為了降低留置導尿管病人發生導尿管相關尿路感染 (CAUTI) 的風險，護理師應執行下列哪項措施？
Which of the following interventions should the nurse perform to reduce the risk of a catheter-associated urinary tract infection (CAUTI) for a client with an indwelling catheter?
- AEncourage the client to sit in a tub bath daily鼓勵病人每日進行盆浴
- BKeep the drainage bag below the level of the bladder✓ 正解將引流袋保持在膀胱水平以下
- CPerform catheter care with povidone-iodine every shift每班次使用聚維酮碘進行導尿管護理
- DIrrigate the catheter with sterile saline daily每日以無菌生理食鹽水沖洗導尿管
本題核心概念是預防導尿管相關尿路感染（Catheter-Associated Urinary Tract Infection, CAUTI）。CAUTI 是醫療照護相關感染中常見的一種，主要原因是微生物沿著導尿管進入膀胱。護理師的介入措施應著重於維持導尿管系統的無菌性，並避免尿液逆流。 正確答案「保持集尿袋低於膀胱水平」是透過重力原理，確保尿液單向流動，避免集尿袋內的尿液逆流回膀胱，從而降低細菌進入膀胱的風險。這是預防 CAUTI 最基本且關鍵的物理性措施。 其他選項則可能不正確、不必要或甚至增加感染風險。在臨床實務中，預防 CAUTI 的策略是多方面的，但維持引流系統的正確位置和閉鎖性是首要任務。
Keep the drainage bag below the level of the bladder to use gravity for preventing urine reflux, which is a key measure in preventing catheter-associated urinary tract infections. Tub baths should be avoided as they can submerge the catheter entry site and increase infection risk. Routine antiseptic catheter care and daily irrigation are not recommended as they can break the closed system or cause unnecessary irritation.
美國 CDC 針對 CAUTI 有極嚴格監測與報告機制；台灣則將其納入醫院評鑑重點指標。