— 安全與感染控制 · HARD · MCQ —
哪項護理措施對預防呼吸器相關肺炎（VAP）最有效？
Which nursing intervention is most effective in preventing ventilator-associated pneumonia (VAP)?
- AMaintaining the head of the bed at 30 to 45 degrees✓ 正解將床頭維持在 30 至 45 度
- BLimiting the use of oral suctioning限制口腔抽吸的使用
- CAdministering antibiotics prophylactically預防性給予抗生素
- DCleaning the ventilator tubing every 24 hours每 24 小時清潔呼吸器管路
— Explanation · 中文詳解 —
抬高床頭 30-45 度是 VAP Bundle Care 的核心，利用重力減少分泌物逆流導致誤吸。頻繁更換管路反而增加污染風險（除非明顯髒污）；預防性使用抗生素不建議（會產生抗藥性）；口咽抽吸應根據需求執行，而非限制。
Maintaining the head of the bed at 30 to 45 degrees is a core component of the VAP bundle, as it uses gravity to reduce the risk of aspiration of gastric contents. Frequent tubing changes can increase bacterial exposure, prophylactic antibiotics promote resistance, and oral suctioning should be performed based on need rather than limited.
✦ 台美臨床差異
兩地均導入 VAP Bundle 照護，台灣臨床在口腔清潔（Chlorhexidine）與抬頭設定的執行度上持續優化中。