中文摘要近年來我國老年長期照護日漸受到政府重視，並列為重要政策議題。因此，如何在有限的資源條件下，健保藥局藥師進行長照機構之住民藥事照護中，對住民服藥安全與服藥順從性，照護者給住民給藥前是否進行藥品三讀五對之核對，長照機構是否認定健保藥局藥師為不可取代性，是否呈現正向關係?藥師在此方面能扮演哪些積極角色與工作?這些對於藥師未來在長期照護與老人照護之領域能提供的服務項目範圍影響頗鉅。本研究想藉由個案健保藥局，在台南地區提供該地區長照機構藥事服務，進行訪談十家機構院長或督導，先由五位長期照護專家審查十項訪談內容，再刪減成八項訪談問題，藉此了解健保藥局藥師對長照機構提供藥師藥事照護，針對專業屬性，需求之急迫性，住民健康照護，評鑑要求，與期望要求等五個構面相關構因之因素探討，經由整理訪談資料分析。結果顯示健保藥局對長照機構提供藥事照護，獲得住民、家屬、醫護人員認同。但以機構負責人觀點，長照機構評鑑要求為主要合作原因，而非專業性考量。因此，當藥師以熱忱的服務提供藥事照護，還得積極準備長期照護機構相關評鑑文件及創新加分給予長照評鑑老師，才能永續合作。以目前相關專業評比，藥事服務只佔兩分，跟營養照護、社工照護、護理照護，差距甚遠，長期合作被替換性太高，無不可取代性。政府單位既然將藥事服務納入評分，更應該將分數提高，讓機構也能重視專業的藥師服務。 Abstract Long-term care of the elderly is a hot topic of the health authority of Taiwan recent years. Does the pharmacist play an important role in increasing the medication adherence and drug safety of the elderly in a long-term care institution? Does the manager of the long-term care institution recognize the contribution of the pharmacist in enhance the prescription adherence, drug safety and drug storage? If pharmacist could play a more aggressive role in helping the prescription / drug management in long-term care institution? These topics are always being discussed while the resource is limited to the long-term care institution. In this study, five experts examined ten query and summarized into an eight query questionnaire for further investigation of these managers who had have the pharmacist providing the pharmacy service in their long-term care institution. We had interviewed 10 managers of 10 long-term care institution in Tainan County. We would like to find out the real demand of the managers to the pharmacy services in their daily practice by five categories pharmacist professionalism, urgency, resident health care, health authority assessment requirement and any particular aspect), in terms of the data analysis. The results reveal that the long-term care resident, family members, health providers and managers highly recognized the pharmacist’s contribution in the prescription adherence, drug safety and drug storage management. From the perspective of the managers of the long-term care institution, the top priority is the health authority assessment requirement every year, that’s also the key to motive managers to deal with the pharmacy. According to our finding, we suggest the health authority should reconsidering the rating system of the assessment of the long-term care institution, low priority of pharmacist’s professionalism may cause the negative impact to the right of the elderly drug usage in the long-term care institution.
