護理師照顧一位有跌倒病史的病人，應執行哪些安全措施？（選所有適合的）
A nurse is caring for a client with a history of falls. Which safety measures should the nurse implement? (Select all that apply.)
- AKeep the bed in the lowest position✓ 正解保持病床處於最低位置
- BPlace the call light within reach✓ 正解將呼叫器置於病人可及範圍內
- CEncourage the client to get up independently for exercise鼓勵病人獨立起身運動
- DKeep the environment clear of clutter✓ 正解保持環境整潔無雜物
- EApply physical restraints to keep the client in bed使用身體約束將病人固定在床上
預防跌倒的核心在於環境改造與增進便利性。降低床位可減少跌落高度；確保呼叫鈴在手邊能讓病人獲得協助；移除雜物可避免絆倒。禁止擅自下床（選項C）與不當使用約束（選項E）皆非正確的 fall prevention 策略，約束應為最後手段。
The core of fall prevention is environmental modification and improved access. Lowering the bed reduces the height of any potential fall; keeping the call light within reach allows the client to summon help; removing clutter prevents tripping. Telling the client to ambulate independently (option C) and using physical restraints inappropriately (option E) are not correct fall-prevention strategies, and restraints should always be a last resort.
台美對約束的使用規範皆嚴格，但美國醫院對於防跌的環境評估量表（如 Morse Fall Scale）應用更具強制性。