護理師準備執行無菌傷口換藥。護理師應首先執行哪項動作？
A nurse is preparing to perform a sterile dressing change. Which action should the nurse perform first?
- ADon sterile gloves戴上無菌手套
- BClean the wound with normal saline用生理食鹽水清潔傷口
- COpen the sterile dressing kit打開無菌敷料包
- DPerform hand hygiene✓ 正解執行手部衛生
核心概念在於醫療程序的標準作業流程與感染預防。手部衛生（Hand hygiene）是所有臨床技術中最優先、最基礎的一步。在執行無菌換藥前，護理師的手部可能帶有來自環境或其他病人的暫時性菌叢。如果在接觸無菌物品或病人傷口前未先清潔雙手，將直接導致交叉污染。根據無菌技術原則，護理師應先洗手，接著準備環境與器材，最後才穿戴無菌手套。這符合臨床安全與預防院內感染的優先順序（Priority）。
The core concept is the standard operating procedure and infection prevention for clinical procedures. Hand hygiene is the most fundamental and highest-priority step in all clinical techniques. Before performing a sterile dressing change, the nurse's hands may carry transient flora from the environment or other patients. Touching sterile supplies or the patient's wound without first cleaning the hands will directly cause cross-contamination. Per aseptic technique, the nurse should first perform hand hygiene, then prepare the environment and supplies, and finally don sterile gloves. This sequence reflects the priorities of clinical safety and prevention of hospital-acquired infection.
台美在手部衛生的重要性上完全一致。但在 NCLEX 考試中，題目若問「First action」，考生常會跳過洗手去選「具體技術動作」。記住，NCLEX 極度強調「洗手」作為所有程序的第一步，這是評估安全意識的關鍵。