of what has been scrubbed already and prevents instruments from contaminating each other. Read More flush and brush 1

2.) Recipe Baskets

These recipe baskets were designed to help central sterile processing techinican’s ability to efficiently follow the Instructions for Use to reprocess full recipe sets of da Vinci Robotic Surgery. Instruments can be transferred from the Flush and Brush Station to the recipe baskets for the Midbrook Ultrasonic Bath. Like the Flush and Brush Station, the baskets are designed to keep surgical sets together during reprocessing allowing CSPD Technicians to reprocess recipe sets for each surgical procedure in a more efficient manner.

OLYMPUS DIGITAL CAMERA3.) The Tempest Surgical Instrument Washer

One of the reasons the Tempest is on the list is because of its automation. With the push of a button the lid comes down and runs a programmable cycle to bring repeatable results.  This instrument washer uses a combination of high-powered, tested, and proven washing actions: ultrasonics, enzymatic soaks, agitation, exterior and interior sprays, and air injection bubble cavitation stream. The instruments are cleaned effectively far surpassing AAMI standards. Just think of what you could accomplish in SPD during this automated 30 minute cleaning cycle.tempestbanner400x289

4,) The UV Flash

Sometimes accidents happen, even in hospitals. What happens when instruments get dropped? Well the good news is that problem can be solved. In 60 seconds. The UV Flash uses UVC light to disinfect objects. All bacteria on the surface of an object will be eliminated by using this station.

UVFlash

5.) Less Repeat (O.K. I know this isnt a product but it’s true!)

Since you’re using the Tempest surgical instrument washer, instruments are being cleaned more effectivly. Since more clean instruments are making their way into the hands of surgeons, less unclean instruments are making the trip back to sterile processing. Sometimes instruments come out of SPD with bio-burden on them so visable that surgeons send them back before even using them. This creates more work for technicians that is really unnecessary. If you do things right the first time, you won’t have to do it again. At least until after the surgery….

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Filed under Gimme Five Friday, Surgical Instrument Cleaning, Ultraviolet light to fight bacteria, Uncategorized

September 13, 2013

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Often times we get stuck on the bad things happening. The evening news is all stories about people doing things they shouldn’t. We call our friends and vent to them about what went wrong in their day. Why is it that the ones who act up are the ones who get suspended and get to stay home from school like everyone else wishes they could?

But what happens to those that do things right? The teacher’s pets, the constant advocates, the heros.

That’s where the Top 5 #InfectionPreventionSuccess Stories come into play. These organizations are doing things right, doing innovative things that go above and beyond normal expectations.

1.) MRSA incidence in dialysis patients declining

2.) Founder of the Committee to Reduce Infection Deaths.

3.) American technology effective for Mers-CoV prevention

4.) CleanLink releases list of infection prevention practices that work!

5.) Achieving Reduced Infection Rates via Hand Hygiene Compliance

How about a round of applause and a little attention to those that deserve it. Keep up the good work!

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Filed under Daily Blog Posts, Gimme Five Friday, Healthcare Acquired Infections, Uncategorized

September 6, 2013

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Twenty-Five 5-letter Words You Don’t Want to Hear

It’s been a long week hasn’t it? So let’s switch up this Gimme 5 post. I know we usually save the games for Monday mornings, but I won’t tell if you won’t. If you work in a healthcare facility, you get feedback from the patients, right? Hopefully, it’s all positive, but I know there are some words I would be just holding my breath and hoping I didn’t hear.

In the spirit of Gimme 5 Fridays, we’ve come up with 25 five-letter words you don’t want to see on that comment card. Let us know which ones we missed in the comments below!

