— 照護管理 · MEDIUM · SATA —
下列哪些屬於醫療照護中的「從不應發生事件（Never Events）」？（選所有適合的）
Which of the following are examples of 'Never Events' in healthcare? (Select all that apply.)
- ASurgery performed on the wrong body part✓ 正解在錯誤的身體部位進行手術
- BPatient death associated with a medication error✓ 正解與給藥錯誤相關的病人死亡
- CDevelopment of Stage 3 or 4 pressure ulcer during admission✓ 正解住院期間發展為第三或第四期壓瘡
- DPatient falls during physical therapy物理治療期間病人跌倒
- ERetained foreign object in a patient after surgery✓ 正解手術後病人體內遺留異物
— Explanation · 中文詳解 —
Never Events 是指重大、可預防的醫療過失。包括手術部位錯誤、術後體內遺留異物、住院期間發生重度壓瘡、醫療失誤導致死亡等。跌倒（D）雖然嚴重，但屬於病人安全指標，不一定被歸類為嚴格定義下的 Never Event。
'Never Events' refers to serious, preventable medical errors, including wrong-site surgery, foreign objects retained after surgery, the development of a severe (Stage 3 or 4) pressure ulcer during admission, and death caused by a medical error. Although falls (D) are serious, they are patient safety indicators and are not necessarily classified under the strict definition of a Never Event.
✦ 台美臨床差異
美國 CMS 對 Never Events 有明確的停扣給付處罰；台灣則納入醫療品質指標考核，政策導向相同。