— 降低風險 · MEDIUM · SATA —
護理師對於留置導尿管的病人，應採取哪些措施以降低感染風險？（選所有適合的）
Which of the following interventions should the nurse perform to reduce the risk of infection in a client with an indwelling urinary catheter? (Select all that apply.)
- AKeep the drainage bag below the level of the bladder✓ 正解保持引流袋低於膀胱水平
- BPerform perineal care daily and after every bowel movement✓ 正解每日及每次排便後執行會陰護理
- CRoutinely irrigate the catheter to maintain patency常規沖洗導尿管以維持通暢
- DEnsure the drainage bag is emptied regularly✓ 正解確保定期排空引流袋
- ESecure the catheter to the client's thigh✓ 正解將導尿管固定於病人大腿上
— Explanation · 中文詳解 —
留置導尿管的感染預防核心在於封閉系統的完整性與避免逆行性感染。引流袋需低於膀胱以利用重力引流，防止尿液倒流（A）；會陰清潔可減少尿道口細菌聚集（B）；定期清空引流袋可防止尿液積滯造成的細菌滋生（D）；妥善固定導管可防止導管滑動刺激尿道黏膜（E）。灌洗（C）會破壞系統完整性，除非有阻塞，否則不建議常規進行。
Maintaining a closed drainage system is crucial to prevent catheter-associated urinary tract infections. Keeping the bag below the bladder prevents reflux, while regular perineal hygiene and emptying reduce bacterial colonization. Securing the catheter minimizes urethral trauma, whereas routine irrigation increases infection risk and should be avoided.
✦ 台美臨床差異
美國醫院實務中，對於 CAUTI 的預防（Bundle care）非常嚴格，護理師需每日評估導尿管的必要性，一旦無醫囑需求即應儘速移除。