5 5-letter words you don't want to hear_cropped

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August 30, 2013

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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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August 23, 2013

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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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August 16, 2013

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5 Places (besides hospitals) that Need Better Infection Prevention

At Midbrook Medical, we are all about infection prevention. And as you can probably guess from our name, we usually focus our prevention efforts in the healthcare world. Eliminating the international epidemic that is Healthcare-Acquired Infections is something we believe should be on the top of everyone’s To Do List. But infection outbreaks and superbugs aren’t limited to healthcare facilities. There’s no security guard stopping MRSA at the exit door of a hospital saying, “Um sorry you can’t leave, you’re an HAI.”

A Healthcare-Acquired Infection outside of a healthcare facility is simply an infection. And these infections are equally as dangerous no matter where you contract them.

That’s why we can’t limit our infection prevention efforts to healthcare facilities only. Many of the advances and technologies we discuss everyday on our blog need to be implemented anywhere where there is a risk of contracting infection.

And, really, anywhere there are human beings, there is a risk.

But some places are more prone to outbreaks than others. Take a look at these 5 places that desperately need proper infection prevention:

1. Retirement Homes and Assisted Living Communities

On a superbug or infection FAQ sheet, there are always risk factors listed, things that increase the chance of contraction. One of the recurring risk factors is age. The elderly tend to have a weaker immune system, making them more prone to infections. Think about how it takes your grandma twice as long as you to get over a cold. And that’s just a cold. Getting over something like C. diff. would be another story altogether. Another group with a higher infection risk is those already on antibiotics. Maybe it’s just the elderly in my life, but I swear they take about half the drugstore every morning with breakfast. If you combine these risk factors with the fact that these communities have a lot of people living in close quarters, then you understand why they really need to be careful about preventing the spread of infections.

2. Dentist Offices

We talk all the time about cleaning the surgical instruments used in the operating rooms at hospitals, but what about those surgical tools used to pull out your wisdom teeth or fill a cavity? Those are some intricate tools that, if not cleaned and sterilized properly, could pass on infections just as easily as those in a hospital. And think about the number of patients that go in and out of a dentist’s office every single day. They’re sitting in the same waiting room chairs, they’re using the same doorknobs, and they could easily be passing on or receiving infections.

3.  Apartment Buildings and Dorms

My freshman year in college I think I vacuumed my dorm room two times at the most. In the dining hall, I ate too many cookies and not enough infection-fighting spinach. I didn’t get enough sleep. My throat hurt one time for about 2 weeks before I even thought about seeing a doctor. And I shared a community bathroom with all 30 girls in my hall. College dorms and apartments with young tenants are great for creating memories with your friends but a nightmare for infection prevention.

4. Athletic Facilities

Before I began working at Midbrook and doing any research on infections, I actually thought MRSA was something only athletes ever got. I had read so many articles on high school football players contracting it from unclean locker rooms or someone with MRSA going to their gym with an open wound and causing an outbreak. Athletic facilities, with their poorly cleaned machines and crowded, damp locker rooms, are breeding grounds for all sorts of infections.

5. Schools

Let’s talk about your average high schooler. She’s moving to a different classroom every hour, using the rusty old drinking fountain in the hall, taking the beat-up hall pass with her to the bathroom, sharing her dessert with her friends at lunch, and chewing on her pen. Honestly I could go on and on about the ways students are exposed to infections in a single classroom, let alone an entire building.

Each of these places poses a risk for infection in its own way. There isn’t one solution we can use to combat them all, just like there isn’t one solution that can eliminate HAIs. But there are technologies and methods already in existence that can be used to really make a dent in these infection rates. Ideas such as antimicrobial copper or UV light are already making waves in the healthcare world but can be just as effective in other settings as well. As long as we don’t get tunnel-vision, we can continue to combat infections, no matter where they appear.

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Filed under Anti microbial copper alloys, Daily Blog Posts, Gimme Five Friday, Ultraviolet light to fight bacteria

August 9, 2013

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5 Common Types of Healthcare-Acquired Infections

HAIs. Healthcare-Acquired Infections. HCAIS. Healthcare-Associated Infections. Hospital-Associated Infections.

