— 降低風險 · EASY · MCQ —
護理師照顧一位留置導尿管的病人。下列哪項護理動作能最小化導尿管相關尿路感染（CAUTI）風險？
A nurse is caring for a client with an indwelling urinary catheter. Which nursing action minimizes the risk of catheter-associated urinary tract infection (CAUTI)?
- AClean the meatus with alcohol prep pads twice a day每日兩次以酒精棉片清潔尿道口
- BIrrigate the catheter with sterile water daily每日以無菌水沖洗導尿管
- CKeep the drainage bag below the level of the bladder✓ 正解保持引流袋低於膀胱水平
- DDisconnect the drainage system to empty the bag斷開引流系統以排空集尿袋
— Explanation · 中文詳解 —
維持引流袋低於膀胱高度是利用重力引流，防止尿液逆流至膀胱引發感染。灌洗導管除非有堵塞，否則屬侵入性操作，增加感染風險。斷開引流系統會破壞密閉性，增加細菌入侵機會。清潔尿道口應使用清水或溫和肥皂，酒精可能刺激黏膜。
Keeping the drainage bag below the level of the bladder uses gravity to prevent urine reflux, which is a primary cause of catheter-associated urinary tract infections. Routine irrigation or disconnecting the system breaks the closed circuit and increases infection risk, while alcohol can irritate the sensitive meatal tissue.
✦ 台美臨床差異
兩地均致力於 CAUTI 的減量，美國護理師常依 'Bundle' 進行稽核；台灣亦有相關感染管制指引，強調非必要即儘早移除導尿管。