— 照護管理 · MEDIUM · MCQ —
護理師應針對哪位病人填寫異常事件報告（Incident Report）？
Which of the following clients would the nurse identify as requiring an incident report?
- AA client who fell out of bed despite having side rails up✓ 正解儘管拉起床欄，病人仍從床上跌落
- BA client who had an unexpected change in vital signs病人出現生命徵象的意外變化
- CA client who required a higher dose of oxygen than usual病人所需的氧氣劑量高於平常
- DA client who refused a medication dose病人拒絕服用藥物
— Explanation · 中文詳解 —
異常事件報告（Incident Report）用於記錄非預期的事件，例如病人跌倒、用藥錯誤、器材故障等。跌倒是必須上報的事件，因為這涉及到病人安全與機構責任。生命徵象改變屬病情變化，拒藥則需記錄於護理紀錄，非異常事件報告。
An incident report is used to document unexpected events such as patient falls, medication errors, or equipment malfunction. Falls are reportable events because they involve patient safety and institutional liability. Changes in vital signs are part of clinical course changes, and medication refusal should be documented in the nursing notes; neither requires an incident report.
✦ 台美臨床差異
美台皆有異常事件通報系統，但美國傾向於無懲罰性通報（No-blame culture），台灣有時仍帶有歸責色彩。