— 照護管理 · EASY · MCQ —
護理師正在指導新進護理師將任務委派給輔助人員（AP）。若新進護理師採取下列哪項行動，表示需要進一步指導？
A nurse is supervising a newly licensed nurse who is delegating tasks to an assistive personnel (AP). Which action by the newly licensed nurse indicates a need for further teaching?
- ARequesting the AP to assist with ambulating a stable surgical client請求輔助人員協助穩定外科病人步行
- BAsking the AP to feed a client who has a risk for aspiration✓ 正解要求輔助人員餵食有嗆咳風險的病人
- CDelegating the collection of a urine specimen to the AP委派輔助人員收集尿液檢體
- DAssigning the AP to obtain vital signs for a client post-cardiac catheterization指派輔助人員測量心臟導管術後病人的生命徵象
— Explanation · 中文詳解 —
護理委派原則規定，涉及高風險病人（如吞嚥困難、易嗆咳）的護理工作，因涉及評估與風險管理，必須由註冊護理師執行。餵食嗆咳風險高的病人需專業評估，不能單純交給 AP 負責。其餘選項如量生命徵象、收集標本或協助行走，皆屬於標準程序且可委派之工作範圍。
Feeding a client with a risk for aspiration requires nursing assessment and judgment regarding swallowing safety, making it inappropriate to delegate to assistive personnel. Tasks such as obtaining vital signs, collecting routine specimens, or assisting stable clients with ambulation are within the scope of practice for unlicensed assistive personnel.
✦ 台美臨床差異
美國非常強調委派（Delegation）的五大原則；台灣則傾向由護理師親力親為，輔助人力運用較受限於健保支付與評鑑制度。