Mathematical calculation skills required for drug administration in undergraduate nursing students to ensure patient safety: A descriptive study

Bagnasco, Annamaria; Lucia, Galaverna; Aleo, Giuseppe; Grugnetti, Anna Maria; Rosa, Francesca; Sasso, Loredana

doi:10.1016/j.nepr.2015.06.006

Cited by 49 publications

(32 citation statements)

References 34 publications

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“…It was surprising to find no significant relationship between arithmetic ability (baseline test scores) and scores on the medication dose calculation test (see Table 2), because many studies have found that arithmetic errors are a common source of error when nursing students are calculating medication doses. [4,5,26,32] The lack of prediction found in the current study could be due to several reasons. First, as a take-home test, the review test was the least controlled variable in this study.…”

Section: Discussionmentioning

confidence: 61%

“…[10] Typically, schools of nursing do not allow calculator use during testing. [4,12,32,34,45] Use of a calculator during testing has been found to lead to improved accuracy in medication dose calculations when a direct comparison was made; [35] this may be linked to increased self-efficacy. [10] When considering Reason's Swiss cheese model and systems approach to reduce errors, [46] the reluctance to use a calculator during testing may be a latent error by nursing educators that should be corrected.…”

Section: Discussionmentioning

confidence: 99%

“…[2] It is clear that effective nursing education around accurate performance of medication dose calculations is essential to reduce medication errors. [3] More than half of nursing students around the world fail numeracy and dose calculation tests; [4][5][6][7][8] only 35% of students can achieve greater than 70% on a medication dose calculation test. [5] Factors that have an impact on the ability to correctly calculate medication doses have been identified as lack of proficiency in numeracy, challenges in correctly conceptualizing the problem, math anxiety and lack of self-efficacy, teaching strategies, and lack of practice opportunities during education to solidify this skill.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between math personality, math anxiety, test preparation strategy and medication dose calculations in first year nursing students

Osahor

Woodend

Mackie

2019

JNEP

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The objectives of this study were twofold: (1) To determine the predictors of performance on a medication dose calculation test in first year baccalaureate nursing students. The variables studied were: level of math anxiety; math personality; arithmetic ability; program of study; age; and the number of strategies used to prepare for a medication dose calculation test. (2) To determine the factors that affect math anxiety. The variables studied were: arithmetic ability, program of study, math personality, the number of test preparation strategies used and age. Participants consisted of a convenience sample (n = 163) from the first year of a Canadian baccalaureate nursing program. Participants completed a mathematics test, which served as a baseline measure of arithmetic ability. They also completed a series of online questionnaires on math anxiety and math personality, age and program of study (compressed program vs. collaborative program). Participants then completed a medication dose calculation test after which they were asked how many different strategies that they had used in preparation for the test. Performance on the medication dose calculation test was regressed on arithmetic ability, mathematics anxiety, program of study, mathematics personality, the number of test preparation strategies and age. Math anxiety was regressed on pretest score, program of study, math personality, the number of test preparation strategies used and age. The variables found to predict performance on the medication dose calculation test were anxiety and program of study. Of the predictors investigated, only the “Inchworm” math personality and number of test preparation strategies used by students significantly predicted anxiety. Strategies to improve nursing students’ ability to perform dosage calculations should incorporate anxiety-reducing tactics as anxiety was found to be a key predictor of performance on the medication dose calculation test. These strategies should focus on supporting students who possess an “inchworm” math personality.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The relationship between math personality, math anxiety, test preparation strategy and medication dose calculations in first year nursing students

Osahor

Woodend

Mackie

2019

JNEP

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“…Although one of the most common nursing functions, medication administration is also a complex process that is rarely performed in isolation, as nurses are often required to juggle multiple other activities that demand their attention (Jennings, Sandelowski, & Mark, 2011). Not surprisingly, high error rates in medication administration are consistently reported in healthcare systems (Bagnasco et al, 2016;Roughead, Semple, & Rosenfeld, 2013;Smeulers et al, 2014;World Health Organization, 2016), including as high as one fifth of medications administered in hospitals (Runciman, Roughead, Semple, & Adams, 2003). While there is a wide range of causes for medication errors, those involving the numeracy skills of nurses, such as calculation errors, incorrect dosages and infusion rates, are among the most common causes reported (Cheragi, Manoocheri, Mohammadnejad, & Ehsani, 2013;Keers, Williams, Cooke, & Ashcroft, 2013).…”

