Abstract:

Background: Drug dosage calculation and administration is important function of nurses. The key professional role of nurses is to ensure safe drug dosage calculation while performing medication administration. Medication errors are a common cause of adverse events that may result due to wrong drug dosage calculation. The assessment of nurse's knowledge related to drug dosage calculation has not been conducted at the time of commencing their employment in the study hospital.

Purpose: The purpose of this study was to assess the drug dosage calculation knowledge and proficiency among our newly hired nurses before and after the training session.

Method and design: Participatory Action Research (PAR) approach was selected using pre and post -test to assess the newly hired nurse's knowledge and proficiency related to drug dosage calculation. Data was collected after IRB approval at private tertiary hospital, Islamabad, Pakistan.

Sample: Purposive sampling technique was adopted (n=135) all nurses on their commencement of employment from July 2016 to October 2016 participated in the study after the informed consent.

Findings: The study results showed the significant improvement in drug dosage calculation knowledge and proficiency among the study participants while comparing pre-test and post-test results.

Conclusion: The study concluded in the light of pre-test and post-test results that there is an intense need to review the nurse's drug dosage calculation knowledge and proficiency at the time of employment as nurses are key player in drug preparation and administration.

Keywords: Drug dosage calculation, conceptual skills in mathematics, proficiency, an evaluation of drug dosage, essential competency, dosage calculation knowledge, numeracy.

References:

[1].     Agalu, A., Ayele, Y., Bedada, W., & Woldie, M. (2012). Medication administration errors in an intensive care unit in Ethiopia. Int Arch Med, 5(1), 15. doi: 10.1186/1755-7682-5-15.

[2].     Anderson, P., & Townsend, T. (2010). Medication errors: Don’t let them happen to you. American Nurse Today, 5(3), 23-27.

[3].     Aronson, J. K. (2009). Medication errors: Emerging solutions. British Journal of Clinical Pharmacology, 67(6), 589-591. doi: 10.1111/j.1365-2125.2009.03420.x.

[4].     Athanasakis, E. (2012). Prevention of medication errors made by nurses in clinical practice. Health Science Journal. Retrieved from http://www.hsj.gr/medicine/prevention-of-medication-errors-made-by-nurses-in-clinical-practice.pdf September 27, 2017.

[5].     Billings, D. M., & Halstead, J. A. (2005). Teaching in Nursing: A Guide for Faculty (2nd ed.): Saunders.

[6].     Blais, K., & Bath, J. B. (1992). Drug calculation errors of baccalaureate nursing students. Nurse Educator, 17(1), 12-15. doi: 10.1097/00006223-199201000-00010.

[7].     Cheragi, M. A., Manoocheri, H., Mohammadnejad, E., & Ehsani, S. R. (2013). Types and causes of medication errors from nurse's viewpoint. Iranian Journal of Nursing and Midwifery Research, 18(3), 228-231.

[8].     Cousins, D. H., Sabatier, B., Begue, D., Schmitt, C., & Hoppe-Tichy, T. (2005). Medication errors in intravenous drug preparation and administration: a multicentre audit in the UK, Germany and France. Quality and Safety in Health Care, 14(3), 190-195. doi: 10.1136/qshc.2003.006676.

[9].     Coyne, E., Needham, J., & Rands, H. (2013). Enhancing student nurses' medication calculation knowledge; integrating theoretical knowledge into practice. Nurse Educ Today, 33(9), 1014-1019. doi: 10.1016/j.nedt.2012.04.006.

[10].       David, G., Gunnarsson, C. L., Waters, H. C., Horblyuk, R., & Kaplan, H. S. (2013). Economic measurement of medical errors using a hospital claims database. Value in Health, 16(2), 305-310. doi: 10.1016/j.jval.2012.11.010.

[11].       Fleming, S., Brady, A. M., & Malone, A. M. (2014). An evaluation of the drug calculation skills of registered nurses. Nurse Educ Pract, 14(1), 55-61. doi: 10.1016/j.nepr.2013.06.002.

[12].       Freedman, J. E., Becker, R. C., Adams, J. E., Borzak, S., Jesse, R. L., Newby, L. K., . . . Cannon, C. (2002). Medication errors in acute cardiac care: An American Heart Association scientific statement from the Council on Clinical Cardiology Subcommittee on Acute Cardiac Care, Council on Cardiopulmonary and Critical Care, Council on Cardiovascular Nursing, and Council on Stroke. Circulation, 106(20), 2623-2629. doi: 10.1161/01.CIR.0000037748.19282.7D.

