護理師照護一位感染困難梭狀芽孢桿菌的病人，為預防擴散，哪項措施最優先？
A nurse is caring for a client with Clostridium difficile infection. Which action is the priority to prevent the spread of this organism?
- AWash hands with soap and water after patient contact✓ 正解接觸病人後用肥皂和水洗手
- BWear a N95 respirator during care照護期間佩戴 N95 呼吸器
- CUse alcohol-based hand sanitizer before entering the room進入房間前使用酒精性乾洗手
- DKeep the client in a negative pressure isolation room將病人安置於負壓隔離室
困難梭狀芽孢桿菌（Clostridioides difficile, C. diff）會產生具有強大抵抗力的芽孢，對酒精類乾洗手液具有抗性。臨床預防傳播的核心在於機械性移除（Mechanical removal），即透過肥皂與水洗手將芽孢沖洗掉。在感染控制中，處理 C. diff 病人時，手部衛生必須嚴格執行肥皂洗手，而非僅依賴酒精製劑，以達到預防交叉感染的目的。
Clostridioides difficile (C. diff) produces highly resistant spores that are not eliminated by alcohol-based hand sanitizers. The core of clinical prevention is mechanical removal — washing hands with soap and water to physically rinse spores away. In infection control, hand hygiene when caring for C. diff patients must consist of soap-and-water handwashing rather than relying solely on alcohol-based products, in order to prevent cross-transmission.
美國醫院對於 C. diff 感染控制極為嚴格，通常在照護此類病人時會明確要求使用 Soap and Water 進行手部衛生，且許多醫院規定在離開房間後即使戴著手套，也必須洗手。台灣臨床亦有類似規範，但美國醫療機構對 compliance 的稽核（如 Infection Control Department 的監測）通常更為頻繁。