感染控制与患者安全
方法
- 对每位患者都从标准预防开始:手卫生、针对预期暴露的个人防护装备、安全使用锐器。
- 按传播途径追加预防措施:接触传播(隔离衣、手套)、飞沫传播(外科口罩)、空气传播(N95、负压病房)。
- 保持无菌物品的无菌状态:如有疑问就视为不无菌;更换,绝不擦拭。
- 预防环境中的伤害:防跌倒措施,约束仅作为最后手段,火灾时用 RACE 和 PASS。
- 核对给药的正确原则、两个身份识别信息,以及对高警示药物的额外保障;报告差错和险兆事件。
公式表、每个专题的关键方法步骤和 6 道练习题,完整解答附在最后。
A nurse wants to set up a sterile field in the morning for a procedure that will take place after lunch. What is correct?
A chemical cloud has been released near the hospital, and authorities order “shelter in place”. What should staff do?
一名患者几乎不会说英语。在重要的知情同意谈话中,应由谁来翻译?
A patient says, "I've bought nicotine patches and I'm stopping smoking on Monday." Which stage of change is this?
哪项实验室检测能把 Staphylococcus aureus 与大多数其他葡萄球菌区分开?
为什么在感染后的最初几周 HIV 抗体检测可能呈阴性?
答案: D · Set it up just before the procedure, because a waiting field may become contaminated
The longer a sterile field is exposed, the more likely it is to be contaminated, and an unattended field cannot be considered sterile. It is prepared just before use.
答案: C · Keep everyone inside, close windows and doors and shut off outside air intake
Sheltering in place keeps people inside, away from the hazard. Windows and doors are closed and ventilation systems that bring in outside air are shut off until the all-clear.
答案: D · 专业的医疗口译员
专业口译员能准确翻译并保守秘密。家庭成员,尤其是孩子,可能遗漏内容、加入自己的看法,或因这些信息而承受负担。
答案: C · Preparation
In preparation the person intends to act soon and has taken small steps, such as buying patches. Action begins when they actually stop smoking.
答案: C · 凝固酶试验
S. aureus 产生凝固酶,把纤维蛋白原转化为纤维蛋白。所有葡萄球菌都是革兰氏阳性和触酶阳性,因此这些试验无法区分它们。
答案: A · 机体尚未产生足以检测到的抗体
抗体需要数周才会出现。同时检测 p24 抗原的联合检测或病毒 RNA 检测可以缩短这一窗口期。
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