為預防中央靜脈導管（CVAD）病人的感染，護理師應優先採取哪些措施？（選所有適合的）
Which of the following actions should the nurse prioritize to prevent infection in a client with a central venous access device (CVAD)? (Select all that apply.)
- APerform hand hygiene before touching the device or site✓ 正解接觸裝置或部位前執行手部衛生
- BScrub the access hub with an antiseptic agent for 15 seconds✓ 正解以消毒劑擦拭接入埠至少15秒
- CChange the sterile dressing if it becomes damp or loose✓ 正解若敷料受潮或鬆脫則更換無菌敷料
- DUse a mask during the dressing change for both nurse and client✓ 正解更換敷料期間護理師與病人都應佩戴口罩
- EFlush the catheter with heparinized saline every 8 hours每8小時以肝素化生理食鹽水沖洗導管
預防導管相關血液感染（CRBSI）的核心是無菌技術。洗手（A）是感染管制基礎；接觸輸液連接埠前必須用力擦拭（B）至少 15 秒，確保生物膜被清除；敷料（C）若受潮或鬆脫即失去阻隔外來病原體的屏障，應立即更換；執行更換敷料時（D）雙方配戴口罩可減少呼吸道飛沫污染。關於 E，雖然肝素沖管能防止血栓，但頻率應根據各醫院政策與導管類型，並非預防「感染」的核心策略，且過度沖洗反而增加操作觸碰頻率，故非預防感染之優先必要選項。臨床思路應聚焦於阻斷病原體進入導管系統的每一道環節。
Preventing central line-associated bloodstream infections requires strict adherence to aseptic technique, including hand hygiene, scrubbing access hubs with antiseptics for at least 15 seconds, and replacing damp or loose dressings promptly. Healthcare providers and clients should wear masks during dressing changes to minimize contamination from respiratory droplets.
美國護理界針對 CVAD 護理有嚴格的 Bundle 制度與稽核機制，違規者會受單位教育；台灣醫院則多依賴醫院內感染管制的 SOP 指導，對於沖管頻率與抗生素鎖定治療（Antibiotic Lock）的臨床執行多半依循醫師個別化醫囑。