護理師照顧隔離病人後準備脫除個人防護裝備（PPE）。下列何者為正確的脫除順序？

在照護隔離病人後，正確且安全地移除個人防護裝備（Personal Protective Equipment, PPE）是防止病原體擴散的關鍵步驟。移除 PPE 的順序至關重要，旨在最大程度地降低護理人員自身被污染的風險。 核心原則是「由淨至穢」，即從相對乾淨的部分開始移除，最後移除最可能被污染的部分。同時，必須避免被污染的 PPE 外層接觸到護理人員的皮膚或衣物。 正確答案 D，手套、護目鏡、隔離衣、口罩（Gloves, goggles, gown, mask），是標準且最推薦的 PPE 移除順序。原因如下： 1. 手套（Gloves）：通常是接觸病人最直接的 PPE，因此被認為是最受污染的，應首先移除，以防止將污染物轉移到身體的其他部位。 2. 護目鏡/面罩（Goggles/Face shield）：這些是保護眼睛和臉部的，移除時應小心，避免其外層接觸到臉部。它們相對較乾淨，可以排在手套之後移除。 3. 隔離衣（Gown）：隔離衣的目的是保護身體和衣物，移除時應從頸部或肩部開始，捲下來，避免外層接觸皮膚，並在移除後妥善處理。 4. 口罩/呼吸器（Mask/Respirator）：這是最後移除的 PPE，因為它保護呼吸道免受空氣傳播的病原體侵害。移除時應只觸摸綁帶或鬆緊帶，避免觸碰口罩前方，並在移除後立即進行手部衛生。 錯誤選項分析： A. 手套、隔離衣、口罩、護目鏡（Gloves, gown, mask, goggles）：此順序將護目鏡放在最後，但護目鏡的移除應早於口罩，因為口罩是最靠近呼吸道的防護，通常是最後移除的。 B. 隔離衣、手套、護目鏡、口罩（Gown, gloves, goggles, mask）：此順序不正確，手套應為第一個移除，因為它最有可能被污染。 D. 口罩、護目鏡、隔離衣、手套（Mask, goggles, gown, gloves）：此順序完全錯誤，將最可能被污染的手套放在最後移除，極易造成嚴重污染。 在移除 PPE 的過程中，每一步驟之間或結束後，都可能需要執行手部衛生，特別是在移除手套後和移除口罩後。確保移除過程的安全，是防止交叉感染的關鍵。

After caring for an isolated client, removing personal protective equipment (PPE) correctly and safely is a critical step in preventing the spread of pathogens. The sequence in which PPE is removed is essential to minimize the risk of self-contamination by the nurse. The core principle is to proceed "from cleanest to dirtiest," beginning with the relatively clean items and finishing with what is most likely contaminated. At the same time, the contaminated outer surfaces of PPE must not touch the nurse's skin or clothing. The correct answer D, gloves, goggles, gown, and mask, is the standard and most recommended order for PPE removal. The reasoning is as follows: 1. Gloves: typically the PPE in most direct contact with the client and considered the most contaminated, so they should be removed first to prevent transferring contaminants to other parts of the body. 2. Goggles/face shield: protect the eyes and face; care should be taken when removing them so that the outer surface does not touch the face. They are relatively clean and can be removed after the gloves. 3. Gown: the gown protects the body and clothing; it should be removed by rolling it down from the neck or shoulders, avoiding contact between the outer surface and the skin, and disposed of properly. 4. Mask/respirator: this is the last item to be removed, as it protects the airway from airborne pathogens. When removing, only the ties or elastic should be touched, avoiding the front of the mask, and hand hygiene should be performed immediately afterward. Analysis of incorrect options: A. Gloves, gown, mask, goggles: this places the goggles last, but goggles should be removed before the mask, since the mask, which is closest to the airway, is usually removed last. B. Gown, gloves, goggles, mask: this is incorrect because gloves, being the most likely contaminated, should be removed first. D. Mask, goggles, gown, gloves: this order is completely wrong; leaving the most contaminated gloves until last would easily cause serious contamination. During PPE removal, hand hygiene may need to be performed between steps or at the end, especially after removing gloves and after removing the mask. Ensuring a safe removal process is key to preventing cross-contamination.