1
|
Suluhan D, Yildiz D, Fidanci BE. Triangle technique: An effective tool for improving nursing students' ability to calculate safe pediatric medication dosages. J Child Health Care 2023; 27:160-173. [PMID: 36537754 DOI: 10.1177/13674935221145511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Calculating the correct medication dosage for pediatric patients can be difficult for nurses to determine, as the pediatric dose is typically a small fraction of the adult dosage. This study aims to examine the impact of the Triangle Technique on the ability of nursing students to calculate low and high safe dosage ranges in children. To evaluate how this educational tool could improve a nurse's skill in this area, a quasi-experimental pre-/post-test research design was employed including one hundred fifty-eight third-year nursing students. The Pediatric Medication Administration Form and Pediatric Safe Dosage Calculations Quiz (PSDCQ) were used to measure the effectiveness of the Triangle Technique. While <50% (n < 79) of students gave correct answers to each question in PSDCQ before this intervention, all of the participants (N = 158, 100%) gave a correct answer to one question, and >89.2% (n > 141) of the students correctly answered the other four questions of PSDCQ. The change in scores (pre-PSDCQ median score = 0, IQR = 60; post-PSDCQ median score = 100, IQR = 0) post-intervention was statistically significant (z = 10.633, p ≤ .001), indicating that this teaching technique was effective for improving students' ability to calculate pediatric safe dose ranges. Nursing students (n = 144, 91.1%) were satisfied with using Triangle Technique. Using the Triangle Technique can increase nursing students' understanding of how they calculate safe pediatric medication dosages.
Collapse
Affiliation(s)
- Derya Suluhan
- Gülhane Faculty of Nursing, University of Health Sciences Turkey, Ankara, Turkey
| | - Dilek Yildiz
- Gülhane Faculty of Nursing, University of Health Sciences Turkey, Ankara, Turkey
| | - Berna Eren Fidanci
- Gülhane Faculty of Nursing, University of Health Sciences Turkey, Ankara, Turkey
| |
Collapse
|
2
|
Nursing students' perspectives on learning math for medication calculations in a Canadian nursing program in Qatar. Nurse Educ Pract 2020; 49:102885. [PMID: 33096334 DOI: 10.1016/j.nepr.2020.102885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/07/2020] [Accepted: 09/09/2020] [Indexed: 11/22/2022]
Abstract
This study describes nursing students' perspectives on learning math for medication calculations in a Canadian baccalaureate nursing program in Qatar. There is a dearth of guidance within the nursing literature to support teachers to develop pedagogical methods to help improve students' math competence. Moreover, the challenge of teaching math skills to student nurses in Qatar is particularly difficult because there is little standardization of curricula in secondary education. Data collected from focus groups was analyzed using interpretive description. Focus groups included, Group 1 those students who were beginning to learn math for medication calculations and had not completed the required math module and Group 2, students who had not yet completed the math module. Themes emerging from the data included from first year students, 1. Fear of math resulting in resistance to learning math for medication administration. 2. Student success is dependent on good instructors. 3. Student resentment towards perceived 'complicated' math in the nursing program. Themes from second year students included 1. Lack of nursing student's confidence with medication calculation within the clinical settings 2. Lack of self-directedness to uptake math knowledge 3. Incongruence amongst clinical instructors with applied math practice whilst in the clinical setting.
Collapse
|
3
|
Márquez-Hernández VV, Fuentes-Colmenero AL, Cañadas-Núñez F, Di Muzio M, Giannetta N, Gutiérrez-Puertas L. Factors related to medication errors in the preparation and administration of intravenous medication in the hospital environment. PLoS One 2019; 14:e0220001. [PMID: 31339914 PMCID: PMC6655641 DOI: 10.1371/journal.pone.0220001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/06/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Medication errors have long been associated with low-quality medical care services and significant additional medical costs. OBJECTIVE The aim of this study was to culturally adapt and validate the questionnaire on knowledge, attitudes and behaviors in the administration of intravenous medication, as well as to explore these factors in a hospital setting. METHODS The study was divided into two phases: 1) validation and cross-cultural adaptation, and 2) cross-sectional study. A total of 276 hospital-based nursing professionals participated in the study. RESULTS A Cronbach's alpha value of 0.849 was found, indicating good internal consistency. In the multivariate analysis, statistically significant differences were found between knowledge and attitudes, demonstrating that having greater suitable knowledge correlates with having a more positive attitude. It was also discovered that having a positive attitude as well as the necessary knowledge increases the possibility of engaging in adequate behaviors. CONCLUSIONS The knowledge, attitudes and behavior questionnaire has a satisfactory internal consistency in order to be applied to the Spanish context. Implications for nursing management: Knowledge acquisition and positive attitude are both factors which promote adequate behavior, which in turn seems to have an impact on medication errors prevention. Health institutions must encourage continuous education for their employees.
