目的： 病人的需求、用藥安全及品質為出發點之輔導計畫，提昇『以病人為中心之用藥安全』 為主要目標，輔導高高屏澎四縣市之診所落實執行病人安全工作目標、加強診所藥物諮 詢及衛教品質、舉辦基層醫療人員教育訓練研討會、提升病人用藥安全之相關知識用藥 安全作業。
方法： 製定診所『用藥安全作業訪視表』共 23 項，作為輔導前以後基層診所評核標準，其訪視 項目包括：人員人力、藥品保存及管理、藥品調劑作業、藥袋標示、病人用藥指導與諮 詢、品管作業。進行輔導建構其病人用藥安全相關作業項目，並在輔導後再次評核成效，另外亦以診所病患、醫師及藥師之問卷作為評量，並舉辦用藥安全教育訓練研討會提昇用藥安全知識。
結果： 完成訪視共 37 家，佔四縣市總診所 2.0%，完成輔導家數共計有 19 家。在 37 家診所訪 視結果中不符合規範項目者佔 32.2%，其中以未能適時給病患用藥衛教單張，並使用淺 顯易懂之文字佔 78.4%居多。經輔導後符合率提昇為 94.3%，輔導後醫療人員的整體滿 意度為 100%。
結論： 計畫開始執行時，部分診所認為此計畫為查核性計畫，而拒絕接受輔導，但於接受輔導 之 19 家診所皆能藉由團隊輔導實地學習到如何建構一個用藥安全的作業模式，希望以 此拋磚引玉，讓更多診所也能建構以病人為中心之用藥安全作業。
Purpose：Research on the need, safety, and quality assurance of the drugs in the treatments incorporated several methodological features of “Drug safety to patients” to generate high-quality clinical practice guidelines. The primary care clinics in the cities of Kaohsiung, Kaohsiung county, Ping Tung county, and Penghu county were primary targets to implement the programs of drug safety to patients, drug information and education, and education seminars to the primary care professionals to promote the idea of “Drug safety to patients” and to fill the gaps of knowledge on drug safety.
Methods：To introduce the evaluation criteria on drug safety in the primary care clinics was to set the standards when we made the inspection visits. 23 items in the criteria included human resource, storage and management of drugs, and dispense of the drugs in the dispensary, label of the drugs, instruction to the patients, and quality control. We helped and guided to establish all the items related to this program and re-evaluated afterwards with the questionnaire to the patients, pharmacists, and clinicians in the primary care clinics. We also held the education workshops to the primary care professionals and education seminars to the communities to promote the knowledge of drug safety.
Results：We had completed the inspection visits of 37 primary care clinics, 2.0% of the total clinics in the target cities, and had completed the guidance of 19 clinics. 32.2% of the 37 primary care clinics failed to cohere with the criteria on drug safety. Inability to provide timely, clear and age-appropriate educational notes or instruction to the patients was the mainspring to fail the criteria with a rate of 78.4%. Among the 19 primary care clinics that we had completed the guidance, 94.3% of them became cohered with the criteria on drug safety. And the total satisfaction rate between pharmacists and clinicians was 100% after the guidance had been completed.
Conclusion：Some clinicians in the primary care clinics mistook the guidance to be an audit to them and refused to implement the program when we started to make the inspection visits. On the other hand, the 19 clinics under guidance learned how to establish a work mode in a team to drug safety. We hereby hoped more and more primary care clinics would participate the program to establish a patient-orientated environment of drug safety.
