專科護理師更換氣管外管之適法性—兼論執業範圍新規定

The Legitimacy of the Outer Cannula of Tracheostomy Tube Changed By a Nurse Practitioner: Discussing New Regulation of Scopy of Practice of Nurse Practitioners

曾有專師於民國94年為病人更換氣管外管，遭檢察官起訴密醫罪，本文將介紹此案例－氣管外管案－之原因事實與法院判決理由，並對此案例進行分析，一則凸顯執業範圍未明確規定，專師極易觸犯密醫罪之現象；二則希望藉由具體案例，協助專師瞭解密醫罪之內涵。民國105年1月1日起，專師之執業範圍告別了以行政函釋規範之舊年代，正式進入以法律規範之新時代，護理人員法第24條第3項與第4項規定以及「專科護理師於醫師監督下執業辦法」所規範之專師執業範圍，因其清楚明確，對密醫罪之防堵，有一定程度之功勞，本文將一併介紹之。

One nurse practitioner who changed the outer cannula of tracheostomy tube for a patient was prosecuted for physician without license in 2005. This study introduces and analysis this case in order to emphasize the indefiniteness of the scope of practice of a NP easily results in the infraction for a NP, and to help the NPs understand the connotation of the Article mentioned above. A NP is able to free to be charged with being a physician without license since January 1, 2016, because the regulations from the Paragraph 3 and Paragraph 4 of Article 24 of the Nursing Personnel Act and the Guidelines on Implementation of Medical Practices for Nurse Practitioners under Supervision of Physicians were amended to define clearly the scope of NP. This study deeply discusses the influence and consequence from the regulations as well.