護理師為高齡住院病人進行入院評估，下列哪項措施對於維護病人安全最優先？

核心概念：入院評估（admission assessment）是護理過程的起始點，對於高齡（older adult）病人而言，其生理功能可能較弱，更容易面臨各種風險，特別是跌倒。因此，識別並預防潛在風險是護理師的首要任務。 為何正確答案 A 對：跌倒風險評估（Fall risk assessment）是高齡病人入院時最優先的安全措施。透過標準化的評估工具（如 Morse Fall Scale, Hendrich II Fall Risk Model），護理師可以系統性地識別影響病人跌倒風險的各種因素（如年齡、病史、用藥、活動能力、認知狀態、先前跌倒史等），並據此制定個別化的預防計畫，及早介入，防止住院期間發生跌倒。 為何其他選項優先級較低： B. 核對醫囑（Verify the provider's admission orders）：核對醫囑是確保病人得到適當醫療照護的重要環節，但其優先級通常在於確保治療的準確性，而非立即的病人安全。跌倒的風險是病人入住環境後立即面臨的威脅，需要優先處理。 D. 藥物盤點（Obtain a complete medication reconciliation）：藥物盤點對於釐清病人所有用藥，預防藥物交互作用和錯誤至關重要，也是安全照護的一部分。然而，相較於立即的跌倒風險，藥物盤點的緊迫性稍低，且通常需要病人或家屬提供資訊，評估過程較長。 C. 告知病人使用呼叫鈴系統（Orient the client to the call light system）：告知病人如何使用呼叫鈴（call light）是提供病人照護和預防跌倒的重要步驟，讓病人需要協助時能及時通知護理人員。但這是在跌倒風險評估之後，根據評估結果所採取的具體預防措施之一。若病人本身跌倒風險極高，則應先進行評估，再決定如何最佳地使用呼叫鈴及其他輔助措施。 臨床思路/安全優先：高齡病人的入院安全，首要考量是預防跌倒。跌倒可能導致嚴重的身體傷害，延長住院時間，甚至影響日後的活動能力。因此，護理師應將跌倒風險評估置於入院評估的首位，以確保能及時採取最有效的預防措施，保護病人安全。

Core concept: The admission assessment is the starting point of the nursing process. For older adults, whose physiologic function may already be reduced, they are at greater risk for various hazards, particularly falls. Identifying and preventing these risks is therefore the nurse's first priority. Why correct answer A is correct: A fall risk assessment is the highest-priority safety measure for older adults at admission. Using standardized tools (such as the Morse Fall Scale or Hendrich II Fall Risk Model), the nurse can systematically identify factors influencing fall risk (such as age, medical history, medications, mobility, cognition, and previous falls) and develop an individualized prevention plan, allowing early intervention to prevent falls during hospitalization. Why the other options have lower priority: B. Verifying the provider's admission orders: Verifying orders is important for ensuring appropriate medical care, but the priority is to ensure treatment accuracy rather than immediate patient safety. Fall risk is an immediate threat that the patient faces upon entering the environment and must be addressed first. C. Obtaining a complete medication reconciliation: Medication reconciliation is critical to clarify all medications, prevent drug interactions and errors, and is part of safe care. However, compared with the immediate fall risk, medication reconciliation is somewhat less urgent and the assessment process is longer because it typically requires information from the patient or family. D. Orienting the client to the call light system: Orienting the client to the call light system is an important step in patient care and fall prevention, enabling the client to notify staff when assistance is needed. However, this comes after fall risk assessment and is one specific preventive measure determined by the results of that assessment. If the patient is at extremely high risk for falls, the assessment should be performed first to determine how best to use the call light and other supportive measures. Clinical reasoning/safety priority: For admission safety in older adults, the foremost consideration is fall prevention. Falls can cause severe injuries, prolong hospitalization, and impair future mobility. The nurse should therefore place fall risk assessment at the top of the admission assessment to ensure timely and effective preventive measures and protect patient safety.