護理師照護一位艱難梭菌感染的病人。下列哪項預防措施最重要？
A nurse is caring for a client with Clostridium difficile infection. Which precaution is most important for the nurse to maintain?
- AMaintain negative pressure room維持負壓隔離病房
- BPerform hand hygiene using soap and water✓ 正解使用肥皂和水進行手部衛生
- CUse alcohol-based hand sanitizer使用酒精性乾洗手液
- DWear a N95 respirator佩戴 N95 呼吸防護具
艱難梭菌（Clostridium difficile）感染屬於接觸傳播（Contact Precautions）。該菌株會產生具有高度抗藥性的芽孢（spores），而酒精性乾洗手液無法有效殺滅或物理移除這些芽孢。因此，臨床上針對 C. diff 病人，必須使用肥皂與水進行機械式洗手，利用物理摩擦將芽孢沖洗掉，這是預防院內交叉感染最關鍵的步驟。
Clostridium difficile spreads via contact precautions, and its spores are resistant to alcohol-based hand sanitizers. Therefore, the nurse must perform hand hygiene with soap and water to mechanically remove the spores and prevent cross-contamination. Standard isolation protocols require strict adherence to this method rather than relying on chemical disinfection alone.
美國醫院對於 C. diff 病人嚴格執行肥皂洗手，且在接觸病人後一律要求洗手，不能僅依賴手部酒精。台灣臨床實務雖亦知曉此原則，但美國護理稽核（如 Joint Commission）對此項目的執行落實度查核極為嚴格。