— 照護管理 · MEDIUM · MCQ —
病患要求自動出院（AMA），護理師的首要責任為何？
A nurse is caring for a client who is requesting to leave the facility against medical advice (AMA). What is the nurse's primary responsibility?
- AForce the client to sign a waiver before any discussion在討論之前強迫病人簽署免責聲明
- BInform the client's family about the decision immediately立即通知病人的家屬這個決定
- CNotify the provider and document the client's understanding of risks✓ 正解通知醫師並記錄病人對風險的理解
- DPrevent the client from leaving the premises阻止病人離開院區
— Explanation · 中文詳解 —
病患有權拒絕醫療，AMA 時護理師需確保病患理解風險。首要行動是通知醫師，讓醫師解釋風險並嘗試尋找替代治療方案，同時確實記錄說明過程以保障醫療法律責任。強迫留人屬非法限制行動自由，強制簽名前應先進行專業衛教。
When a client requests to leave against medical advice (AMA), the nurse's primary responsibility is to notify the healthcare provider and document that the client understands the risks of leaving. Competent adults have the legal right to refuse treatment, so preventing them from leaving constitutes false imprisonment. The nurse must ensure informed refusal is documented rather than forcing a signature or disclosing information to family without consent.
✦ 台美臨床差異
台美皆強調告知後簽署自動出院書，台灣更重視在病人離開前再次確認其風險知情狀況。