內外科病房的護理師準備將任務委派給非執照輔助人員（UAP）。下列哪項任務最適合委派給 UAP？
A nurse on a medical-surgical unit is preparing to delegate tasks to an Unlicensed Assistive Personnel (UAP). Which task is most appropriate for the nurse to delegate to the UAP?
- AProviding discharge instructions to a client with diabetes對糖尿病病人提供出院衛教
- BPerforming an initial assessment on a newly admitted client對新入院病人進行初步評估
- CEvaluating a client's response to pain medication評估病人對止痛藥的反應
- DAssisting a stable client with a bed bath✓ 正解協助病情穩定的病人進行床上擦浴
護理委派的核心原則是區分「專業評估與判斷」與「常規生活照顧」。根據美國護理學會（ANA）的委派五權原則，護理師（RN）不能委派涉及評估（Assessment）、計畫（Planning）、教育（Education）及評價（Evaluation）的任務。選項 D 的床上沐浴屬於常規、非侵入性且結果可預測的日常活動照顧（ADLs），適合委派給 UAP。相較之下，選項 C（評價藥物反應）、A（出院衛教）與 B（初步評估）都涉及臨床判斷與護理專業職責，必須由 RN 親自執行。若將這些任務委派，將違反護理實踐法規並威脅病人安全。護理師在委派 D 選項後，仍負有最終責任，需確認 UAP 執行完成並觀察病人皮膚狀況。
The core principle of nursing delegation is to distinguish 'professional assessment and judgment' from 'routine activities of daily living.' According to the American Nurses Association (ANA) Five Rights of Delegation, an RN cannot delegate tasks that involve assessment, planning, education, or evaluation. Option D, assisting with a bed bath, is a routine, non-invasive activity of daily living (ADL) with predictable outcomes and is appropriate to delegate to a UAP. By contrast, option C (evaluating medication response), A (discharge teaching), and B (initial assessment) all involve clinical judgment and the professional responsibility of the RN, and must be performed by the RN. Delegating these tasks would violate nursing practice regulations and jeopardize client safety. Even after delegating option D, the RN retains ultimate accountability and must confirm that the UAP has completed the task and observed the client's skin condition.
在美國，UAP（如 CNA）的職權界定非常明確，護理師需嚴格遵守國家護理委員會（NCSBN）的委派指引；而在台灣，病房通常由「照顧服務員」協助生活照顧，雖然角色相似，但在法律授權與醫院行政管理上，台灣護理師往往在人員短缺時需承擔更多雜項，委派的結構化程度較美國低。