[13].       Grandell-Niemi, H., Hupli, M., & Leino-Kilpi, H. (2001). Medication calculation skills of graduating nursing students in Finland. Adv Health Sci Educ Theory Pract, 6(1), 15-24.

[14].       Han, P. Y., Coombes, I. D., & Green, B. (2005). Factors predictive of intravenous fluid administration errors in Australian surgical care wards. Qual Saf Health Care, 14(3), 179-184. doi: 10.1136/qshc.2004.010728.

[15].       McMullan, M., Jones, R., & Lea, S. (2010). Patient safety: numerical skills and drug calculation abilities of nursing students and Registered Nurses. Journal of Advanced Nursing, 66(4), 891-899. doi: 10.1111/j.1365-2648.2010.05258.x.

[16].       Michaels, A. D., Spinler, S. A., Leeper, B., Ohman, E. M., Alexander, K. P., Newby, L. K., . . . Gibler, W. B. (2010). Medication errors in acute cardiovascular and stroke patients: a scientific statement from the American Heart Association. Circulation, 121(14), 1664-1682. doi: 10.1161/CIR.0b013e3181d4b43e.

[17].       Polit, D. F., & Beck, C. T. (2004). Nursing research principles and methods (Seventh ed.). Philadelphia: Lippincott Williams & Wilkins.

[18].       Savage, A. R. (2015). Educational audit on drug dose calculation learning in a Tanzanian school of nursing. Afr Health Sci, 15(2), 647-655. doi: 10.4314/ahs.v15i2.44.

[19].       Shamsuddin, A. F., & Shafie, S. D. (2012). Knowledge of Nurses in the Preparation and Administration of Intravenous Medications. Procedia - Social and Behavioral Sciences, 60, 602-609. doi: http://dx.doi.org/10.1016/j.sbspro.2012.09.429.

[20].       Simonsen, B. O., Daehlin, G. K., Johansson, I., & Farup, P. G. (2014). Differences in medication knowledge and risk of errors between graduating nursing students and working registered nurses: comparative study. BMC Health Serv Res, 14, 580. doi: 10.1186/s12913-014-0580-7.

[21].       Sohrevardi, S. M., Mirjalili, M. R., Jarrahzadeh, M. H., Mirjalili, M., & Mirzaei, E. (2014). Evaluating the Frequency of Errors in Preparation and Administration of Intravenous Medications in the Intensive Care Unit of Shahid-Sadoughi Hospital in Yazd. Journal of Pharmaceutical Care, 2(3), 114-119. doi: http://jpc.tums.ac.ir/index.php/jpc/article/view/57/57.

[22].       Sulosaari, V., Huupponen, R., Hupli, M., Puukka, P., Torniainen, K., & Leino-Kilpi, H. (2015). Factors associated with nursing students’ medication competence at the beginning and end of their education. BMC Medical Education, 15(1), 223. Retrieved from https://doi.org/10.1186/s12909-015-0513-0 September 27, 2017 doi:10.1186/s12909-015-0513-0.

[23].       Taxis, K., & Barber, N. (2003). Causes of intravenous medication errors: an ethnographic study. Quality & safety in health care, 12(5), 343-347. doi: 10.1136/qhc.12.5.343.

[24].       Tshiamo, W. B., Kgositau, M., Ntsayagae, E., & Sabone, M. B. (2015). The role of nursing education in preventing medication errors in Botswana. International Journal of Africa Nursing Sciences, 3, 18-23. Retrieved from http://www.africanursingsciencesjournal.com/article/S2214-1391(15)00013-X/pdf September 27, 2017 doi:10.1016/j.ijans.2015.06.001.

[25].       Westbrook, J. I., Rob, M. I., Woods, A., & Parry, D. (2011). Errors in the administration of intravenous medications in hospital and the role of correct procedures and nurse experience. BMJ Qual Saf, 20(12), 1027-1034. doi: 10.1136/bmjqs-2011-000089.

[26].       Wright, K. (2004). An investigation to find strategies to improve student nurses' maths skills. Br J Nurs, 13(21), 1280-1287. doi: 10.12968/bjon.2004.13.21.17114.

[27].       Wright, K. (2010). Do calculation errors by nurses cause medication errors in clinical practice? A literature review. Nurse Educ Today, 30(1), 85-97. doi: 10.1016/j.nedt.2009.06.009.

[28].       Zare, Z. G., Purfarzad, Z., & Adib-Hajbaghery, M. (2013). Medication Management Skills of Nursing Students: Comparing the Students and Their Instructors Evaluation in two Universities. [Research Article]. Nurs Midwifery Stud, 1(3), 139-145. doi: 0.5812/nms.8555.