Collapse
Affiliation(s)
- Verónica V. Márquez-Hernández
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, Almería, Spain
- Research Group for Health Sciences, University of Almería, Almería Spain
| | | | | | - Marco Di Muzio
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Noemi Giannetta
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Lorena Gutiérrez-Puertas
- Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almería, Almería, Spain
| |
Collapse
|
4
|
Özyazıcıoğlu N, Aydın Aİ, Sürenler S, Çinar HG, Yılmaz D, Arkan B, Tunç GÇ. Evaluation of students' knowledge about paediatric dosage calculations. Nurse Educ Pract 2017; 28:34-39. [PMID: 28942096 DOI: 10.1016/j.nepr.2017.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 09/09/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022]
Abstract
Medication errors are common and may jeopardize the patient safety. As paediatric dosages are calculated based on the child's age and weight, risk of error in dosage calculations is increasing. In paediatric patients, overdose drug prescribed regardless of the child's weight, age and clinical picture may lead to excessive toxicity and mortalities while low doses may delay the treatment. This study was carried out to evaluate the knowledge of nursing students about paediatric dosage calculations. This research, which is of retrospective type, covers a population consisting of all the 3rd grade students at the bachelor's degree in May, 2015 (148 students). Drug dose calculation questions in exam papers including 3 open ended questions on dosage calculation problems, addressing 5 variables were distributed to the students and their responses were evaluated by the researchers. In the evaluation of the data, figures and percentage distribution were calculated and Spearman correlation analysis was applied. Exam question on the dosage calculation based on child's age, which is the most common method in paediatrics, and which ensures right dosages and drug dilution was answered correctly by 87.1% of the students while 9.5% answered it wrong and 3.4% left it blank. 69.6% of the students was successful in finding the safe dose range, and 79.1% in finding the right ratio/proportion. 65.5% of the answers with regard to Ml/dzy calculation were correct. Moreover, student's four operation skills were assessed and 68.2% of the students were determined to have found the correct answer. When the relation among the questions on medication was examined, a significant relation (correlation) was determined between them. It is seen that in dosage calculations, the students failed mostly in calculating ml/dzy (decimal). This result means that as dosage calculations are based on decimal values, calculations may be ten times erroneous when the decimal point is placed wrongly. Moreover, it is also seen that students lack maths knowledge in respect of four operations and calculating safe dose range. Relations among the medications suggest that a student wrongly calculating a dosage may also make other errors. Additional courses, exercises or utilisation of different teaching techniques may be suggested to eliminate the deficiencies in terms of basic maths knowledge, problem solving skills and correct dosage calculation of the students.
Collapse
Affiliation(s)
- Nurcan Özyazıcıoğlu
- Department of Pediatric Nursing, Faculty of Health Sciences, Uludağ University, Bursa, Turkey.
| | - Ayla İrem Aydın
- Department of Pediatric Nursing, Faculty of Health Sciences, Uludağ University, Bursa, Turkey.
| | - Semra Sürenler
- Department of Management Nursing, Faculty of Health Sciences, Uludağ University, Bursa, Turkey.
| | - Hava Gökdere Çinar
- Department of Management Nursing, Faculty of Health Sciences, Uludağ University, Bursa, Turkey.
| | - Dilek Yılmaz
- Department of Fundamental Nursing, Faculty of Health Sciences, Uludağ University, Bursa, Turkey.
| | - Burcu Arkan
- Department of Psychiatric Nursing, Faculty of Health Sciences, Uludağ University, Bursa, Turkey.
| | - Gülseren Çıtak Tunç
- Department of Psychiatric Nursing, Faculty of Health Sciences, Uludağ University, Bursa, Turkey.
| |
Collapse
|
5
|
Gaard M, Orbæk J. Supervising nursing students in a technology-driven medication administration process in a hospital setting: a systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2016; 14:52-57. [PMID: 27635745 DOI: 10.11124/jbisrir-2016-003051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The objective of this review is to identify, describe and synthesize the experiences of nurse supervisors and the factors that influence the supervision of pre-graduate nursing students in undertaking technology-driven medication administration in hospital settings.The current review seeks to answer the following questions.
