護理師可以將哪些處置委託給協助照護員(AP)執行?(選所有適合的)
Which of the following interventions are appropriate for a nurse to delegate to an assistive personnel (AP)? (Select all that apply.)
- AAmbulating a stable client down the hallway✓ 正解陪穩定病人沿走廊散步
- BAssisting with the bed bath of a client✓ 正解協助病人擦澡
- CReporting the intake and output totals✓ 正解報告攝入與排出量總計
- DEvaluating the skin integrity of a bedbound client評估臥床病人的皮膚完整性
- EDocumenting the client's vital signs✓ 正解記錄病人的生命徵象
委託(Delegation)遵循「委託五權」(Five Rights of Delegation),護理師僅能將常規性、非侵入性、結果可預測且穩定(Stable)的照護工作委託給協助照護員(AP)。評估(Assessment)、教學(Teaching)與專業判斷(Evaluation)屬於護理師的專業職責,絕對不可委託。本題中,AP 可執行基本的 ADL 協助、體徵測量與常規紀錄,但評估皮膚狀況涉及臨床判斷,必須由護理師執行。
Ambulating stable clients, assisting with hygiene, recording intake and output, and documenting vital signs are routine tasks appropriate for delegation to assistive personnel. However, evaluating skin integrity involves clinical assessment and judgment, which remains the exclusive responsibility of the registered nurse.
在美國,AP(如 CNA)的職責界定非常明確,護理師若將專業評估工作委託出去,一旦發生延誤診斷,護理師將承擔法律責任。相較於台灣,部分基層照護工作界線較模糊,但在 NCLEX 考試中必須嚴守「評估不外包」原則。