Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses Page: 38
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were between 22% and 31% of total preparations, and administration error rates were between
22% and 49% of total administrations, with the majority of errors likely to have moderate to
severe outcomes (Wirtz et al., 2003, p. 104). Many of the errors occurred when the caregiver
gave the medication too fast, or the drug required multiple steps to prepare. Taxis and Barber
(2003) found an error rate of 14% in doses that required multiple steps to prepare and administer,
and they suggest that nurses may be unaware that they have committed an error. Some of the
causes they suggest are lack of perceived risk, poor role models, and available technology (did
not know how to use the technology available or simply did not use resources available) (Taxis
& Barber, 2003, p. 343). They suggest fewer unit-based IV drug preparations, improved staff
training, and satellite pharmacies in addition to bar coding systems, CPOE, and unit dose
Results from Parshuram et al. (2008) indicated that in the preparation of IV infusions
34.7% had concentration errors. The authors evaluated steps in the preparation of infusions in
order to identify factors related to preventable medication errors. The 118 health care
professionals, pharmacists, registered nurses, pharmacists, and pharmacy technicians (largest
number being registered nurses), performed 1,180 drug-volume calculations, 1,767 syringe-
volume measurements, and prepared 464 morphine infusions. The researchers detected an
average of 4.9% errors in drug-volume calculations, 1.6% errors in volume measurements, and
1.6% errors in drug mixing. In the morphine infusions the researchers found an average of 34.7%
errors in contained concentrations. Larger magnitude errors were associated with fewer hours of
sleep in the previous 24 hours (p = 0.02), the use of more concentrated solutions (p < 0.001), and
preparation of smaller infusion doses (p < 0.001) (Parshuram et al., 2008, p. 42). Professionals
with more than 10 years experience made more rounding errors (p = 0.0003), and other
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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/m1/46/: accessed January 24, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .