下列哪一位病人發生醫療照護相關感染（HAI）的風險最高？
Which of the following clients is at the highest risk for developing a healthcare-associated infection (HAI)?
- AA 25-year-old with a fractured radius25歲桡骨骨折病人
- BAn 80-year-old with an indwelling urinary catheter✓ 正解80歲留置導尿管病人
- CA 50-year-old with a primary diagnosis of asthma50歲原發性氣喘診斷病人
- DA 40-year-old receiving oral antibiotics for sinusitis40歲接受口服抗生素治療鼻竇炎病人
醫療照護相關感染（Healthcare-associated infection, HAI）的風險主要與病人的免疫狀態、侵入性裝置的使用以及住院時間長短有關。留置導尿管（Indwelling urinary catheter）是導致導尿管相關泌尿道感染（CAUTI）的最主要風險因子，因為導尿管破壞了尿道的自然屏障，並為細菌提供了逆行性感染的通道。高齡病人通常伴隨免疫功能下降與慢性疾病，使其更易受感染。相比之下，骨折或氣喘等非侵入性治療項目，若無其他併發症，其發生 HAI 的機率遠低於長期留置導尿管的病人。
An 80-year-old client with an indwelling urinary catheter is at the highest risk for healthcare-associated infections because invasive devices breach natural body barriers and provide a pathway for bacterial entry. Elderly clients often have compromised immune systems, further increasing susceptibility. Clients with fractures, asthma, or those taking oral antibiotics without invasive devices generally present a lower immediate risk for such infections.
在美國，CAUTI 的監測與預防是醫院品質評核（如 CMS 的 Value-Based Purchasing Program）的重要指標。美國護理師對於導尿管的適應症（Indications）審核極為嚴格，通常每日需評估是否能移除，護理師有權主動詢問醫師移除需求。