— 安全與感染控制 · MEDIUM · MCQ —
護理師進行洗手稽核。哪種情況必須使用肥皂和水洗手，而非使用乾洗手液？
A nurse is conducting a hand hygiene audit. Which scenario requires the nurse to perform handwashing with soap and water instead of using alcohol-based hand rub?
- AAfter checking a client's blood pressure測量病人血壓後
- BBefore touching a patient with intact skin觸碰皮膚完整的病人前
- CAfter removing sterile gloves脫除無菌手套後
- DAfter caring for a client with Clostridium difficile infection✓ 正解照護患有艰难梭菌感染的病人後
— Explanation · 中文詳解 —
酒精性乾洗手無法有效殺死芽孢菌（如困難梭狀桿菌，C. difficile），因其孢子對酒精有抗性，必須透過機械性的肥皂沖洗才能有效移除。其餘情境（如接觸完整皮膚、測量血壓、脫手套後）酒精性乾洗手皆符合 CDC 手部衛生規範。
Alcohol-based hand rubs cannot effectively kill spore-forming bacteria (such as Clostridium difficile), because the spores are resistant to alcohol; mechanical removal with soap and water is required. In the other situations (touching intact skin, taking blood pressure, removing gloves), alcohol-based hand rub complies with CDC hand hygiene guidelines.
✦ 台美臨床差異
台灣醫院對抗 C. diff 的手部衛生規範與美國 CDC 一致，要求絕對流水洗手。