Collapse
Affiliation(s)
- Mette Gaard
- 1Department of Medicine: University Amager-Hvidovre Hospital, Hvidovre, Denmark 2Department of Gastroenterology: University Amager-Hvidovre Hospital, Hvidovre, Denmark
| | | |
Collapse
|
6
|
Bagnasco A, Galaverna L, Aleo G, Grugnetti AM, Rosa F, Sasso L. Mathematical calculation skills required for drug administration in undergraduate nursing students to ensure patient safety: A descriptive study. Nurse Educ Pract 2016; 16:33-9. [DOI: 10.1016/j.nepr.2015.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 03/10/2015] [Accepted: 06/16/2015] [Indexed: 10/23/2022]
|
7
|
Alteren J, Nerdal L. Relationship between High School Mathematics Grade and Number of Attempts Required to Pass the Medication Calculation Test in Nurse Education: An Explorative Study. Healthcare (Basel) 2015; 3:351-63. [PMID: 27417767 PMCID: PMC4939530 DOI: 10.3390/healthcare3020351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/15/2015] [Indexed: 11/21/2022] Open
Abstract
In Norwegian nurse education, students are required to achieve a perfect score in a medication calculation test before undertaking their first practice period during the second semester. Passing the test is a challenge, and students often require several attempts. Adverse events in medication administration can be related to poor mathematical skills. The purpose of this study was to explore the relationship between high school mathematics grade and the number of attempts required to pass the medication calculation test in nurse education. The study used an exploratory design. The participants were 90 students enrolled in a bachelor’s nursing program. They completed a self-report questionnaire, and statistical analysis was performed. The results provided no basis for the conclusion that a statistical relationship existed between high school mathematics grade and number of attempts required to pass the medication calculation test. Regardless of their grades in mathematics, 43% of the students passed the medication calculation test on the first attempt. All of the students who had achieved grade 5 had passed by the third attempt. High grades in mathematics were not crucial to passing the medication calculation test. Nonetheless, the grade may be important in ensuring a pass within fewer attempts.
Collapse
Affiliation(s)
- Johanne Alteren
- Faculty of Professional Studies, University of Nordland, Campus Helgeland, Postboks 614, N-8607 Mo i Rana, Norway.
| | - Lisbeth Nerdal
- Faculty of Professional Studies, University of Nordland, Campus Helgeland, Postboks 614, N-8607 Mo i Rana, Norway.
| |
Collapse
|
8
|
Patient safety and technology-driven medication – A qualitative study on how graduate nursing students navigate through complex medication administration. Nurse Educ Pract 2015; 15:203-11. [DOI: 10.1016/j.nepr.2014.11.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 11/15/2014] [Accepted: 11/19/2014] [Indexed: 11/17/2022]
|
9
|
Simonsen BO, Daehlin GK, Johansson I, Farup PG. Differences in medication knowledge and risk of errors between graduating nursing students and working registered nurses: comparative study. BMC Health Serv Res 2014; 14:580. [PMID: 25413244 PMCID: PMC4243274 DOI: 10.1186/s12913-014-0580-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 11/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nurses experience insufficient medication knowledge; particularly in drug dose calculations, but also in drug management and pharmacology. The weak knowledge could be a result of deficiencies in the basic nursing education, or lack of continuing maintenance training during working years. The aim of this study was to compare the medication knowledge, certainty and risk of error between graduating bachelor students in nursing and experienced registered nurses. METHODS Bachelor students in closing term and registered nurses with at least one year job experience underwent a multiple choice test in pharmacology, drug management and drug dose calculations: 3x14 questions with 3-4 alternative answers (score 0-42). Certainty of each answer was recorded with score 0-3, 0-1 indicating need for assistance. Risk of error was scored 1-3, where 3 expressed high risk: being certain that a wrong answer was correct. The results are presented as mean and (SD). RESULTS Participants were 243 graduating students (including 29 men), aged 28.2 (7.6) years, and 203 registered nurses (including 16 men), aged 42.0 (9.3) years and with a working experience of 12.4 years (9.2). The knowledge among the nurses was found to be superior to that of the students: 68.9%(8.0) and 61.5%(7.8) correct answers, respectively, (p < 0.001). The difference was largest in drug management and dose calculations. The improvement occurred during the first working year. The nurses expressed higher degree of certainty and the risk of error was lower, both overall and for each topic (p < 0.01). Low risk of error was associated with high knowledge and high sense of coping (p < 0.001). CONCLUSIONS The medication knowledge among experienced nurses was superior to bachelor students in nursing, but nevertheless insufficient. As much as 25% of the answers to the drug management questions would lead to high risk of error. More emphasis should be put into the basic nursing education and in the introduction to medication procedures in clinical practice to improve the nurses' medication knowledge and reduce the risk of error.
