護理師準備病人出院，何者最能體現「連續性護理」的角色？
A nurse is preparing to discharge a client. Which action best reflects the nurse's role in continuity of care?
- AScheduling a visit from a social worker after the client is home安排病人在回家後由社工訪視
- BEnsuring the client has a follow-up appointment with the primary provider✓ 正解確保病人有與主要醫師的門診追蹤預約
- CEncouraging the client to call the hospital if they have any questions鼓勵病人有任何問題時致電醫院
- DProviding the client with a copy of their entire medical record提供病人其完整病歷的副本
連續性護理（Continuity of Care）的核心在於醫療照護在不同階段間的銜接。確保病人出院後有門診追蹤，能使醫師持續監控治療效果，是預防再入院的最直接手段。D 選項包含隱私問題且不具實用性；C 選項缺乏結構化管理；A 選項雖好，但非所有病人適用，不如門診追蹤具普適性與強制性。
The core of continuity of care lies in linking medical care across different phases. Ensuring that the patient has outpatient follow-up after discharge allows the physician to continue monitoring the treatment effect and is the most direct means of preventing readmission. Option D involves privacy concerns and is not practical; option C lacks structured management; option A is favorable but is not appropriate for every patient and is not as universally applicable or enforceable as outpatient follow-up.
美國醫院重視出院後的 Care Coordination；台灣健保體系下，護理師衛教與轉診單對接機制較為單一。