— 安全與感染控制 · EASY · MCQ —
護理師正照護一名因 MRSA 需接觸隔離的病人。執行洗手衛生時，下列哪項做法最正確？
A nurse is caring for a client on contact precautions for MRSA. Which action is the most appropriate when performing hand hygiene?
- AWash hands with soap and water after removing gloves✓ 正解脫去手套後以肥皂和水洗手
- BWear double gloves and hand sanitize between each戴雙層手套，並在每次操作間隙進行手部消毒
- CUse alcohol-based hand sanitizer immediately upon leaving the room離開房間後立即使用酒精性手部消毒液
- DPerform surgical scrub for 5 minutes before entering the room進入房間前進行五分鐘的外科刷手
— Explanation · 中文詳解 —
針對產孢子細菌（如 C. difficile）或抗藥性微生物，使用肥皂與水洗手是最佳防禦。MRSA 雖可使用酒精，但在接觸隔離房間後，肥皂洗手能更有效移除環境中的菌落。C 選項若酒精乾燥不完全效果不佳；B 為錯誤防護習慣；D 為外科手術需求。
For clients on contact precautions, washing hands with soap and water after removing gloves is the gold standard for preventing cross-contamination, as it mechanically removes pathogens more effectively than alcohol-based sanitizers. While alcohol sanitizers are useful, soap and water are preferred in contact isolation settings to ensure thorough decontamination of the hands.
✦ 台美臨床差異
台美均強調接觸隔離後的洗手標準，台灣醫院感控指引常要求接觸抗藥性菌種後優先使用肥皂水而非酒精。