Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses Page: 40
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150 medication orders 120 were converted from milligrams to milliliters, and of these, 14.2%
were converted incorrectly, with the maximum dose deviating 400%. Dextrose was not diluted,
as required for children in 17% of the orders, and in 12% it was diluted improperly. An antibiotic
which required reconstitution was not properly reconstituted approximately 40% of the time.
Morgan et al. also noted that the nurses took a "prolonged" time to convert the doses and draw
up the medications. The conclusion was that nurses need "improved education, training, and use
of clinical aids or adjuncts for pediatric emergency nurses" (p. 179) and that the process of
medication administration should be simplified. If nurses make this many errors in a simulation,
they are probably making many more in the practice environment. It becomes imperative to
improve the delivery of nursing care to patients in the health care system.
Many factors may be related to medication errors and error reporting. In a study in
Arizona (Patanwala, Warholak, Sanders & Erstad, 2010), emergency department nurses were
observed by pharmacists for twenty-eight 12-hour shifts regarding the medication process.
"There were 178 medication errors in 192 patients .... At least one error occurred in 59.4% of
the patients . .. and medication administration accounted for 34.8% of the errors" (p. 522).
Variables such as boarded patient status, number of medication ordered and administered, and
nurses' employment status (full-time vs. part-time) were correlated with error rate.
Sheu et al. (2008) investigated possible error-related circumstances and to identified
high-alert situations. Eighty-five nurses reported 328 administration errors, 69 of them near
misses, and found that most errors were on the medical surgical units of teaching hospitals,
during the day, and were committed by nurses with less than 2 years experience. More than 60%
of the errors were wrong dose and wrong drug. The majority of errors were discovered by double
checking with another person. High-alert situations were related to potassium, insulin, and
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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/m1/48/: accessed November 24, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .