— 照護管理 · MEDIUM · MCQ —
護理師參與品質改善委員會。品質改善（QI）流程的第一步為何？
A nurse is working on a quality improvement committee. Which of the following is the first step in the quality improvement process?
- AAnalyze the results of a pilot study分析試點研究的結果
- BIdentify a clinical problem or area for improvement✓ 正解識別臨床問題或改善領域
- CImplement a new protocol on the unit在病區實施新協議
- DCollect data on current nursing practices收集當前護理實踐的數據
— Explanation · 中文詳解 —
品質改善流程（如 PDSA 循環）的第一步始終是「識別問題（Identification of the problem）」。只有先明確哪些指標（如跌倒率、壓瘡率）偏高或流程有缺陷，才能進一步收集數據、制定計畫並執行改變。這屬於護理行政與管理的基礎知識。
The first step in the quality improvement process is identifying a specific clinical problem or area needing enhancement, such as high fall rates or infection clusters. Only after defining the issue can the team collect baseline data, develop interventions, and evaluate outcomes.
✦ 台美臨床差異
美國醫護環境非常強調品質指標（Quality Indicators）與聯邦給付掛鉤；台灣則多透過醫院評鑑進行品質管控。