— 降低風險 · MEDIUM · SATA —
護理師在輸血前進行病人辨識，下列哪些措施符合安全要求？（選所有適合的）
A nurse is identifying a client before administering a blood transfusion. Which actions are appropriate to ensure client safety? (Select all that apply.)
- AAsk the client to state their full name and birth date✓ 正解請病人說出全名和出生日期
- BVerify the blood unit tag against the client's identification band✓ 正解將血袋標籤與病人的識別手環進行核對
- CCheck the blood type and crossmatch results with another nurse✓ 正解與另一位護理師檢查血型及交叉配血結果
- DUse only the room number to confirm the client's identity僅使用房間號碼來確認病人身份
- EEnsure the blood component is transfused within 4 hours✓ 正解確保血液成分在四小時內輸注
— Explanation · 中文詳解 —
輸血安全是護理高風險環節。A 採取雙重識別（姓名、生日）；B 與 C 執行兩名護理師雙重簽核核對，確保血袋標籤、配血報告與病人手圈一致。D 選項錯誤，絕對不可使用床號作為辨識依據，因床號易更換。E 正確，輸血時間不可超過 4 小時以防細菌滋生與溶血。
Transfusion safety requires strict adherence to protocols to prevent fatal errors. Nurses must use two unique patient identifiers, such as full name and birth date, rather than room numbers. Verification involves checking the blood unit tag against the client’s ID band and crossmatching results with a second nurse. Additionally, blood components must be administered within four hours to minimize the risk of bacterial growth.
✦ 台美臨床差異
台美對於輸血辨識之雙人核對（Double-Check）原則一致，皆屬護理評鑑重點項目。