— 照護管理 · MEDIUM · MCQ —
護理師正在監督一位新進護理師將任務委託給照服員。下列哪項新進護理師的行為需要護理師立即介入？
A nurse is supervising a newly licensed nurse who is delegating tasks to an Assistive Personnel (AP). Which action by the newly licensed nurse requires immediate intervention?
- ADelegating the measuring and recording of intake and output委託測量並記錄攝入量與排出量
- BDelegating the repositioning of a client every two hours委託每兩小時為客戶翻身
- CDelegating the feeding of a client who is currently receiving enteral tube feedings✓ 正解委託餵食目前接受腸道營養灌食的客戶
- DDelegating the collection of a midstream urine specimen from a client with a foley catheter委託從帶有福來氏導尿管的客戶收集中段尿液標本
— Explanation · 中文詳解 —
護理委託（Delegation）必須符合「穩定、可預測、非侵入性」原則。管灌餵食的病人若發生反流或誤吸風險高，屬於專業評估範圍，不可委託給照服員。其餘選項如量尿、翻身、留檢體（非導尿管採檢）均屬於常規護理輔助範圍。
Delegation to assistive personnel must adhere to stable, predictable, and non-invasive tasks. Feeding a client receiving enteral tube feedings requires clinical assessment for aspiration risk and proper tube placement, making it inappropriate for delegation to unlicensed staff.
✦ 台美臨床差異
台美兩地對於照服員執行管灌的限制類似，皆須具備執照才可執行，否則屬違法。