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The Courage to Change the Things We Can

The Serenity Prayer is a well known piece of recommendation about how one can strategy life’s challenges. In it, the speaker asks for serenity to simply accept the issues that can’t be modified, braveness to alter the issues that may, and knowledge to know the distinction. Relating to an infection management, the identical sentiment may apply to threat components. There are some dangers that can’t be modified, well being challenges that we simply have to simply accept and work round. However there are these we can change, and these are modifiable threat components. The knowledge to know the distinction? We’ll attempt to sort out that matter in immediately’s publish.


There are specific threat components that make some sufferers extra susceptible to buying a healthcare-associated an infection. First, let’s listing all of the dangers that healthcare professionals in an infection management and prevention (IP) can’t impression.

Non-Modifiable Danger Elements

  1. Affected person Age: Newborns and the aged are at higher threat on account of their weaker immune techniques.
  2. Co-morbid circumstances or underlying illness: IP cannot change the affected person’s well being standing or severity whereas they’re receiving therapy.
  3. Immunosuppressed standing: Neither main nor secondary immunodeficiency will be affected by IP.
  4. Remedy: IP can’t alter essential invasive procedures, the necessity for indwelling units, or an prolonged keep in a hospital as a result of underlying well being situation.
  5. Submit-discharge habits: Whereas IP can present in depth affected person training, their habits post-discharge is out of our attain.

After we take a quick second to take a deep breath and settle for that there are issues we can’t change, let’s dive into a few of these issues that we can change by means of interventions that disrupt the three parts wanted for an HAI: A supply, a number, and a way of transmission.

Modifiable Danger Elements

  1. Eliminating sources of pathogens: We will scale back threat by working to eradicate pathogen reservoirs, from surfaces to units to HCW palms. Environmental companies in partnership with IP workers, nurses, and different HCWs make sure that high-touch surfaces are clear. Biocidal supplies can scale back organic contamination by repeatedly killing micro organism.

  2. Defending the potential host: By use of private protecting gear, isolation, and hand hygiene, we are able to defend susceptible sufferers from pathogens. We will additionally mitigate some dangers introduced on by their therapy, akin to lowering catheter days and monitoring antibiotic use. Biocidal supplies can preserve the affected person space within the benign zone by repeatedly killing micro organism.

  3. Stopping technique of transmission: Know-how can present threat discount in these areas. Air scrubbers can take away airborne pathogens, whereas adverse air circulation reduces the circulation of contaminated air across the affected person. Single-use merchandise or patient-dedicated gear may also scale back the danger of transmission.

The place does braveness are available to the equation? It takes braveness to face up for an infection management and prevention, in any context. Even in essentially the most profitable and well-funded services, medical professionals are busy and single-minded, two attributes that may make discussions of an infection management protocols and rules troublesome. It takes braveness to level out the place your facility may do higher, braveness to ask for funds to cowl essential upgrades to gear, braveness to look your colleagues within the eye and inform them they should wash their palms. It additionally takes braveness to find out about a brand new intervention and suggest it in your facility, particularly when it requires a monetary funding.


And now, the knowledge. The place we want knowledge is to see when new interventions and practices make a threat issue really one thing we are able to change, one thing that we are able to do to extend higher affected person outcomes. The place prior to now an infection itself was seen as a non-modifiable threat of medical therapy, we now know we are able to scale back the dangers. It took generations of physicians to simply accept this truth, however in time, the shift passed off. Maybe the following shift will probably be in areas the place important progress has already been made, however the place a couple of brave people say “we are able to do even higher.” The consequence simply may be an answered prayer for therefore many susceptible sufferers.

Modes of Transmission and what Stops them

Editor’s Observe: This publish was initially revealed in August 2019 and has been up to date for freshness, accuracy and comprehensiveness. 

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