— 安全與感染控制 · HARD · MCQ —
下列哪項措施對於預防導尿管相關尿路感染（CAUTI）最有效？
Which of the following interventions is most effective in preventing catheter-associated urinary tract infections (CAUTI)?
- AFrequent prophylactic irrigation頻繁預防性沖洗
- BEarly removal of the catheter✓ 正解早期拔除導尿管
- CCleaning the meatus with betadine daily每日使用聚維酮碘清潔尿道口
- DAdministering prophylactic antibiotics給予預防性抗生素
— Explanation · 中文詳解 —
根據實證醫學，預防 CAUTI 最有效的手段是「盡早移除導尿管」。只要導尿管留置時間越長，細菌沿管壁向上爬升定植的風險就呈指數級上升。其他選項如每日消毒或預防性給藥，證據等級均不如縮短留置時間來得顯著且具體。
According to evidence-based medicine, the most effective measure to prevent CAUTI is early removal of the catheter. The longer a urinary catheter remains in place, the more the risk of bacteria migrating along the catheter and colonizing increases exponentially. Other options such as daily antiseptic cleaning or prophylactic antibiotic administration have lower evidence levels than shortening dwell time.
✦ 台美臨床差異
美台皆強調護理師應評估移除必要性，台灣護理師通常需醫師醫囑方可執行拔除，美國部分醫療系統允許護理師依 protocol 自行拔除。