護理師照護一位有植入式人工血管 (Port) 的病人。在進行存取時,護理師維持無菌技術,這主要是為了預防哪種併發症?
The nurse is caring for a client with an implanted port. During access, the nurse maintains sterile technique. Which potential complication is the nurse primarily preventing?
- APneumothorax氣胸
- BExtravasation滲漏
- CCatheter occlusion導管阻塞
- DCentral Line-Associated Bloodstream Infection (CLABSI)✓ 正解中心靜脈導管相關血流感染 (CLABSI)
核心概念是中心靜脈導管相關血流感染(CLABSI)的預防。植入式人工血管(Port-a-Cath)是一種長期中心靜脈通路,其末端位於靠近心臟的大血管中。當護理師使用無菌技術(Sterile technique)存取 Port 時,目的是防止皮膚表面的細菌(如 Staphylococcus aureus)隨針頭進入血液系統。CLABSI 是一種嚴重的院內併發症,會導致病人住院時間延長、醫療成本增加及死亡風險提升,因此無菌操作是護理照護中的最高安全準則。
Maintaining strict sterile technique during the access of an implanted port is primarily aimed at preventing central line-associated bloodstream infections (CLABSI). Since the port provides direct access to the central circulation, introducing skin flora like Staphylococcus aureus can cause severe systemic infection. Sterile practice is the highest safety standard to protect the client from this serious complication.
美國對於 CLABSI 的預防有一套嚴格的「Bundle」(組合式介入),且 CLABSI 的發生率直接影響醫院的評鑑與保險給付。台灣也有類似的感控監測,但美國在執行「Scrub the hub」(消毒接頭)的時間與標準上極其嚴格。