陪病者在小兒科病房中的感染管制角色與挑戰

The Role and Challenges of Caregivers in Infection Control in Pediatric Wards

小兒科住院病童常需家屬全程於病房陪伴與照顧，惟陪病者（通常為病童父母或主要照顧者）在提供身心支持的同時，亦可能成為感染在院內傳播的媒介。因此，探討陪病者於小兒科病房的感染管制角色與挑戰，對於確保病童安全與維持院內良好之感染控制品質，實有其必要性。本綜論從陪病者在小兒科病房的重要性出發，說明其在感染管制中所扮演的角色，並彙整相關文獻以歸納出實務上五項主要的感染管制措施，包括：手部衛生、佩戴個人防護裝備、環境清潔消毒、探視與陪病管理、健康教育宣導等。同時，本綜論亦整理陪病者在執行上述措施時所面臨的挑戰，例如配合度不高、認知不足及心理壓力等。最後，根據文獻提出強化陪病者感染管制效能之策略與建議，以期提升小兒科病房之感染預防成效，保障病童健康。除了傳統宣導方式，亦可導入數位與互動式衛教工具，例如開發手機App、動畫影片與互動遊戲，結合QR碼提供多語言衛教素材，搭配感應裝置於適當時機提醒洗手。研究顯示，使用兒童友善產品與互動教材可使洗手遵從率提升約38%。這些工具兼具趣味性和教育性，有助於陪病者及病童主動學習。近期研究對陪病者的手衛生依從情況提出警訊：觀察研究顯示，陪病者實際洗手率僅約9%至5%，而自我報告卻高達80%以上，系統性回顧亦指出醫院訪客平均遵從率僅37%。因此，除了提供正確的洗手時機與步驟教育外，建議在病房入口設置顯眼的手部清潔站，使用感應式聲光提示，並結合互動式教材（如Soaper Stars計畫）提升洗手動機。

Hospitalized pediatric patients often require a family member to remain at the bedside and provide continuous care. While these attendants, typically parents or other primary caregivers, offer crucial psychosocial support, they may also serve as vectors for nosocomial infection. Therefore, it is essential to clarify the attendant’s role and the challenges they face in infection prevention within pediatric wards to safeguard children and maintain high-quality infection-control standards. This narrative review highlights the importance of attendants in pediatric care and outlines their roles in infection control. Drawing on current literature, it identifies five key practical measures: hand hygiene, use of personal protective equipment (PPE), environmental cleaning and disinfection, regulation of visiting and attendant practices, and health-education outreach. The review also summarizes the main challenges attendants face when implementing these measures—namely, limited compliance, insufficient knowledge, and psychological stress. Finally, it proposes evidence-based strategies to enhance attendants’effectiveness in infection control, thereby improving prevention efforts in pediatric wards and protecting the health of hospitalized children.