Collapse
|
10
|
Grugnetti AM, Bagnasco A, Rosa F, Sasso L. Effectiveness of a Clinical Skills Workshop for drug-dosage calculation in a nursing program. NURSE EDUCATION TODAY 2014; 34:619-624. [PMID: 23810339 DOI: 10.1016/j.nedt.2013.05.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Revised: 05/20/2013] [Accepted: 05/31/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Mathematical and calculation skills are widely acknowledged as being key nursing competences if patients are to receive care that is both effective and safe. Indeed, weaknesses in mathematical competence may lead to the administration of miscalculated drug doses, which in turn may harm or endanger patients' lives. However, little attention has been given to identifying appropriate teaching and learning strategies that will effectively facilitate the development of these skills in nurses. One such approach may be simulation. OBJECTIVES To evaluate the effectiveness of a Clinical Skills Workshop on drug administration that focused on improving the drug-dosage calculation skills of second-year nursing students, with a view to promoting safety in drugs administration. DESIGN A descriptive pre-post test design. SETTINGS Educational. Simulation center. PARTICIPANTS The sample population included 77 nursing students from a Northern Italian University who attended a 30-hour Clinical Skills Workshop over a period of two weeks. METHODS The workshop covered integrated teaching strategies and innovative drug-calculation methodologies which have been described to improve psychomotor skills and build cognitive abilities through a greater understanding of mathematics linked to clinical practice. RESULTS Study results showed a significant improvement between the pre- and the post-test phases, after the intervention. Pre-test scores ranged between 0 and 25 out of a maximum of 30 points, with a mean score of 15.96 (SD 4.85), and a median score of 17. Post-test scores ranged between 15 and 30 out of 30, with a mean score of 25.2 (SD 3.63) and a median score of 26 (p<0.001). CONCLUSIONS Our study shows that Clinical Skills Workshops may be tailored to include teaching techniques that encourage the development of drug-dosage calculation skills, and that training strategies implemented during a Clinical skills Workshop can enhance students' comprehension of mathematical calculations.
Collapse
Affiliation(s)
- Anna Maria Grugnetti
- Department of Health Sciences, University of Genoa, Via Pastore 1, I-16132 Genoa, Italy.
| | - Annamaria Bagnasco
- Department of Health Sciences, University of Genoa, Via Pastore 1, I-16132 Genoa, Italy.
| | - Francesca Rosa
- Department of Health Sciences, University of Genoa, Via Pastore 1, I-16132 Genoa, Italy.
