— 安全與感染控制 · HARD · MCQ —
護理師準備置入周邊靜脈導管(IV),哪項行為符合無菌技術原則?
A nurse is preparing to insert a peripheral IV catheter. Which action demonstrates adherence to sterile technique?
- AWearing sterile gloves for every IV insertion每次置入靜脈導管時都戴無菌手套
- BAllowing the antiseptic to dry completely before insertion✓ 正解在置入前讓消毒劑完全乾燥
- CTouching the catheter hub with sterile gloves用無菌手套觸碰導管接頭
- DCleaning the site with alcohol in a circular motion以環狀動作用酒精清潔部位
— Explanation · 中文詳解 —
靜脈導管(IV)置入屬於無菌技術(sterile technique)範疇,目的是防止外源性細菌進入血液系統。臨床關鍵在於消毒劑的化學作用需時間發揮,若酒精或氯己定(chlorhexidine)未完全乾燥即進行穿刺,消毒劑不僅無法達到最高殺菌效力,還可能隨針頭進入皮下或血管,造成局部組織刺激或疼痛。確保消毒劑完全自然乾燥是預防導管相關感染(CRBSI)的關鍵步驟。
Antiseptics like chlorhexidine or alcohol require adequate contact time to effectively kill bacteria; inserting the catheter before the solution dries compromises sterility and may cause tissue irritation. Thus, allowing the antiseptic to dry completely is the correct sterile technique.
✦ 台美臨床差異
在美國臨床,置入周邊靜脈導管通常使用乾淨手套(Clean gloves),而非無菌手套(Sterile gloves)。此題選項 A 的敘述過於絕對,故選 B 為最符合無菌原則的操作細節。