護理師照顧一名困難梭狀桿菌感染的病人。下列哪項措施在感染控制上優先級最高?
A nurse is caring for a client with Clostridium difficile. Which action is the highest priority for infection control?
- AWash hands with soap and water after leaving the room✓ 正解離開房間後用肥皂和水洗手
- BEnsure the client is in a private, negative-pressure room確保病人住在單獨的負壓病房
- CWear a N95 respirator while in the client's room在病人房間內佩戴 N95 呼吸器
- DPerform hand hygiene with an alcohol-based hand rub使用酒精性搓手液進行手部衛生
困難梭狀桿菌(C. difficile)會產生具有極強抗藥性的芽孢(Spores),這些芽孢對於酒精(Alcohol-based hand rub)具有耐受性,酒精無法有效殺滅或移除它們。因此,在照護此類病人時,僅依賴酒精乾洗手是無效的,必須採取接觸隔離(Contact Precautions),並在接觸病人或環境後,透過「肥皂與清水」洗手,利用物理摩擦與流動水將芽孢沖刷掉。這是預防院內交叉感染的關鍵安全措施。
C. difficile produces alcohol-resistant spores. Alcohol-based hand rubs do NOT inactivate the spores; soap-and-water washing physically removes them via mechanical friction and is required after every patient/environment contact. Contact precautions (gown and gloves) are used, not airborne/N95 precautions, and negative-pressure rooms are not required.
台美對於 C. diff 的感染控制標準一致。美國醫院(如 CDC 指引)嚴格要求在病房門口張貼接觸隔離標示,並強制執行肥皂洗手。此外,美國醫院常使用含漂白水(Bleach)成分的清潔劑進行環境消毒,因為酒精無法殺滅芽孢。