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。
Why is keeping a patient warm (normothermia) during surgery part of infection prevention?
在为中心静脉导管无菌换药时,一名同事越过打开的无菌区把一卷胶带递给护士。护士应怎么做?
In adult basic life support, how long should the rescuer take to check for normal breathing?
A patient has a generalised tonic-clonic seizure in bed. What should the nurse do?
哪种生物是烧伤和囊性纤维化患者感染的常见病原,并能产生绿色色素?
血培养阳性,显示成簇的革兰氏阳性球菌。最可能是哪种微生物?
答案: D · Low body temperature reduces blood flow and immune function in the wound
Hypothermia causes vasoconstriction and less oxygen in the wound, which weakens the immune defense. Keeping the patient warm is linked to fewer surgical site infections.
答案: A · 将该无菌区视为已污染,重新铺设
用非无菌的手臂或物品越过无菌区,即使没有接触也会造成污染。应更换无菌区,非无菌物品应从无菌区旁边传递,而不是从上方越过。无菌状态存疑时,应视为已污染。
答案: C · No more than 10 seconds
Rescuers look, listen and feel for normal breathing for no more than 10 seconds. If breathing is absent or not normal, they call for help and start CPR.
答案: C · Protect the head, move objects away, time it and do not restrain
During a seizure the nurse keeps the patient safe, notes the time and the features, and never puts anything in the mouth. Afterwards the patient is placed in the recovery position and the airway checked.
答案: D · Pseudomonas aeruginosa
铜绿假单胞菌(Pseudomonas aeruginosa)是烧伤、机械通气患者和囊性纤维化患者肺部的机会性病原体。它对许多抗生素天然耐药。
答案: B · Staphylococcus
葡萄球菌呈葡萄串状成簇生长;链球菌和肠球菌呈链状或成对。奈瑟菌是革兰氏阴性双球菌。
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