一位內科加護病房（ICU）的註冊護理師被支援（Float）到兒科病房。哪位病人的分配對這位護理師最合適？
An RN is floating to a pediatric unit from an adult intensive care unit (ICU). Which client assignment is most appropriate for this nurse?
- AA 4-year-old child scheduled for a routine appendectomy in the morning一名四歲兒童，預計於隔日進行常規闌尾切除手術
- BA 10-year-old child admitted with diabetic ketoacidosis (DKA) on an insulin drip✓ 正解一名十歲兒童，因糖尿病酮酸中毒（DKA）住院，正接受胰島素靜脈滴注
- CA 2-year-old child with a newly diagnosed case of Kawasaki disease一名兩歲兒童，新診斷患有川崎氏症
- DA 6-month-old infant with respiratory syncytial virus (RSV) needing suctioning一名六個月大的嬰兒，患有呼吸道合胞病毒（RSV）感染，需要抽吸
人力支援（Floating）的原則是：將支援護理師分配給與其「原始專長最相似」或「照護需求最標準化」的病人。這名護理師來自成人 ICU，對重症監測、滴注藥物（Titration）與酸鹼平衡（DKA）非常熟悉。雖然選項 B 是小孩，但 DKA 的生理機轉與胰島素幫浦的管理在跨年齡層上有高度的技能重疊。選項 C（川崎氏症）具有高度兒科專業性。選項 A 雖穩定但涉及兒科術前衛教。選項 D 的嬰兒呼吸道照護與成人 ICU 差異較大（如吸鼻腔）。因此，選擇與其 ICU 背景最吻合的 B 是最能確保安全的做法。核心思路：技能匹配（Skill matching）。
The principle of floating is to assign the floating nurse to the client whose care most closely matches the nurse's primary expertise or whose care needs are most standardized. This nurse comes from an adult ICU and is very familiar with critical-care monitoring, titrated drips, and acid-base management (DKA). Although option B is a child, the pathophysiology of DKA and management of the insulin drip have substantial skill overlap across age groups. Option C (Kawasaki disease) is highly pediatric-specific. Option A is stable but involves pediatric preoperative teaching. Option D involves infant airway care that differs substantially from adult ICU practice (such as nasal suctioning). Therefore, selecting option B, which best matches the nurse's ICU background, is the safest assignment. The core principle is skill matching.
美國護理部在進行支援（Floating）時，必須考量護理師的「適任性（Competency）」，若護理師認為自己無法安全照護該病人，有權拒絕並要求重新分配；台灣則較強調服從調度，專長匹配的系統性考量較少。