— 安全與感染控制 · HARD · SATA —
下列哪些項目在醫療安全管理中被定義為「從不該發生的事件」（Never Events）？（選所有適合的）
Which of the following are considered 'Never Events' in healthcare safety management? (Select all that apply.)
- ASurgery performed on the wrong body part✓ 正解在錯誤的身體部位進行手術
- BPatient fall resulting in a minor bruise導致輕微瘀傷的病人跌倒
- CForeign object left inside a patient after surgery✓ 正解手術後異物遺留病人体内
- DDeath or serious injury associated with a medication error✓ 正解與用藥錯誤相關的死亡或嚴重傷害
- EDevelopment of a Stage 1 pressure injury during hospital stay住院期間發生第一度壓瘡
— Explanation · 中文詳解 —
Never Events 是由 NQF 定義的重大醫療不良事件。包括：部位錯誤手術（A）、異物留置體內（C）、藥物錯誤導致嚴重傷害或死亡（D）。B（輕微瘀傷）雖為意外，但不構成 Never Event。E（第一期壓瘡）雖不應發生，但因其定義與嚴重程度判定複雜，不歸類在最嚴重的 Never Event 清單中。
Never Events are serious, preventable medical errors defined by the National Quality Forum, including wrong-site surgery, leaving a foreign object in a patient, and medication errors causing death or serious harm. Minor injuries like bruises or stage 1 pressure ulcers do not meet the severity criteria for this classification.
✦ 台美臨床差異
美國醫保（CMS）拒絕支付與 Never Events 相關的醫療費用；台灣則透過醫療品質指標（TQIP）進行監測。