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Via Pastore 1, I-16132 Genoa, Italy.
| |
Collapse
|
11
|
van de Mortel TF, Whitehair LP, Irwin PM. A whole-of-curriculum approach to improving nursing students' applied numeracy skills. NURSE EDUCATION TODAY 2014; 34:462-467. [PMID: 23684524 DOI: 10.1016/j.nedt.2013.04.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 04/22/2013] [Accepted: 04/25/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Nursing students often perform poorly on numeracy tests. Whilst one-off interventions have been trialled with limited success, a whole-of-curriculum approach may provide a better means of improving applied numeracy skills. OBJECTIVE The objective of the study is to assess the efficacy of a whole-of-curriculum approach in improving nursing students' applied numeracy skills. DESIGN Two cycles of assessment, implementation and evaluation of strategies were conducted following a high fail rate in the final applied numeracy examination in a Bachelor of Nursing (BN) programme. Strategies included an early diagnostic assessment followed by referral to remediation, setting the pass mark at 100% for each of six applied numeracy examinations across the programme, and employing a specialist mathematics teacher to provide consistent numeracy teaching. SETTING The setting of the study is one Australian university. PARTICIPANTS 1035 second and third year nursing students enrolled in four clinical nursing courses (CNC III, CNC IV, CNC V and CNC VI) were included. METHODS Data on the percentage of students who obtained 100% in their applied numeracy examination in up to two attempts were collected from CNCs III, IV, V and VI between 2008 and 2011. A four by two χ(2) contingency table was used to determine if the differences in the proportion of students achieving 100% across two examination attempts in each CNC were significantly different between 2008 and 2011. RESULTS The percentage of students who obtained 100% correct answers on the applied numeracy examinations was significantly higher in 2011 than in 2008 in CNC III (χ(2)=272, 3; p<0.001), IV (χ(2)=94.7, 3; p<0.001) and VI (χ(2)=76.3, 3; p<0.001). CONCLUSIONS A whole-of-curriculum approach to developing applied numeracy skills in BN students resulted in a substantial improvement in these skills over four years.
Collapse
Affiliation(s)
| | | | - Pauletta M Irwin
- Southern Cross University, PO Box 157, Lismore 2480, NSW, Australia
| |
Collapse
|
12
|
Ramjan LM, Stewart L, Salamonson Y, Morris MM, Armstrong L, Sanchez P, Flannery L. Identifying strategies to assist final semester nursing students to develop numeracy skills: a mixed methods study. NURSE EDUCATION TODAY 2014; 34:405-412. [PMID: 23623279 DOI: 10.1016/j.nedt.2013.03.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 03/15/2013] [Accepted: 03/22/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND It remains a grave concern that many nursing students within tertiary institutions continue to experience difficulties with achieving medication calculation competency. In addition, universities have a moral responsibility to prepare proficient clinicians for graduate practice. This requires risk management strategies to reduce adverse medication errors post registration. AIM To identify strategies and potential predictors that may assist nurse academics to tailor their drug calculation teaching and assessment methods. This project builds on previous experience and explores students' perceptions of newly implemented interventions designed to increase confidence and competence in medication calculation. METHODS This mixed method study surveyed students (n=405) enrolled in their final semester of study at a large, metropolitan university in Sydney, Australia. Tailored, contextualised interventions included online practice quizzes, simulated medication calculation scenarios developed for clinical practice classes, contextualised 'pen and paper' tests, visually enhanced didactic remediation and 'hands-on' contextualised workshops. Surveys were administered to students to determine their perceptions of interventions and to identify whether these interventions assisted with calculation competence. Test scores were analysed using SPSS v. 20 for correlations between students' perceptions and actual performance. Qualitative open-ended survey questions were analysed manually and thematically. RESULTS The study reinforced that nursing students preferred a 'hands-on,' contextualised approach to learning that was 'authentic' and aligned with clinical practice. Our interventions assisted with supporting students' learning and improvement of calculation confidence. Qualitative data provided further insight into students' awareness of their calculation errors and preferred learning styles. Some of the strongest predictors for numeracy skill performance included (1) being an international student, (2) completion of an online practice quiz, scoring 59% or above and (3) students' self-reported confidence. CONCLUSION A paradigm shift from traditional testing methods to the implementation of intensive, contextualised numeracy teaching and assessment within tertiary institutions will enhance learning and promote best teaching practices.