Section: Introductionmentioning

confidence: 99%

The influence of mathematics self‐efficacy on numeracy performance in first‐year nursing students: A quasi‐experimental study

Gregory

Villarosa

Ramjan

et al. 2019

Journal of Clinical Nursing

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Aim and objectives To examine the factors that influence nursing students’ mathematics self‐efficacy, the effect of numeracy instruction on self‐efficacy, and the association between self‐efficacy and numeracy test performance. Background Medication administration errors, including administering incorrect dosages or infusion rates, can result in serious harm to patients. Hence, it is essential that nursing students are adequately prepared with the necessary numeracy skills during their nursing program. Design This quasi‐experimental cohort study used a pre‐ and post‐test survey design. The study complied with the STROBE checklist for cohort research. Methods In total, n = 715 undergraduate first year nursing students participated in the study from June to October 2017 at a single multi‐campus university in the Western Sydney region of Australia. Data were collected at three time‐points: (a) baseline, including assessing pre‐instruction mathematics self‐efficacy (NSE‐Math scale); (b) 6‐week follow‐up; including assessing post‐instruction mathematics self‐efficacy; and (c) numeracy test performance was collected at 7‐week follow‐up. Findings At baseline, those with high NSE‐Math scale scores were more likely to be male and have at least high school advanced mathematics level education. Following structured numeracy instruction, NSE‐Math scale scores increased significantly, and those who obtained a satisfactory grade in their numeracy assessment were more likely to have high NSE‐Math scale scores and high academic performance in the previous semester. Conclusion The study shows that structured numeracy instruction improved mathematics self‐efficacy, which in turn influenced numeracy test performance. Relevance to clinical practice Using a structured medication numeracy pedagogical approach, to teach skills in nursing undergraduate programs, provides students with the foundations to improve mathematics self‐efficacy and to be successful and safe with medication numeracy calculations and administration in clinical practice.

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“…Drug dose calculation errors are a cause of medication error and have been researched extensively in the nursing literature (Johnson and Johnson 2002;Hutton et al 2010;McMullan et al 2010;Wright 2010;Sabin et al 2013;McDonald et al 2013;Weeks et al 2013a, b, c;Young et al 2013;Coben and Weeks 2014;Fleming et al 2014;Bagnasco et al 2016). However, there has been little research on drug dose calculation skills of medical students and doctors, perhaps due to the assumption that entry to medical school assures good numeracy (Rowe et al 1998;Simpson et al 2009;Harries and Botha 2013).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Calculators on a Test of Clinician Numeracy: A Randomized Controlled Trial

Taylor¹,

Corfield²,

Byrne‐Davis³

2019

Numeracy

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Clinician numeracy (CN), the ability to use and understand quantitative data in patient care, is an important skill for healthcare professionals. Nonetheless, it is recognized that many healthcare professionals, including doctors, have deficiencies in CN, and that this may affect patient safety. In our previous research using the Medical Interpretation and Numeracy Test (MINT), we found that many doctors in training in the UK had low CN. However, participants were not permitted to use calculators when taking the MINT, even though staff has access to calculators in clinical practice. Therefore, our original study may have underestimated doctors' CN, compared to their ability in clinical practice. We designed a randomized controlled trial to assess the impact of calculators on MINT score. We recruited 110 third-year medical students to participate in the study. Our results show that having access to a calculator had no impact on test scores. We consider that this is due to two factors: (1) CN is a complex construct that involves problem-solving and analysis, skills that are not improved by using calculators; (2) errors made by participants in our study are predominantly errors of understanding rather than calculation errors. We suggest that participants taking CN tests should have access to calculators as they would do in the workplace. We recognize that further research is needed, but suggest that educational interventions to improve CN should primarily be directed at improving understanding of mathematical concepts rather than focusing on calculation skills.

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Mathematical calculation skills required for drug administration in undergraduate nursing students to ensure patient safety: A descriptive study

Cited by 49 publications

References 34 publications

The relationship between math personality, math anxiety, test preparation strategy and medication dose calculations in first year nursing students

The relationship between math personality, math anxiety, test preparation strategy and medication dose calculations in first year nursing students

The influence of mathematics self‐efficacy on numeracy performance in first‐year nursing students: A quasi‐experimental study

The Impact of Calculators on a Test of Clinician Numeracy: A Randomized Controlled Trial

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