護理師準備給予周邊中心靜脈導管（PICC）藥物，防止感染的最優先動作為何？
A nurse is preparing to administer medication via a peripherally inserted central catheter (PICC). Which action is priority to prevent infection?
- AChange the IV tubing every 24 hours每 24 小時更換靜脈輸液管路
- BFlush the line with normal saline after medication給藥後以生理食鹽水沖洗導管
- CDon sterile gloves before accessing the line接觸導管前戴無菌手套
- DScrub the access hub with an antimicrobial agent for 15 seconds✓ 正解以抗菌劑搓揉穿刺接頭 15 秒
靜脈導管相關血流感染（CRBSI）最常見的原因是病原體從導管接頭進入系統。使用酒精棉片或氯己定徹底擦拭接口（Scrub the hub）至少 15 秒，能有效去除生物膜並減少菌落數。無菌手套雖好，但徹底消毒接頭更為關鍵；沖洗管路防止阻塞， tubing 更換頻率依醫院指引，非最優先。
The priority intervention to prevent catheter-related bloodstream infections is scrubbing the access hub with an antimicrobial agent for at least 15 seconds to remove biofilm and microorganisms. While sterile gloves are beneficial, rigorous disinfection of the hub is the most critical step in maintaining aseptic technique. Flushing ensures patency but does not primarily prevent infection, and tubing changes follow specific protocols rather than serving as the immediate priority for hub access.
美國醫院針對 CLABSI 預防有嚴格的 Bundles，台灣臨床執行 Scrub the hub 的時間觀念日漸提升。