護理師教導病人如何預防醫療照護相關感染（HAIs），哪項陳述表示病人需要進一步教育？
A nurse is educating a client about preventing healthcare-associated infections (HAIs). Which statement indicates the client needs further education?
- AHealthcare workers should wash their hands before touching me.醫療人員在接觸我之前應洗手。
- BI should cough into my elbow or a tissue.我應該用手肘或紙巾掩住口鼻咳嗽。
- CI should report any new or worsening symptoms to the nurse.我應該向護理師報告任何新出現或惡化的症狀。
- DIt is okay for visitors to use the client's personal items.✓ 正解訪客使用病人的個人物品是可以的。
核心概念：醫療照護相關感染（Healthcare-Associated Infections, HAIs）是指病人在接受醫療照護過程中發生的感染，這些感染並非在入院時就已存在或處於潛伏期。預防 HAIs 需要病人、家屬和醫護人員共同努力。 為何正確答案 D 錯（表示需要進一步教育）：病人應避免與訪客共用個人物品，例如水杯、餐具、毛巾等。這是因為訪客可能攜帶病原體，共用物品會增加病原體在病人與訪客之間傳播的風險，也可能增加病人感染 HAIs 的機會。病人應被教育保護自己的個人物品。 為何其他選項對： A. 醫護人員執行手部衛生是預防 HAIs 最基本也最重要的措施。病人應被鼓勵和教育認識到這一點，並可在適當時機提醒醫護人員。 B. 病人應被教導主動報告任何新的或惡化的症狀（如發燒、傷口紅腫、咳嗽加劇等），這有助於及早發現和處理潛在的感染。 D. 咳嗽或打噴嚏時用手肘或衛生紙遮掩，是預防呼吸道病原體（如流感病毒、新冠病毒）散播的有效方法，有助於減少 HAIs 的發生。 臨床思路（Safety / Infection Control）：此題重點在於病人教育，確保病人了解預防 HAIs 的關鍵行為。選項 D 顯示病人可能未能理解個人物品隔離的重要性，這是一個需要加強衛教的環節，以保護病人免受潛在的感染威脅。
Core concept: Healthcare-Associated Infections (HAIs) are infections that develop during the course of receiving healthcare and were not present or incubating at the time of admission. Preventing HAIs requires a joint effort by the patient, family, and healthcare staff. Why the correct answer D is incorrect (indicates a need for further education): The client should avoid sharing personal items such as cups, utensils, and towels with visitors. Visitors may carry pathogens, and sharing items increases the risk of pathogen transmission between the client and visitors as well as the client's risk of acquiring an HAI. Clients should be educated to protect their personal items. Why the other options are correct: A. Hand hygiene by healthcare workers is the most fundamental and most important measure to prevent HAIs. Clients should be encouraged and educated to recognize this and to remind staff at appropriate moments. B. Clients should be taught to actively report any new or worsening symptoms (such as fever, wound redness or swelling, or worsening cough) to allow early detection and treatment of potential infection. D. Covering the mouth and nose with the elbow or a tissue when coughing or sneezing is an effective way to prevent the spread of respiratory pathogens (such as influenza or COVID-19) and helps reduce HAIs. Clinical reasoning (Safety / Infection Control): This item focuses on client education, ensuring that the client understands the key behaviors for preventing HAIs. Option D indicates that the client may not understand the importance of segregating personal items, an area that requires reinforced teaching to protect the client from potential infection.
預防醫療照護相關感染（HAIs）的原則在美國和台灣的醫療體系中是共通的，都強調手部衛生、標準預防措施（Standard Precautions）、病人與訪客教育等。美國的 CDC 提供詳盡的 HAIs 指南，並有嚴格的監測與報告系統。台灣的疾管署也推動類似的措施。在病人教育方面，兩地都鼓勵病人積極參與，但具體衛教內容和方式可能因醫院文化和資源而略有不同。