— 安全與感染控制 · MEDIUM · MCQ —
護理師進入病房發現病人跌倒在地，護理師的首要行動為何？
A nurse enters a room and finds a client on the floor after a fall. What is the nurse's priority action?
- AAssess the client for injuries and status✓ 正解評估病人有無受傷及目前狀況
- BFill out an incident report form填寫意外報告表
- CCall the physician to report the fall打電話通知醫師報告跌倒事件
- DHelp the client back into bed immediately立即協助病人回到床上
— Explanation · 中文詳解 —
處理跌倒事件，首要原則是評估（Assess）。在未評估傷勢（特別是頭部外傷或骨折）前，不可隨意搬動病人，以免造成二次傷害。評估完成後，視傷情決定是否請求協助或通知醫師，最後才是撰寫意外報告（Incident Report）。
The nurse's priority action is to assess the client for injuries and overall status before taking any other steps. Moving the client immediately could exacerbate potential fractures or spinal injuries, so assessment must precede intervention. Documentation and physician notification occur only after the client is stabilized.
✦ 台美臨床差異
美台醫療系統均嚴格規定跌倒後須先評估方可移動，且皆強制要求填寫意外報告以進行改善分析。