# 一名內外科病房的註冊護理師於上班時欲分派任務。下列何者最適合委派給無執照輔助人員(UAP)?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=360523&lang=zh-tw  
> language: zh-TW  
> subject: Assignment/Delegation/Supervision  
> category: MOC

## 題目

一名內外科病房的註冊護理師於上班時欲分派任務。下列何者最適合委派給無執照輔助人員(UAP)?

## 選項

1. 為新近診斷高血壓之個案執行口服藥物的首次給藥
2. 評估剛從恢復室返回病房之個案的手術切口部位
3. 為接受傷口負壓治療(wound vacuum)的術後個案加固無菌敷料
4. 為入院接受擇期髖關節置換術術前衛教、病情穩定之個案測量例行生命徵象 **✔ 正確答案**

**正確答案: 4**

## 解析

為穩定的個案測量常規生命徵象是一項標準化、可預測的任務，可委派給受過訓練的UAP，由護理師負責解讀和追蹤結果。UAP不給予首次抗高血壓藥物劑量、評估新的手術切口，或處理負壓傷口治療周圍的無菌敷料。這些任務需要給藥權限、評估或無菌照護的護理判斷。

## 深入解析

Clinical Judgment
NCLEX委派題考委派5原則。Recognize Cues(穩定個案+例行任務+UAP範圍配對)→Analyze Cues(排除需評估、無菌或藥物知識者)→Take Action(選擇穩定術前個案的例行生命徵象測量)。

Memory Tip
UAP的3S:Stable(穩定)+Standard(標準)+Simple(簡單)。UAP絕對不可執行評估(Assess)、給藥(Administer)、無菌或侵入性操作。

KR vs US
韓國:護理助理員業務範圍依醫療法較窄。美國:UAP可協助穩定個案測量生命徵象、行走、ADL、收集並回報資料,但不得評估、判斷或給藥。

## 臨床情境

Clinical Practice Guide
委派5原則(NCSBN/ANA):Right Task、Right Circumstance、Right Person、Right Direction/Communication、Right Supervision/Evaluation。UAP常見範圍含穩定個案的生命徵象、行走、衛生與ADL照護、I/O測量、每日體重、無誤吸風險個案的進食協助。

Caution
護理過程(評估、計劃、評值、臨床判斷)、給藥、侵入性與無菌操作絕不委派。任務本身雖看似例行,個案若不穩定,任務即返回RN。

## 重要概念

- **UAP(Unlicensed Assistive Personnel,無執照輔助人員)** — 無護理執照之醫療人員(如護理助理員、病人照護技術員),於RN督導下執行穩定個案的例行性、可預測性業務;不得評估、計劃、評值或給藥。
- **委派5原則(5 Rights of Delegation)** — NCSBN/ANA架構:Right Task(正確任務)、Right Circumstance(情境)、Right Person(對象)、Right Direction/Communication(指引與溝通)、Right Supervision/Evaluation(督導與評值)。五項全數符合方可委派。
- **Scope of Practice(執業範圍)** — 依執照與訓練,醫療人員依法可執行之業務範圍。RN範圍含完整護理過程與複雜介入,UAP範圍限於穩定個案之例行性、非臨床性或基本照護任務。
- **Clinical Judgment** — The cognitive process used by nurses to observe, interpret, and respond to a patient's needs, which involves critical thinking and decision-making and cannot be delegated.
- **Stable Client** — A patient whose health status is predictable and not at immediate risk for deterioration, making routine monitoring tasks appropriate for delegation to a UAP.

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