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。
病房暴发诺如病毒感染期间,工作人员在护理患者后应采用哪种手卫生方法?
A nurse cannot find a confused patient who was in their room 15 minutes ago. What should the nurse do first?
A nurse posts about an "interesting patient" on social media without naming them. Why is this a problem?
An older patient with diarrhoea for three days is dizzy on standing and passing small amounts of dark urine. What is the most likely problem?
人们通常如何感染 Legionella pneumophila?
为什么克拉维酸等 β-内酰胺酶抑制剂要与阿莫西林联用?
答案: C · 用肥皂和水洗手
酒精手消毒剂不能可靠地杀灭诺如病毒,所以应使用肥皂和水洗手,通过机械作用将其清除。同时还应采取接触传播预防和彻底的环境清洁。
答案: C · Alert staff and security at once, following the missing-patient procedure
A missing vulnerable patient is an emergency. The nurse immediately activates the facility’s missing-patient procedure so a search starts, and the provider and family are informed per policy.
答案: A · The patient may still be identifiable, which breaches confidentiality
Details such as the ward, the condition or the date can reveal who a patient is. Professional codes forbid sharing patient information on social media, even without names.
答案: D · Dehydration from fluid loss
Diarrhoea causes loss of water and electrolytes. Postural dizziness and concentrated low-volume urine show dehydration, which needs fluid replacement, electrolyte checks and close monitoring.
答案: C · 吸入来自被污染水系统的气溶胶
军团菌在温水系统中生长。人吸入被污染的气溶胶后可能患上军团病,这是一种严重的肺炎。它通常不在人与人之间传播。
答案: B · 它们保护阿莫西林不被破坏它的细菌酶分解
β-内酰胺酶会水解 β-内酰胺环。克拉维酸与这些酶结合,使阿莫西林对产 β-内酰胺酶的细菌保持活性。
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