Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses Page: 28
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monitoring of patients. Monitoring of patients, depending on the type of medication and the
condition of the patient, may be conducted in a specialized unit with specially trained nurses.
When medications are to be administered via an infusion device, nurses usually take care
of the device set-up and operation. Most infusion devices require a rate set with a reference to
time and/or can be programmed for many standard infusions. The pharmacy can print the rate at
which to set the device or print it on the medication administration record (MAR). The nurse
administering the medication must double-check the doses programmed into the infusion device
or that the pharmacy calculated. Failure to double-check doses with another source is cited to be
a cause of medication errors (Jones, 2009).
Medication calculations are necessary to determine the volumes of additives and diluents
for accurate injections, infusions, and safe medication administration. Some calculations are
simple and require the use of seventh-grade mathematics (Polifroni et al., 2003), multiplication
and division and simple fractions which require only a couple of steps. Other calculations are
more complex and involve metric conversions, teaspoons to milliliters, weight-based dosing,
pounds to kilograms, and infusion calculations which add time, minutes, and hours to the
equation and increase the number of steps required to complete the calculation. Complicated
infusion calculations may involve micrograms per kilogram per minute first, then must be
converted to milliliters per hour, the most common setting for infusion pumps.
Medication Safety Initiatives
Safety initiatives have been suggested to decrease errors across all stages of the
medication process and are promoted worldwide (Doormaal et al., 2010; Shamliyan, Duval, Du,
& Kane, 2008; Taxis & Barber, 2004; Wirtz et al., 2003). In the United States, payment
providers and accreditation agencies such as the Center for Medicare and Medicaid Services
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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/m1/36/: accessed January 17, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .