護理師照護一位局部皮膚感染 MRSA 的病人。護理師的哪項行為需要護理長介入糾正？
A nurse is caring for a client with a localized MRSA skin infection. Which action by the nurse would require intervention by the charge nurse?
- AWearing a gown only when a splash is expected✓ 正解僅在預期有噴濺時穿著隔離衣
- BUsing a dedicated stethoscope for the client為該病人使用專用聽診器
- CPerforming hand hygiene before and after client contact在接觸病人前後執行手部衛生
- DEnsuring the client is in a private room確保病人安置於單人病房
核心概念是接觸防護（Contact precautions）的標準規範。MRSA（抗藥性金黃色葡萄球菌）主要透過直接接觸病人或其周邊環境（如床欄、床單）傳播。根據 CDC 指引，對於採取接觸隔離的病人，醫療人員在「進入病房」時就必須穿戴隔離衣與手套，不論是否預期有噴濺。這是因為環境表面可能已被病菌污染。護理長的介入是必要的，因為護理師將「標準防護（Standard precautions）」的原則誤用於「接觸防護」，這會增加細菌在單位內擴散的風險。
The core concept is the standard for contact precautions. MRSA spreads mainly through direct contact with the client or their environment (e.g., bedrails, linens). According to CDC guidelines, for clients on contact precautions, healthcare workers must don a gown and gloves upon entering the room, regardless of whether splashing is anticipated, because environmental surfaces may already be contaminated. Intervention by the charge nurse is necessary because the nurse is applying standard precaution principles to a situation that requires contact precautions, which increases the risk of spreading the organism within the unit.
在美國 NCLEX 考試中，對於 Contact Precautions 的要求是「Gown and gloves upon entry」，非常死板且嚴格。台灣部分醫院在臨床執行上，若不直接接觸病人可能不一定穿隔離衣，但在考試中必須遵守最嚴格的 CDC 標準。