and Change Theory Paper: Copper-Infused Products

            According to a 2013 study, approximately $9.8 billion is
spent treating hospital-acquired infections (HAIs) annually (Waknine, 2013). The
health care community is always looking for fresh, innovative techniques to
combat HAI’s. Recently, Sentara Healthcare discovered new products such as bed
linens, patient gowns, bedside tables, side rails, sinks, bath towels and
countertops that are infused with copper to prevent the growth of bacteria and
the spread of dangerous pathogens. The potential for copper in health care is
limitless; switching to these revolutionary products could ultimately save
thousands of lives and millions of dollars in expenses.

Stage 1: Unfreezing

             Kurt Lewin’s
classic change theory proposes three steps that must occur for a change to
become a part of an organization: unfreezing, movement, and refreezing. Unfreezing
occurs when the need
for change is recognized by the organization and data begins to be collected (Marquis
& Huston, 2017, p. 188). Despite the progression efforts in infection
prevention, the Centers for Disease Control and Prevention estimates that one in
twenty-five hospitalized patients have a hospital-acquired infection (CDC,
2018). Health care-associated pathogens, such as methicillin-resistant
Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) are
able to survive on inanimate objects for prolonged periods of time; certain
organisms such as Clostridium difficile are able to live for months (Sifri,
Burke, & Enfield, 2016). Cupron Incorporated specializes in the
antimicrobial properties of copper and invented a patented copper oxide
technology, while EOS Surfaces, LLC is a corporation dedicated to the
innovation of specialty countertops and hard surfaces. Together, these companies
developed products that have the potential to transform health care and
infection prevention. Sentara Healthcare teamed up with Cupron, Inc. and EOS
Surfaces, LLC in an effort to inhibit the further escalation of resilient hospital-acquired
infections (Gauding, 2016).

Stage 2: Movement

            Movement ensues when a plan for change is in effect and
actions have been taken toward attainment of the goal (Marquis & Huston,
2017, p. 190). Sentara and the partnered companies conducted a 10-month
clinical trial at Sentara Leigh Hospital in Norfolk, Virginia to assess the biocidal
effects of the copper-infused products on the hospital-associated pathogens (Gauding,
2016). In the East Tower of Sentara Leigh, the hard surfaces in 124 patient
rooms, nursing stations, and restrooms were upgraded with copper-infused
countertops, sinks, vanities, patient room desks, computer stations, soiled utility
rooms, nurse workstations, over-the-bed tray tables and bed rails (Sifri et
al., 2016). Additionally, the conventional cotton linens were replaced for
copper-woven linens that included patient gowns, pillowcases, fitted sheets, flat
sheets, washcloths, bath towels, bath blankets, and thermal blankets (Sifri et
al., 2016). The West Tower of Sentara Leigh remained unchanged, acting as a
constant in the clinical trial experiment. The results of the trial, published
in the American Journal of Infection Control, showed the patented copper-oxide
products reduced the incidence of Clostridium difficile by 83 percent, with an
overall reduction of multidrug-resistant organisms (MDROs) by 78 percent
(Downs, 2017). However, no significant changes were seen in device-associated
infections in patients residing in the rooms upgraded with copper-infused
products (Sifri et al., 2016). The compelling results of the trial influenced
Sentara Healthcare to install the products in all Sentara hospital locations and
potentially in nursing and assisted living centers (Gauding, 2016).

Stage 3: Refreezing

            After the implementation of a change, in order for it to
remain effective, refreezing must occur. During this phase, the organization
stabilizes and efforts are put in place to ensure the continuity of change (Marquis
& Huston, 2017, p. 191). After all 12 Sentara hospital facilities employed
the copper-oxide products, Sentara, Cupron, Inc. and EOS Surfaces, LLC launched
a second clinical trial in April 2015. This trial evaluated the efficiency of
the products in the West Tower of Sentara Leigh Hospital compared to the
efficiency of the products at Sentara Virginia Beach General Hospital and Sentara
Princess Anne Hospital (Gauding, 2016). The expected publication date for the
results of this trial was the end of 2017; however, the findings have yet to be
released. Sentara Healthcare’s efforts to maintain and further evaluate the
revisions set forth are a prime example of Lewin’s refreezing technique. The preservation
of change is imperative for healthcare to remain innovative and provide
patients with safe, quality care.

Copper In The Future

            The healthcare
environment is in a constant state of fluidity, making cutting-edge technology a
necessity (Laureate Education, 2010). In the
medical field, copper’s distinctive characteristics have a tremendous amount of
untapped potential; Sentara, Cupron, Inc. and EOS Surfaces, LLC just grazed the
surface. Copper has been proven to rapidly kill a variety of microorganisms
through a method called “contact killing” (Zeiger, Solioz, Edongué, Arzt, &
Schneider, 2014). The patented product EOScu, created by EOS Surfaces, LLC, has
been proven to kill 99.9 percent of bacteria within two hours of initial contact
(Gauding, 2016). Consider the extensive
amount of products in healthcare that are manufactured from stainless steel
such as, door handles, IV poles, surgical instruments, implantable medical
devices and more, if copper replaces all stainless steel in the medical field the
potential to eradicate HAI’s is extraordinary.

Enacting Change

            Burrowes and Needs “stages of change model” is a
five-step design that guides organizations through the key phases of change. The
first stage is preconception; during
this period there is no intention to change because it is perceived as unneeded
(Marquis & Huston, 2017, p. 193). The second stage is contemplation; in
this step, the idea of change is being considered, but action has not been
taken toward achieving it (Marquis & Huston, 2017, p. 193).  The third stage is preparation, throughout this phase planning,
organizing and goal setting takes place. The fourth stage is action; in this
step, plans are put into effect and modifications begin being implemented.

Lastly, the fifth stage is maintenance; during this phase, efforts are taken to
ensure relapse does not occur (Marquis & Huston, 2017, p. 193).  Currently, the change initiative for copper
to replace all stainless steel products in healthcare is in the contemplation
stage. Sentara Healthcare has already recognized the need for a change and
taken a step in the right direction with the partnering companies, Cupron, Inc.

and EOS Surfaces, LLC; however, a plan aimed at the total replacement of
stainless steel with copper has not been established.  Terry Gilliland, MD, chief medical officer for
Sentara Healthcare states, “My sense is that everything we touch will have some
kind of copper associated with it, from doorknobs to computer covers and
devices used in patient care. It will take time, but I believe it’s inevitable”
(Gauding, 2016). Utilizing each strategic phase of the “stages of change model”
can make the idea become a reality.



infections have been one of healthcare’s toughest challenges to overcome. The
powerful biocidal properties of copper are what make it so unique. Dr. Gene
Burke states, “Healthcare-associated infections are becoming a national dilemma
and having an additional tool to help combat those is absolutely vital to
meeting the expectations of our patients. This, to me, is the beginning of a
new wave of technologies to help solve those problems” (Gauding, 2016). The realization
of copper’s groundbreaking qualities has the ability to revolutionize infection
prevention and allow patients to have unwavering confidence in the safety of
their care. 

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