Collapse
Affiliation(s)
- Lucie M Ramjan
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751.
| | - Lyn Stewart
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751.
| | - Yenna Salamonson
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751.
| | - Maureen M Morris
- Student Learning Unit, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751.
| | - Lyn Armstrong
- Student Learning Unit, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751.
| | - Paula Sanchez
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751; Centre for Applied Nursing Research (CANR), South Western Sydney Local Health Network Services, Locked Bag 7103, Liverpool BC NSW 1871.
| | - Liz Flannery
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751.
| |
Collapse
|
13
|
Wright K. How do nurses solve drug calculation problems? NURSE EDUCATION TODAY 2013; 33:450-457. [PMID: 22595613 DOI: 10.1016/j.nedt.2012.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 04/12/2012] [Accepted: 04/19/2012] [Indexed: 05/31/2023]
Abstract
UNLABELLED This article reports on a pilot study that examined the cognitive processes and strategies used by senior nurses to solve written drug calculation problems. METHODOLOGY Verbal protocol methodology was used to gain and analyse data from eight senior nurses now working in the education setting. The data was analysed using verbal protocol analysis. RESULTS Nurses used a range of strategies to solve the problems, not just the nursing formula. The cognitive processes of the nurses showed a larger number of steps devoted to problem representation and only a few steps devoted to actually solving the problem. CONCLUSION Nurse educators need to consider the importance of problem representation in solving drug calculations and in particular ensure that written questions are representative of clinical practice.
Collapse
Affiliation(s)
- Kerri Wright
- University of Greenwich, Avery Hill Campus, Eltham, London, SE9 2UG, United Kingdom.
| |
Collapse
|
14
|
Weeks KW, Sabin M, Pontin D, Woolley N. Safety in numbers: An introduction to the nurse education in practice series. Nurse Educ Pract 2013; 13:e4-e10. [DOI: 10.1016/j.nepr.2012.06.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 06/09/2012] [Indexed: 11/28/2022]
|
15
|
Weeks KW, Hutton BM, Young S, Coben D, Clochesy JM, Pontin D. Safety in numbers 2: Competency modelling and diagnostic error assessment in medication dosage calculation problem-solving. Nurse Educ Pract 2013; 13:e23-32. [DOI: 10.1016/j.nepr.2012.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 10/16/2012] [Accepted: 10/17/2012] [Indexed: 11/25/2022]
|
16
|
Safety in numbers 4: The relationship between exposure to authentic and didactic environments and Nursing Students' learning of medication dosage calculation problem solving knowledge and skills. Nurse Educ Pract 2013; 13:e43-54. [DOI: 10.1016/j.nepr.2012.10.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 10/16/2012] [Accepted: 10/17/2012] [Indexed: 11/17/2022]
|
17
|
Weeks KW, Higginson R, Clochesy JM, Coben D. Safety in numbers 7: Veni, vidi, duci: a grounded theory evaluation of nursing students' medication dosage calculation problem-solving schemata construction. Nurse Educ Pract 2013; 13:e78-87. [PMID: 23287565 DOI: 10.1016/j.nepr.2012.10.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 10/16/2012] [Accepted: 10/17/2012] [Indexed: 11/19/2022]
Abstract
This paper evaluates nursing students' transition through schemata construction and competence development in medication dosage calculation problem-solving (MDC-PS). We advance a grounded theory from interview data that reflects the experiences and perceptions of two groups of undergraduate pre-registration nursing students: eight students exposed to a prototype authentic MDC-PS environment and didactic transmission methods of education and 15 final year students exposed to the safeMedicate authentic MDC-PS environment. We advance a theory of how classroom-based 'chalk and talk' didactic transmission environments offered multiple barriers to accurate MDC-PS schemata construction among novice students. While conversely it was universally perceived by all students that authentic learning and assessment environments enabled MDC-PS schemata construction through facilitating: 'seeing' the authentic features of medication dosage problems; context-based and situational learning; learning within a scaffolded environment that supported construction of cognitive links between the concrete world of clinical MDC-PS and the abstract world of mathematics; and confidence-building in their cognitive and functional competence ability. Drawing on the principle of veni, vidi, duci (I came, I saw, I calculated), we combined the two sets of evaluations to offer a grounded theoretical basis for schemata construction and competence development within this critical domain of professional practice.
