— 照護管理 · HARD · MCQ —
護理師準備協助病人出院，下列哪項行動對於確保連續性護理最重要？
A nurse is preparing to discharge a client. Which nursing action is most important to ensure continuity of care?
- AConfirming the client has transportation to home確認病人是否有回家交通工具
- BScheduling a follow-up appointment with the primary healthcare provider預約主治醫師的回診
- CReviewing medication side effects with the client與病人複習藥物副作用
- DCoordinating with the interdisciplinary team to ensure home health referrals are sent✓ 正解與跨專業團隊協調，確保已發送居家護理轉介
— Explanation · 中文詳解 —
連續性護理（Continuity of care）核心在於跨專業與跨機構間的資訊銜接。雖然其他選項皆是出院準備的一部分，但確保居家護理（Home Health）銜接最能直接影響出院後的照護品質與安全。
Continuity of care relies on seamless information transfer across disciplines and settings. While transportation, follow-up appointments, and medication education are important components of discharge planning, coordinating with the interdisciplinary team to ensure home health referrals directly impacts post-discharge care quality and safety by maintaining the care plan in the home environment.
✦ 台美臨床差異
美國健保體系極度依賴出院轉介（Case Management），台灣則多由護理站自主安排，後續追蹤資源較為鬆散。