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A recent study from the Feinberg School of Medicine at Northwestern University indicated that a stunning sixty percent of paid caregivers made mistakes when they were sorting medications for people in their care. It also indicated that a third of the caregivers had trouble reading directions for medications.
The study was a small one, examining one hundred paid, non-family-member caregivers in the Chicago area. But the fact that such a relatively small sample revealed such a potentially large number of medication errors is alarming. Could it be that if you looked at any one hundred caregivers across the country, you would find that a third would not understand the directions on how to administer medication? Or that more than half would make easily-identifiable mistakes in preparing medications for someone who is already ill enough to require outside care?
If the error rate seems abnormally high, the lead author of the Northwestern study, Dr. Lee Lindquist, offered these additional details: “The jobs typically pay just under nine dollars per hour, but nearly one-third of the caregivers earn less than minimum wage…Most of the caregivers are women, about fifty years old, many are foreign born or have a limited education.”
The study raises several questions about liability for medication errors and the responsibilities of medical professionals and what we might call “medical nonprofessionals.”
We could say that paid caregivers who opt to perform medical services such as dispensing medication should be held liable for their errors. This might be justifiable, but since Dr. Lindquist’s comments indicate that these caregivers tend to make extremely small amounts of money, it ultimately avails no one to pour blame and judgment (in both the moral and legal senses) on them.
In any case, paid caregivers might have a pretty good argument in their defense that they never held themselves out to be qualified medication dispensers. They only did what was requested of them, by people who were in a position to know their qualifications, or lack thereof.
This leads to the question of doctor and pharmacist liability, if any. If everyone knows that many medications are going to be dispensed by low-paid and non-native English-speaking or undereducated caregivers, is there a responsibility to ensure that those caregivers can understand what they need to do? Is it fair for healthcare professionals to close their eyes to a situation they are well aware of? Does their responsibility end when a medication leaves the pharmacy, prescribed, filled and directed correctly? Or could they do more to ensure correct and safe dispensing of drugs?
It may not be realistic to hold medical professionals responsible for the actions of others over which they have no control and no specific knowledge. But it is not too much to ask that they consider what is generally known, and take steps to ensure patient safety.
The answer to exactly what medical professionals can and should do has not yet emerged, but Pennsylvania medication error attorneys know one thing: as baby boomers retire and later reach an age where they are likely to employ a caregiver, the number of medication errors is likely to swell unless better patient protections are put in place.
Source: UPI “Paid caregivers can make medication errors” 2/23/2011