Collapse
Affiliation(s)
- Keith W Weeks
- Faculty of Health, Sport & Science, University of Glamorgan, United Kingdom.
| | | | | | | |
Collapse
|
18
|
|
19
|
Wright K. The assessment of drug calculation skills--time to rethink the whole process. NURSE EDUCATION TODAY 2012; 32:341-344. [PMID: 22153386 DOI: 10.1016/j.nedt.2011.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 11/16/2011] [Indexed: 05/31/2023]
Affiliation(s)
- Kerri Wright
- University of Greenwich, Avery Hill campus, Eltham, London, SE9 2UG, United Kingdom
| |
Collapse
|
20
|
Ramjan LM. Contextualism adds realism: nursing students' perceptions of and performance in numeracy skills tests. NURSE EDUCATION TODAY 2011; 31:e16-e21. [PMID: 21126812 DOI: 10.1016/j.nedt.2010.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 10/29/2010] [Accepted: 11/04/2010] [Indexed: 05/30/2023]
Abstract
This project investigated nursing students' perceptions of and performance in a de-contextualised diagnostic maths paper (i.e. questions only) and a contextualised diagnostic maths paper (i.e. visual pictures along with questions). Sampling was purposive, the criteria being that participants would be from the population of student nurses (n=700) in their second year, of a three-year Bachelor of Nursing course, undertaking a Unit 'Medical-Surgical Nursing 1' (MSN1) at one of four campuses across the University of Western Sydney (UWS), NSW, Australia. The numerical test scores for both papers were analysed with the assistance of SPSS software and a Professional Development Officer. The survey data were analysed manually and thematically by the researcher. There was a substantive improvement in scores from Test 1 (de-contextualised) to Test 2 (contextualised). It is uncertain whether the change occurred because Test 2 is a genuinely better presentation than Test 1 or just a practice effect. Nevertheless, the contextualised paper was preferred by the majority of students (80%). Students preferred the visual images and revealed that it led to a "deeper learning" of numeracy skills, reduced stress and anxiety levels and simulated 'the real life' clinical setting, thus adding "an element of realism" to the situation.
Collapse
Affiliation(s)
- Lucie M Ramjan
- School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith South DC 1797, Sydney, NSW, Australia.
| |
Collapse
|
21
|
|
22
|
Dilles T, Vander Stichele RR, Van Bortel L, Elseviers MM. Nursing students' pharmacological knowledge and calculation skills: ready for practice? NURSE EDUCATION TODAY 2011; 31:499-505. [PMID: 20837376 DOI: 10.1016/j.nedt.2010.08.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 08/03/2010] [Accepted: 08/07/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To evaluate graduating students' pharmacological knowledge and calculation skills and describe their self-rated readiness to safe medication care in practice on two nurse educational levels. Additionally, the study describes some characteristics of pharmacology in nurse education in Flanders, Belgium. METHODS Thirty-eight nursing schools (bachelor's degree in nursing [N=18] and diploma in nursing [N=20]) were asked to provide details on their pharmacology curriculum and to let their graduating students participate in a cross-sectional survey using the Medication Knowledge and Calculation test in February/March 2009. RESULTS The 29 participating schools showed a large diversity in pharmacology curricula. Mean scores on the pharmacology section and calculation section were 55% and 66%, respectively, for bachelor's degree and 52% and 53% for diploma students. On a scale of 1-10, 27% had a self-rated readiness perception≤5. Results differed significantly between schools. CONCLUSIONS Just before graduation, nursing students' pharmacological knowledge and calculation skills are limited. Apart from the test results, students did not perceive themselves able to deliver safe medication care in practice. Schools need to address the shortcomings. In practice, awareness is needed regarding possible limitations of the newly graduated.
Collapse
MESH Headings
- Adult
- Belgium
- Clinical Competence/standards
- Cross-Sectional Studies
- Curriculum
- Drug Dosage Calculations
- Education, Nursing, Baccalaureate
- Education, Nursing, Diploma Programs
- Female
- Health Knowledge, Attitudes, Practice
- Humans
- Male
- Middle Aged
- Nursing Education Research
- Pharmacology, Clinical/education
- Schools, Nursing
- Self Efficacy
- Students, Nursing/psychology
- Students, Nursing/statistics & numerical data
- Young Adult
Collapse
Affiliation(s)
- Tinne Dilles
- University of Antwerp, Department of Nursing Science, Belgium.
