下列哪些護理措施最能有效降低導尿管相關尿路感染 (CAUTI) 的風險？（選所有適合的）
Which actions by the nurse are most effective in reducing the risk of catheter-associated urinary tract infection (CAUTI)? (Select all that apply.)
- AMaintaining a closed drainage system at all times✓ 正解始終維持封閉的引流系統
- BCleaning the peri-urethral area with soap and water daily✓ 正解每日用肥皂和水清潔尿道周圍區域
- CPlacing the drainage bag on the floor for gravity drainage將引流袋放置於地面以利重力引流
- DAssessing the ongoing need for the urinary catheter daily✓ 正解每日評估持續使用導尿管的必要性
- EKeeping the drainage bag below the level of the bladder✓ 正解保持引流袋低於膀胱水平
預防 CAUTI 的黃金準則在於維持系統封閉性與減少逆行性感染。維持封閉系統（A）可防止細菌進入尿管；每日清潔會陰部（B）可移除附著的細菌；每日評估留置必要性（D）是減少感染最有效的手段，因為越早拔除風險越低；維持引流袋低於膀胱（E）利用重力確保尿液流動，防止尿液逆流回膀胱。選項 C 是錯誤的，引流袋放在地板會增加污染風險，且可能因位置過低導致重力過大，應該掛在床緣下方的支架上，而非直接接觸地板。護理師應確保管路無扭曲、無滯留尿液，這些都是臨床減少感染風險的關鍵。
The gold standard for preventing CAUTI is maintaining a closed system and minimizing the risk of retrograde infection. Maintaining a closed drainage system (A) prevents bacterial entry into the catheter; daily perineal cleansing (B) removes adherent bacteria; daily assessment of the ongoing need for the catheter (D) is the most effective measure for reducing infection, because earlier removal lowers the risk; and keeping the drainage bag below the level of the bladder (E) uses gravity to ensure urine flow and prevent reflux back into the bladder. Option C is incorrect: placing the drainage bag on the floor increases contamination risk and may also produce excessive gravitational drag; the bag should hang on a support below the bed rail rather than touch the floor. The nurse should also ensure that tubing is not kinked or pooled with urine, which is also key to clinically reducing infection risk.
美國醫院極度強調 CAUTI 的護理紀錄，護理師必須在電子病歷中每日勾選「為什麼需要留置尿管」，若無合適理由需即時與醫師討論拔除；台灣則多依據醫師醫囑進行拔除，護理師較少主動要求醫師拔除尿管，除非出現明顯感染徵象。