Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses Page: 37
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pediatrics, the most common error was wrong dose (23.8% of the errors), and in adults the most
common error was wrong drug (60.9% of the errors). Six newborns were given a 10-fold
overdose. A 10-fold error could be a calculation error, an error of the vial of two different
concentrations looking alike, with the nurse picking up the wrong vial; or the nurse not carefully
checking and picking the vial in that location by habit. Whatever the cause, it does not change
severity of the error to the patient.
According to Hughes and Edgerton (2005), children are at a higher risk for harmful
medication errors than are adults. Dosing errors are the most common type of drug errors in
pediatrics because many of their medications are weight based. In patients who are small, such as
premature babies, dosing errors are more harmful, and many times have devastating
consequences. Calculations using dilution for liquid medications for oral administration, IV, and
injections are more difficult than calculating the number of pills. The most common calculations
use fractions, decimals, percentages, and ratios (Hughes & Edgerton, 2005).
The Food and Drug Administration reviewed 273 medication reports and classified each
report into categories: communication, name confusion, labeling, human factors (knowledge
deficit, performance deficit, miscalculation of dosage or infusion rate, drug preparation error,
transcription error, stress), and packaging/design (Thomas et al., 2001). They found that the
majority of errors (42%), were human factors.
Researchers in Germany and the United Kingdom worked together and studied the
incidence and causes of intravenous medication errors in hospitals in two countries and three
pharmacy services (Taxis & Barber, 2003; 2004; Wirtz et al., 2003). They observed nurses
preparing and giving IV medications and found a high incidence of intravenous drug errors at all
the hospitals, suggesting that changes in practice are needed urgently. Preparation error rates
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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/m1/45/: accessed July 22, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .