護理師準備為一位病人肌肉注射一劑抗生素。為了預防給藥錯誤，哪一項行動最重要？
A nurse is preparing to administer an intramuscular dose of an antibiotic to a client. Which action is most important for preventing a medication error?
- AConfirm the client's identity using two identifiers, such as name and date of birth給藥前以姓名與出生日期等兩項識別資料核對病人身分正確答案
- BUse the Z-track technique to prevent leakage of the medication into subcutaneous tissue使用 Z 字型注射技術以防止藥物滲漏至皮下組織
- CSelect a needle length that is appropriate for the client's muscle mass依病人肌肉量選擇適當長度的針頭
- DApply gentle pressure with dry gauze to the site after withdrawing the needle拔針後以乾紗布輕壓注射部位
- A給藥前以姓名與出生日期等兩項識別資料核對病人身分
正確答案是 A。給藥的「六大正確」（正確的病人、藥物、劑量、途徑、時間與紀錄）中，確認病人身分是預防給錯病人的核心。Joint Commission 國家病人安全目標 NPSG.01.01.01 要求在給藥前以至少兩項識別資料（如姓名、出生日期或病歷號，不可使用病房號或床號）核對病人，並與醫囑及給藥紀錄比對；這是把藥物給到正確病人的最後一道防線。B：Z 字型技術用於刺激性藥物，可減少藥物滲漏至皮下組織與局部刺激，是注射技術而非防錯步驟。C：依肌肉量選擇針頭長度可確保藥物確實進入肌肉，同樣屬於技術層面。D：拔針後以乾紗布輕壓是舒適與止血措施。這三項都是正確的注射照護，但都不能防止把藥給錯人或給錯藥。另需注意：注射後不得回套針帽，應啟動安全針具並直接丟入尖銳物容器，以預防針扎。來源：The Joint Commission, National Patient Safety Goals（NPSG.01.01.01）；Potter & Perry, Fundamentals of Nursing（Medication administration）。
- A · 正確答案給藥前以姓名與出生日期等兩項識別資料核對病人身分
正確。給藥前以姓名、出生日期等兩項識別資料核對病人身分，是 Joint Commission 病人安全目標的要求，也是防止給錯病人的最後一道防線。
- B使用 Z 字型注射技術以防止藥物滲漏至皮下組織
錯誤。Z 字型技術可減少刺激性藥物滲漏至皮下組織，是正確的注射技術，但無法預防給錯病人或給錯藥。
- C依病人肌肉量選擇適當長度的針頭
錯誤。依肌肉量選擇針頭長度能確保藥物進入肌肉，屬於技術層面的正確作法，與預防給藥錯誤無關。
- D拔針後以乾紗布輕壓注射部位
錯誤。拔針後以乾紗布輕壓注射部位是舒適與止血措施，不是預防給藥錯誤的步驟。
美國依 Joint Commission 要求至少兩項識別資料，口頭醫囑須複誦確認（read-back）；台灣醫院評鑑與病人安全年度目標同樣要求兩種以上辨識方式並核對手圈，作法一致，但美國對禁止回套針帽與安全針具使用的查核更為嚴格。
English explanation
Option A is correct. Among the rights of medication administration (right client, drug, dose, route, time, and documentation), confirming the client's identity is the key step for preventing a wrong-client error. The Joint Commission National Patient Safety Goal NPSG.01.01.01 requires at least two identifiers, such as name, date of birth, or medical record number, never the room or bed number, checked against the prescription and the medication administration record before any dose is given; this is the final safeguard that the right medication reaches the right client. Option B is incorrect because the Z-track technique reduces leakage and irritation from irritating medications; it is an injection technique, not an error-prevention step. Option C is incorrect because choosing a needle length based on muscle mass ensures the medication reaches the muscle, again a matter of technique. Option D is incorrect because gentle pressure with dry gauze after withdrawing the needle is a comfort and hemostasis measure. All three are appropriate injection care, but none prevents giving the drug to the wrong client or giving the wrong drug. The nurse also never recaps a used needle; the safety device is activated and the needle is discarded directly into a sharps container to prevent needlestick injury. Source: The Joint Commission, National Patient Safety Goals (NPSG.01.01.01); Potter & Perry, Fundamentals of Nursing (medication administration).