— 安全與感染控制 · EASY · MCQ —
護理師照護一位困難梭狀桿菌陽性的病人，下列哪項措施優先級最高？
A nurse is caring for a client who has a positive result for Clostridium difficile. Which action is the highest priority for the nurse to implement?
- AWear a N95 respirator when entering the room進入房間時佩戴 N95 呼吸防護具
- BPerform hand hygiene using an alcohol-based hand rub使用酒精性搓手液進行手部衛生
- CPlace the client on droplet precautions將病人實施飛沫隔離
- DClean the client's room with a bleach-based disinfectant✓ 正解使用含氯消毒劑清潔病人房間
— Explanation · 中文詳解 —
困難梭狀桿菌（C. difficile）會產生芽孢，酒精無法殺滅芽孢，必須以肥皂洗手，並使用漂白水（含氯消毒劑）清潔環境。這類病原體需採接觸隔離措施，而非飛沫隔離或戴 N95。臨床重點在於嚴格執行接觸防護以防止芽孢擴散至其他住院病人。
Clostridium difficile produces spores that are resistant to alcohol-based hand rubs, requiring hand washing with soap and water instead. The highest priority is to clean the environment with a bleach-based disinfectant, which effectively kills spores, and to implement contact precautions. N95 respirators and droplet precautions are not indicated for this pathogen.
✦ 台美臨床差異
美台對於 C. diff 的環境消毒皆要求含氯製劑，台灣臨床特別強調洗手盆的距離與洗手查核機制。