No matter which specific terminology you use, it sounds ominous right? “HAI” (I like this way best, I hope you don’t mind) is kind of a blanket term, encompassing any infection you get in a healthcare facility while being treated for something else.

But HAIs come in many shapes and forms. Some have symptoms you can see, some have symptoms you can feel, some are in your blood, some are in your lungs, some are easy to treat, some are more difficult…

Confused yet? I know I am. I can barely keep my coworkers’ names straight, much less differentiate between specific infections.

So to help us all out, I did a little research on the CDC website and found these 5 Common Types of HAIs. There are quite a few more variations and details, but this gives us someplace to start. So study up, you might be tested on these later 🙂

  1. Central Line-Associated Bloodstream Infection (aka Catheter-Associated Bloodstream Infection or CLABSI)

Definitions:

  • Central line/central venous catheter= a tube placed in a patient’s vein to draw blood or administer fluids and medication; empties out near the heart

Contracting CLABSI: Bacteria travels down the tube into blood

Symptoms: fever, chills, soreness or redness around the catheter

Treatment: antibiotics, removal of catheter

Prevention:

  • Don’t use catheter any longer than necessary
  • Make sure your healthcare providers and visitors are following correct hand hygiene rules
  • Don’t let visitors touch catheter
  • Tell your doctor or nurse if the bandage comes off or becomes dirty or wet

 2. Catheter-Associated Urinary Tract Infection (aka CAUTI)

Definitions:

  • Urinary catheter= tube used to drain the bladder

Contracting CAUTI: Germs travel through catheter into urinary tract

Symptoms: burning/pain in lower abdomen, fever, burning during urination, more frequent urination, bloody urination

Treatment: antibiotics, removal/change of catheter

Prevention:

  • Don’t use catheter longer than necessary
  • Clean hands before and after touching catheter
  • Make sure urine bag is below level of bladder
  • Don’t tug, pull, or twist catheter tubing

3. Surgical Site Infection (aka SSI)

Definitions:

  • Surgical site= part of body where surgery took place; where incision was made

Contracting SSI: germs enter body through surgical site

Symptoms: redness/pain around surgical site, drainage/cloudy fluid around surgical wound, fever

Treatment: antibiotics, possibly more surgery

Prevention:

  • Make sure doctor is aware of your medical background
  • Don’t smoke
  • Don’t shave before surgery
  • Don’t allow visitors to touch wound or bandages
  • Make sure healthcare providers and visitors are following proper hand hygiene rules

4. Ventilator-Assoicated Pneumonia (aka VAP)

Definitions:

  • Ventilator= used to help patient breathe; tube is placed in mouth, nose, or a hole in the neck and connected to ventilator machine

Contracting VAP: germs travel through tube into lungs

Symptoms: coughing, fever, fatigue, nausea/vomiting, shortness of breath, chills, chest pain

Treatment: Antibiotics

Prevention:

  • Don’t smoke
  • Ask for hospital bed to be raised to 30-45°
  • Make sure healthcare providers and visitors are following proper hand hygiene rules
  • Clean the inside of your mouth regularly

 5. Clostridium Difficile (aka C. diff.)

Definitions:

  • C. diff= type of germ

Contracting C. diff:

  • Found in feces
  • Can be transmitted person-to-person or through contaminated surfaces (spores can survive outside the body for long periods of time)
  • Usually affects people on antibiotics

Symptoms: watery diarrhea, fever, loss of appetite, nausea, stomach pain

Prevention:

  • Take only antibiotics prescribed to you
  • Make sure you, your healthcare providers, and any visitors are following proper hand hygiene rules

Getting into the nitty gritty details of infections isn’t exactly a feel-good Friday activity. But I think, and I’m sure you feel the same way, it’s much better to read about something like Ventilator-Associated Pneumonia and learn the facts that way than to get it in real life and learn the hard way.

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