— 照護管理 · MEDIUM · MCQ —
病人要求自動出院（AMA），護理師應採取何種行動？
A nurse is caring for a client who is requesting to leave against medical advice (AMA). Which action should the nurse take?
- ALock the client’s belongings to prevent them from leaving鎖住病人的物品以防止其離開
- BNotify the provider and document the client's decision and education provided✓ 正解通知醫師並記錄病人的決定及所提供的衛教內容
- CTell the client they cannot leave until the bill is paid告訴病人必須付清帳單才能離開
- DIgnore the request until the doctor arrives忽略該請求直到醫師到達
— Explanation · 中文詳解 —
病人擁有醫療自主權。當病人要求 AMA，護理師必須通知醫師，確保病人了解自動出院帶來的風險，並在病歷中詳實紀錄教育過程與病人拒絕治療的意願。限制自由（A）或以費用威脅（C）均涉及非法拘禁與侵權，是嚴重的倫理與法律錯誤。
The nurse must notify the provider immediately and document the client's decision and the education provided regarding the risks of leaving against medical advice. Restricting the client's movement or withholding care for payment is illegal and unethical.
✦ 台美臨床差異
台美對於 AMA 的流程大同小異，皆要求簽署同意書並教育風險，但美國醫療保險（如 Medicare）常會因 AMA 導致給付爭議。