Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses Page: 51

to validation of mathematical competency are validation procedures, actual test used, scoring
criteria, outcomes if passing not achieved, and remediation procedures (Polifroni et al., 2003, p.
456). Acute care institutions had specific passing rates ranging from 70% to 100%; most
required 80% and above. According to Polifroni et al. (2003), all acute care institutions reported
validation of medication calculation skills prior to medication administration using an institution
designed test with no attention to grade level of mathematics and test-taking skills. The acute
care institutions provided remediation with some practice problems before repeating the same
test and did not report testing after initial passing of the examination. Pietsch (2005) discussed
the need for continued competency measurements of medication calculation ability in nurses and
nursing students. She states that since the mathematical competency is also linked to health care
institutions many hospitals have started testing mathematical competency annually. There is
concern about nursing teacher's practice of allowing the student to take the medication
calculation test three times. Nurses do not get three tries to give medication correctly. Pietsch
concludes with the question of how the medication calculation administration tests impact
medication errors.
Hospital educators are concerned with the new graduates' ability regarding medication
administration (Polifroni et al., 2003). However, most are not clear in expectations and do not
address the ongoing mathematical skills in regards to medication calculations (Polifroni et al.,
2003, p. 81). It has been recommended to test nurses who use these types of infusions and have
their competency periodically checked as often as annually (McMullan et al., 2010; Pietsch,
2005; Polifroni et al., 2005). Harne-Britner et al. (2006) found that nurses and nursing students
had limited medication calculation skills and showed significant improvement of scores on a 20-
item medication calculation test with the various interventions. The interventions included a 30-

51