Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses Page: 9
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found that 7% of the errors were miscalculation of dosage or infusion rate, 2.3% drug
preparation errors, and the majority of errors, 42%, were the human factors combined.
Medication calculations prone to errors usually involve dosages or dilutions (McDowell, Ferner,
& Ferner, 2009).
Medication risk factors are the types of medications, actual number of medications,
number of medications that are injected or infused, number that are based on the patient's
weight, those that require calculations and careful monitoring, and use of sophisticated pumps
that require programming (Moyen et al., 2008). Calculations using dilution for liquid
medications for oral administration, IV, and injections are more difficult than calculating the
number of pills (Bayne & Bindler, 1991; Walsh, 2006). Some IV infusions have to be given
based on a dose of micrograms per kilogram per minute, and the infusion pump is set in
milliliters per hour. The calculation of weight-based doses and/or infusion rates would be most
difficult for the nurse who cannot do the simpler dose calculations with accuracy. Many errors
may simply be because nurses have limited skills in doing simple medication calculations, and
fixing these skills may improve the system and create safer nurses (Polifroni, Allchin, &
Several researchers agree that one in six medication errors involve calculations (Capriotti,
2004; Lesar et al., 1997). Medication calculation errors are between 7% and 14% of all
medication errors (Polifroni et al., 2003, p. 455). The calculations involved in most medication
calculations are estimated to be at a 7th-grade mathematics level or below and involve simple
arithmetic, multiplication, division, fractions, decimals, percentages, and conversions to the
metric system (Hughes & Edgerton, 2005; Polifroni et al., 2003; Rainboth & DeMasi, 2006).
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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/m1/17/: accessed February 19, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .