感染控制与患者安全：速成包

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。

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1公式与方法

感染控制与患者安全

方法

  1. 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。
  2. 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）。
  3. 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。
  4. 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。
  5. 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。

2练习题

1.感染控制与患者安全中等

How should a portable oxygen cylinder be kept in a patient’s room?

  1. ASecured upright in a stand or holder
  2. BPlaced next to a heater to keep it warm
  3. CLying loose on the floor beside the bed
  4. DLaid on the bed next to the patient
2.感染控制与患者安全困难

According to the “Swiss cheese” model of error, why do errors reach patients?

  1. AWeaknesses in several layers of defense line up at the same time
  2. BPatients often do not follow their care instructions
  3. CTechnology fails more often than people do
  4. DOne careless person makes a mistake that no system could stop
3.护理学基础中等

A patient has pneumonia in the right lung only. In which side-lying position is oxygenation usually best?

  1. ALying on the right side
  2. BLying face down
  3. CLying on the left side
  4. DLying flat on the back
4.护理学基础困难

Which feature suggests that a sore area is a moisture lesion rather than a pressure ulcer?

  1. AA circular area of damage directly over the sacral bone
  2. BDiffuse, irregular redness in a skin fold, not over a bone
  3. CA dark area of necrotic tissue over the heel
  4. DA deep wound with straight edges over the hip
5.微生物学中等

哪种细菌引起百日咳？

  1. AMycoplasma pneumoniae
  2. BBordetella pertussis
  3. CHaemophilus influenzae
  4. DCorynebacterium diphtheriae
6.微生物学困难

R0（基本再生数）为 3 是什么意思？

  1. A百分之三的感染者死亡
  2. B需要接种三剂疫苗
  3. C感染持续三天
  4. D在完全易感人群中，平均一个病例会传染另外三个人

3溶液

1.感染控制与患者安全

答案: A · Secured upright in a stand or holder

为什么是这个答案

Oxygen cylinders are under high pressure and can be damaged or cause injury if they fall. They are kept upright in a holder or cart, away from heat and flames.

答案

A · Secured upright in a stand or holder
2.感染控制与患者安全

答案: A · Weaknesses in several layers of defense line up at the same time

为什么是这个答案

Reason’s Swiss cheese model shows that each safety layer, such as prescribing, dispensing, checking and scanning, has weaknesses. Harm happens when the holes in several layers line up, so safety improvement focuses on strengthening the system.

答案

A · Weaknesses in several layers of defense line up at the same time
3.护理学基础

答案: C · Lying on the left side

为什么是这个答案

Gravity sends more blood to the lower lung. Placing the healthy lung down matches more blood flow to the lung that is ventilating well, improving oxygenation.

答案

C · Lying on the left side
4.护理学基础

答案: B · Diffuse, irregular redness in a skin fold, not over a bone

为什么是这个答案

Moisture lesions are usually superficial, diffuse and irregular, often in the natal cleft or skin folds. Pressure ulcers are typically over bony prominences and may have necrotic tissue.

答案

B · Diffuse, irregular redness in a skin fold, not over a bone
5.微生物学

答案: B · Bordetella pertussis

为什么是这个答案

百日咳鲍特菌（Bordetella pertussis）引起长时间的阵发性咳嗽，伴有"鸡鸣样"回声。它对幼小婴儿最危险，这就是许多国家为孕妇提供疫苗接种的原因。

答案

B · Bordetella pertussis
6.微生物学

答案: D · 在完全易感人群中，平均一个病例会传染另外三个人

为什么是这个答案

R0 是在所有人都易感时，一个病例平均引起的继发病例数。群体免疫大约需要 1 − 1/R0 的人群免疫：R0 = 3 时约为 67%。

答案

D · 在完全易感人群中，平均一个病例会传染另外三个人

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