— 降低風險 · HARD · MCQ —
哪項護理介入措施對於預防呼吸器相關肺炎（VAP）最有效？
Which of the following nursing interventions is most effective in preventing ventilator-associated pneumonia (VAP)?
- AUsing humidifiers for all air delivery對所有空氣給送設備使用加濕器
- BMaintaining head of bed elevation at 30 to 45 degrees✓ 正解維持床頭抬高 30 至 45 度
- CAdministering prophylactic antibiotics daily每日給予預防性抗生素
- DSuctioning the airway every hour consistently規律地每小時進行氣道抽吸
— Explanation · 中文詳解 —
將床頭抬高 30-45 度能有效減少口咽分泌物倒流至下呼吸道，這是 VAP 集束照護（VAP bundle）中最核心的步驟。定時抽痰非 VAP 預防之必要指標，應依病況需求（PRN）；預防性使用抗生素會增加抗藥性；潮濕瓶容易污染，需嚴格控管。
Maintaining the head of the bed elevated at 30 to 45 degrees is a key component of the ventilator-associated pneumonia (VAP) prevention bundle, as it reduces the risk of aspiration of oropharyngeal secretions. Routine suctioning and prophylactic antibiotics are not recommended for prevention due to risks of mucosal trauma and antimicrobial resistance, respectively.
✦ 台美臨床差異
兩地均廣泛採用 VAP Bundle 照護策略，包含口腔護理（Chlorhexidine）、抬高床頭與減重型氣管內管。