護理師在社區課程教導手部衛生。參加者說出哪些陳述顯示了解何時應使用肥皂與水而非酒精洗手液？（選所有適合的）
A nurse is teaching a community class on hand hygiene. Which statements by participants show understanding of when to use soap and water over alcohol-based hand sanitizer? (Select all that apply.)
- AWhen my hands are visibly soiled✓ 正解當雙手明顯髒污時
- BAfter using the restroom✓ 正解使用廁所後
- CAfter caring for someone with C. difficile infection✓ 正解照護艰难梭菌（C. difficile）感染患者後
- DWhen I am in a public place with no sink在沒有水槽的公共場所時
- EBefore preparing food✓ 正解準備食物前
酒精洗手液對肉眼可見髒污或特定細菌（如梭狀芽孢桿菌 C. diff，因其具芽孢）無效，必須使用肥皂與水洗手。如廁後（B）與準備食物前（E）也是洗手黃金時間，水洗效果更佳。D 時因環境限制才用酒精，非優先選擇。
Alcohol-based hand sanitizers are ineffective against visible soiling and against certain pathogens (e.g., Clostridioides difficile, due to its spores); soap and water must be used in these situations. After using the restroom (B) and before preparing food (E) are also key handwashing opportunities where water-based washing is more effective. Option D is appropriate only when environmental constraints exist and is not the preferred option.
兩地對手衛生指引一致，但在民眾認知上，酒精普及度很高，需教育其侷限性。