Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses Page: 26
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The administration stage is the last step in the process before the medication reaches the
patient and is the last chance to prevent an error. Preparation and administration are the steps
when most medication calculation errors occur, with more errors occurring during administration
(Kuitunen, Kuisma, & Hoppu, 2008; Shane, 2009, Williams & Maddox, 2005).Since nurses
predominantly administer most of the medications they need to be the "last potential barrier
between a medication error" (Hughes & Edgerton, 2005, p. 79). The administration stage can be
a simple process such as giving oral medications in the form of a tablet or capsule to an alert,
oriented, and cooperative patient. Or the process may be complicated such as when giving
liquids and parenteral (other than by gastrointestinal tract) medications. Liquid medications for
oral or gastrointestinal use must first be measured into a measuring device and then given to the
patient by mouth or placed into feeding tubes. Some liquid medications have to be converted
from teaspoons to milliliters. An error in mixing up milliliters with teaspoons can be quite
harmful; 5 milliliters is a very different dose from 5 teaspoons. Not all patients are cooperative
when receiving medication; for instance, infants and toddlers have to be coaxed. Additionally,
many pediatric medications have to be dosed and administered according to the patient's weight.
Since many pediatric medications are liquid, it is important to administer the medication by the
correct route. Devastating errors, including death, have been made by giving liquid doses in the
wrong route, wrong device, and/or wrong dose (Brehio, 2009; ISMP, 2000). An 18-year-old was
prescribed oxycodone oral solution for a sore throat; however, he mistakenly received 100 mg
instead of the 5 mg prescribed (Brehio, 2009). The patient suffered organ failure, was put on a
ventilator, and remains in a coma. The ISMP has had reports of more than 30 mix-ups between
milliliters to teaspoons, and several cases have required treatment or hospitalization (Brehio,
2009). The potential for errors can become more probable with the increase in the number of
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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/m1/34/: accessed November 24, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .