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Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Dental Lab Products. He is also the author of 18 technology books, including the award-winning Green IT: Reduce Your Information System's Environmental Impact While Adding to the Bottom Line. As such, he’s particularly interested in the technological side of dentistry.
As with any job, it can be easy to fall into the rut of doing the same work day-in and day-out. And if that happens, things can fall through the cracks. Unfortunately, sometimes good infection control habits can be one of those things.
In order to get staff excited about the infection control, there are a number of strategies that can be employed. For instance, an appeal to their professionalism may be in order. Reminding them that they are all part of the team is another strong strategy. And there is also the simple act of finding what motivates them.
In this day and age, it is easy to get necessary training from online sources. While that is certainly convenient, Dr. Lisa Kane, DMD, Dental Consultant at Dental Office Compliance of New England observes that it is not always the best. She recommends performing in-person training.
“A big thing is doing it in-office,” she says. “It’s actually a controlled training, unlike doing it online. If you do it in-office, it’s more personal. It’s absolutely more engaging. You can make it relatable to exactly what they’re doing.”
Conducting training in-house affords the opportunity to make it more applicable to their work circumstances.
“When I go to offices, they will say, ‘This is so much better than the last time we did this online,’” Dr. Kane says. “They can ask questions and can find out, exactly, if they’re doing something correctly. ‘Is this the right way to do it?’ ‘What do you guys think?’ ‘What should we do?’ You can actually make it about their office and the issues they’re having, specifically. And it’s always more engaging with a person than just watching a computer screen.”
Dental professionals are just that: Professionals. Team members are in the career because they want to help people and be leaders in their field. As such, an appeal to their expertise can be the spark that reignites their fire.
“Everybody thinks they’re doing things correctly, because they wouldn’t intentionally do things wrong,” Karen Gregory, RN, Director of Compliance and Education for Total Medical Compliance says. “So, when they come back from an educational opportunity and are presenting ideas to the team-for instance, we need to transport our instruments in a closed container. People are saying, ‘Well, we’ve never done that.’ So it’s, it’s a challenge.”
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In some cases, there might be several habits in need of correction. If that’s the case, establishing a plan is in order.
“One of the things that I tell people is that you need to prioritize your needs and focus on something that you can fix very quickly. That will give you a kind of momentum,” Gregory advises. “And then, maybe implement two or three other ideas so that people aren’t overwhelmed, because with any improvement that you make, you’re moving forward and creating a safer environment. I think that a lot of times people go in and they all have a list of 20 things that they have to get fixed and, ‘We need to do this by tomorrow.’ What we’ve found is that if that is overwhelming and people shut down, then they end up not getting anything done.”
Once the rules are learned, refreshers are, of course, a good idea, but the core lessons usually don’t change, because they tend not to be especially dynamic.
“There is really not been a huge change in the industry,” Gregory observes. “And, in fact, back in 2016, the CDC published a summary document, and when they went back and did a literature review, there really wasn’t anything significant, as far as infection control processes related to dental that had changed. This is not a moving target. I think that, perhaps, people just have not been given the education that they needed in a timely manner.”
That notion of professionalism will be evident, noticeably when patients come in.
“If you’re doing things right, you’re doing it the most ideal,” Dr. Kane says. “It would feel really good when a patient comes in and says, ‘Okay, what are you doing for infection control? ‘How are you cleaning this?’ ‘How have you’ve taken care of your waterlines?’ And for you to be able to say, ‘Oh, we are set.’ ‘This is what we do.’ ‘We are going above and beyond.’ If you can feel good about being protectors of the patients, then I would imagine you would feel good about what you’re doing.”
Motivation is always an effective tool. In some cases, a carrot-or-stick approach-that is, presenting positive or negative incentives-can be very appealing.
For Gregory, looking at the positives is always a good inspiration.
“We went into healthcare to help people,” Gregory says. “You didn’t go into healthcare to get sick, yourself. So you are telling them what could happen, but you focus more on the solution as a preventative, ‘Let’s look at what you can do to keep this from happening.’ And, of course, we do share some stories. A lot of times, once people see the reality of noncompliance, then they’ll say, ‘Oh, maybe what they’re saying is true.’ A lot of times we hear, ‘Well, we’ve always done it that way’.”
Understanding the rationale behind why something is done the way that it’s done is important for team buy-in.
“When I'm working with people, they may not understand the reason why they should be performing tasks in a certain manner. Most adults need to understand the why behind anything they are asked to do,” Gregory says. “And I agree with that. The reason why you would transport something in a closed container is so that if you dropped it, the instruments wouldn’t fall out. Or if you trip, the instruments wouldn’t be on the tray and you would pull them up and stick yourself with them. So, ‘Oh, well now that makes sense.’ For me, it really is a mixture of, ‘Let’s focus on what are the pros and cons of things?’ Here are some of the things that can happen.”
“The more you explain that you’re doing this to help them and not just to help protect patient is a good thing,” Dr. Kane adds. “Everyone, obviously, cares about the patient, but they want to avoid our needlestick, too. There are real risks for them to get injured.”
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On the other hand, reminding staff of the various threats out there can also be motivational. For instance, sharps injuries and bloodborne pathogens aren’t the only risks when proper infection control protocols fail to be observed.
“Sharps injuries and bloodborne pathogens are a big deal,” Dr. Kane says. “But, there are a lot of other things, too. Waterlines, fungal infection, and antibiotic resistant bacteria are prominent in the news. You’re supposed to have monthly safety meetings in your office, anyway. So, you could see what’s in the news, see what’s happening with other people.”
All team members should understand what to do and why to do it. That understanding helps ensure staff consistency.
“It seems daunting to people,” Dr. Kane says. “So, if you get someone to come in and help your infection prevention coordinator or you have a good infection prevention coordinator, and you have everything written out-making a list of how they’re supposed to do everything-that takes the thought out of it. Then everyone does everything the same way, and if everyone does everything the same way, the right way, then you have much less of a chance for something to go wrong.”
Ensuring that the right message is conveyed can be tricky, but it’s necessary.
“That’s one of the things that we have really been working on is making sure that we are consistently training people to give the right message and to do the right things,” Gregory says. “And I think it’s kind of like that rumor game that you play where you start with one person and by the time it gets to the end, it’s totally changed. So, a lot of times, we hear, ‘This is what I think,’ instead of really tying it to, ‘Here’s what the regulation says,’ or ‘Here’s what the enforcement guidance says,’ or ‘Here’s the guidance from the CDC, verbatim.’ There becomes this interpretation, and then I think the message gets a little blurred.”
That concept of consistency helps the practice deliver the best patient care with ideal infection prevention outcomes in mind.
“Everyone needs to be on the same page, and everyone should understand the importance of it,” Dr. Kane says. “Even though it might take an extra minute or two, you need to do things right. It’s better to do that than just rush. It’s good to have everyone following the same rules and doing everything that they’re supposed to do and not worrying about racing around.”
“I encourage people to talk to each other,” Gregory adds. “When I do a class, I’ll say, go back, sit down with your team, and say, ‘Look, we all care about each other. And if I see you not wearing personal protective equipment when you should be, I’m going to remind you.’ We’ve agreed that this is the best thing for you to reduce that likelihood of some kind of event. Having a conversation, back and forth, in a nonthreatening manner, and holding each other accountable, I think you can move forward in that environment. But just ignoring things will never change.”
A trendy thing to discuss is creating a “culture of safety.” While that is, of course, a noble aspiration, that concept can become somewhat diluted if the true meaning is lost.
“People talk about a culture of safety and, ‘Okay, we’re going to have a culture of safety,” Gregory observes. “If you’re not talking to each other, then there is no culture of safety.”
Really embracing that culture starts at the top.
“I’ve seen it work the best when the dentist says, ‘This is a priority for our practice,’” Gregory says. “And, honestly, if the dentist is not on board, it’s very difficult for the team members to follow suit.”
There are many motivators that can help pull staff out of the doldrums of complacency and get them excited about following optimal infection control procedures. Finding the right tool-be it appealing to their sense of professionalism; their identity as a team member, or finding what motivates them-are all good mechanisms to get the team excited about infection control.