— 照護管理 · EASY · MCQ —
對於長期臥床的病人，下列哪項護理措施預防壓瘡最有效？
Which of the following nursing interventions is the most effective in preventing pressure injuries in a bedbound client?
- AApplying a high-quality barrier cream every shift每班次塗抹高品質的隔離霜
- BElevating the head of the bed to 45 degrees將床頭抬高至 45 度
- CMassaging the bony prominences to increase circulation按摩骨突處以增加血液循環
- DRepositioning the client at least every two hours✓ 正解至少每兩小時為個案翻身
— Explanation · 中文詳解 —
預防壓瘡的核心原則是減壓（Offloading）。每兩小時翻身一次是臨床實證最有效的預防手段，能有效中斷壓力持續對皮膚及深層組織造成的灌流受損。按摩突出骨處已被研究證實會造成組織損傷，應避免；抬高床頭過高會增加剪切力。
The most effective evidence-based intervention for preventing pressure injuries is repositioning the client at least every two hours to redistribute pressure and restore tissue perfusion. Other measures like barrier creams are adjunctive, while massaging bony prominences is contraindicated as it can cause tissue damage, and excessive head-of-bed elevation increases shear forces.
✦ 台美臨床差異
美台對壓瘡預防的臨床規範一致，皆將定期翻身作為核心標準護理（Standard of Care）。