| | | | | | | |
Collapse
|
23
|
Dyjur L, Rankin J, Lane A. Maths for medications: an analytical exemplar of the social organization of nurses' knowledge. Nurs Philos 2011; 12:200-13. [DOI: 10.1111/j.1466-769x.2011.00493.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
24
|
Koohestani H, Baghcheghi N. Comparing the effects of two educational methods of intravenous drug rate calculations on rapid and sustained learning of nursing students: Formula method and dimensional analysis method. Nurse Educ Pract 2010; 10:233-7. [PMID: 20018563 DOI: 10.1016/j.nepr.2009.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Revised: 09/12/2009] [Accepted: 11/15/2009] [Indexed: 10/20/2022]
|
25
|
Wright K. Do calculation errors by nurses cause medication errors in clinical practice? A literature review. NURSE EDUCATION TODAY 2010; 30:85-97. [PMID: 19666199 DOI: 10.1016/j.nedt.2009.06.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 06/10/2009] [Accepted: 06/15/2009] [Indexed: 05/28/2023]
Abstract
This review aims to examine the literature available to ascertain whether medication errors in clinical practice are the result of nurses' miscalculating drug dosages. The research studies highlighting poor calculation skills of nurses and student nurses have been tested using written drug calculation tests in formal classroom settings [Kapborg, I., 1994. Calculation and administration of drug dosage by Swedish nurses, student nurses and physicians. International Journal for Quality in Health Care 6(4): 389 -395; Hutton, M., 1998. Nursing Mathematics: the importance of application Nursing Standard 13(11): 35-38; Weeks, K., Lynne, P., Torrance, C., 2000. Written drug dosage errors made by students: the threat to clinical effectiveness and the need for a new approach. Clinical Effectiveness in Nursing 4, 20-29]; Wright, K., 2004. Investigation to find strategies to improve student nurses' maths skills. British Journal Nursing 13(21) 1280-1287; Wright, K., 2005. An exploration into the most effective way to teach drug calculation skills to nursing students. Nurse Education Today 25, 430-436], but there have been no reviews of the literature on medication errors in practice that specifically look to see whether the medication errors are caused by nurses' poor calculation skills. The databases Medline, CINAHL, British Nursing Index (BNI), Journal of American Medical Association (JAMA) and Archives and Cochrane reviews were searched for research studies or systematic reviews which reported on the incidence or causes of drug errors in clinical practice. In total 33 articles met the criteria for this review. There were no studies that examined nurses' drug calculation errors in practice. As a result studies and systematic reviews that investigated the types and causes of drug errors were examined to establish whether miscalculations by nurses were the causes of errors. The review found insufficient evidence to suggest that medication errors are caused by nurses' poor calculation skills. Of the 33 studies reviewed only five articles specifically recorded information relating to calculation errors and only two of these detected errors using the direct observational approach. The literature suggests that there are other more pressing aspects of nurses' preparation and administration of medications which are contributing to medication errors in practice that require more urgent attention and calls into question the current focus on calculation and numeracy skills of pre registration and qualified nurses (NMC 2008). However, more research is required into the calculation errors in practice. In particular there is a need for a direct observational study on paediatric nurses as there are presently none examining this area of practice.
Collapse
Affiliation(s)
- Kerri Wright
- University of Greenwich, Avery Hill Road, Eltham SE9 2UG, United Kingdom.
| |
Collapse
|
26
|
Wright K. Resources to help solve drug calculation problems. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2009; 18:878-883. [PMID: 19633600 DOI: 10.12968/bjon.2009.18.14.43357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This article is the third in a series of articles discussing drug calculations and discusses the resources, in terms of knowledge and skills, that are required to support the use of methods for solving calculation problems (Wright, 2009). The main resources discussed are clinical practice, numeracy knowledge (including number patterns), proportions and factors, and clinical tools such as syringes. These resources can be used as part of formal teaching sessions, or can be developed and practised by individual nurses to improve knowledge and confidence in solving drug calculations. The most important resource for developing drug calculation skills is regular exposure to drug calculations in clinical practice. Any drug calculation teaching and assessing, therefore must have clinical practice as the starting point, with numeracy knowledge not extracted and taught separately, but developed as a resource from within practice, for the purpose of supporting practice.
Collapse
|