Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses Page: 5
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Also, many other cases of medication errors have caused complications that did not result in
death, but did cause injury, suffering, or increased medical care. One case in California involved
the overdose of heparin to three infants, including a celebrity's twins ("Cedars-Sinai Fined,"
2008; Errico, 2007; Finn, 2008; "Heparin Overdose," 2007). The calculation errors were made
by doctors, anesthesia personnel, nurses, and pharmacists (Finn, 2008; "Heparin Overdose,"
2007; ISMP, 2007, 2008a, 2008b, 2008c; "Methodist Hospital Admits," 2006). The system
should have enough check systems in the process to catch such errors (Horns & Loper, 2002;
Mullner, 2003; Shane, 2009). Calculation errors should be infrequent; there should be several
steps in the process/system to check and recheck the calculations. A significant need exists to
determine what can be done to minimize medication dosage errors. Nurses are the most common
providers of care at the drug administration stage of the medication process. One important
element to improving patient safety would be to analyze the medication calculation attitudes and
skills of bedside nurses in the hospital. Nurses need to improve performance and skills in
preparing and administering medications accurately, including calculating dosages, determining
IV infusion rates, and operating medication delivery devices.
Chang and Mark (2009) describe several antecedents that relate to medication errors such
as work environment factors, team factors, person factors, and medication-related support
services. Human factors can include attitudes, emotional states, stress levels, and many other
personal variables. Greenfield, Whelan, and Cohn (2006) believe that "the current failure of
hospital-based initiatives to significantly reduce calculation errors may be a signal that this issue
needs to be addressed at the educational level" (p. 91). The training and competency of
practicing nurses needs to be reinforced and mathematic skills mastered for accurate medication
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Melius, Joyce. Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses, dissertation, May 2012; Denton, Texas. (digital.library.unt.edu/ark:/67531/metadc115119/m1/13/: accessed May 22, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .