護理師在指派任務給 LPN/LVN 時,應採取哪些措施?(選所有適合的)
Which of the following actions should the nurse take when delegating tasks to an LPN/LVN? (Select all that apply.)
- AAssess the complexity of the client's condition✓ 正解評估個案病情的複雜程度
- BVerify the LPN's scope of practice according to state regulations✓ 正解依據各州法規確認 LPN 的執業範圍
- CDelegate initial nursing assessments and care planning委託進行初步護理評估與照護計畫擬定
- DProvide clear instructions and expected outcomes✓ 正解提供明確的指示與預期結果
- EFollow up to ensure the task was completed safely✓ 正解進行追蹤以確保任務已安全完成
護理委任(Delegation)是五大護理權力之一,必須嚴格遵守『五項正確原則』(Right Task, Circumstance, Person, Communication, Supervision)。護理師不能將評估(Assessment)、診斷(Diagnosis)、規劃(Planning)與衛教(Education)等 ADPIE 中的關鍵步驟委任出去,因為這些動作涉及專業臨床判斷。因此,C 選項是錯誤的。在進行指派時,必須先確認病人的穩定度(Complexity)以及該人員的法規權限(Scope of Practice)。接著,清楚的溝通期望結果與任務內容是關鍵,最後的監督與回饋(Follow-up)則是確保病人安全與品質控制的必要步驟。護理師需銘記:即使工作委任出去了,責任(Accountability)仍歸屬於護理師本人。
The nurse must assess client stability, verify the LPN's legal scope of practice, provide clear instructions, and follow up to ensure safe delegation. Initial assessments, care planning, and education involve complex clinical judgment and cannot be delegated. Although accountability remains with the RN, proper supervision and adherence to the 'five rights' of delegation are essential for patient safety.
美國 LPN 在不同州的執照範圍差異大,如給藥權限可能因州而異;台灣雖然有護理師與護士的區分,但實際上兩者在臨床工作上的職責範圍幾乎相同,因此『委任』概念在台灣臨床多是『護理師對護理師』的交班或分工,缺乏像美國那樣嚴格的層級化委任訓練。