Enhancing Safe Medication Administration: Math Readiness Assessment and Learning Plan Pilot Study
AUTHORS
Shelley Cobbett,Assistant Professor, Curriculum Implementation Lead,Dalhousie University School of Nursing, Halifax and Yarmouth Site’s, Yarmouth and Halifax, NS, Canada
Melanie Deveau,Adjunct Lecturer, Dalhousie University School of Nursing- Yarmouth Site,52 Vancouver St., Yarmouth NS, Canada
Shauna Houk,Assistant Professor & EB Bennett Professorship, Dalhousie University School of Nursing- Halifax Site, Halifax, NS, Canada
ABSTRACT
The Math Readiness Assessment (MRA) and Learning Plan Pilot Study provided the School of Nursing (SON) with evidence to guide future curriculum decisions to maximize student success, ultimately leading to improved patient safety in relation to accurate dosage calculation and safe medication administration. A pre-test, post-test one-group design was used to investigate initial math readiness in nursing students in preparation for attaining competency in dosage calculation and medication administration and the effects of a self-remediation learning plan. The pretest was the Foundational Numeracy Assessment (FNA) from safeMedicateTM, with a demonstrated Cronbach’s alpha of 0.891 and established criterion validity. The posttest was developed for use within this study and conceptually reflected the FNA. The pretest was administered to Year 2 undergraduate nursing students (N=227); those students who achieved less than 90% (n=166) were required to engage in a learning plan and write a math reassessment, the posttest. A paired sample t-test indicated statistically significant differences in student scores from the pre-test to the post-test (t= 17.25, df (136), <.0001) lending support for implementation of a learning plan that enhances mathematical competency.
KEYWORDS
Dosage calculation, Curriculum, Patient safety, Math competence
REFERENCES
[1] K. Macdonald, K. Weeks, and L. Moseley, “Safety in numbers 6: Tracking pre-registration nursing students’ cognitive and functional competence development in medication dosage calculation problem-solving: The role of authentic learning and diagnostic assessment environments,” Nurse Education in Practice, vol.13, pp.e66-e77, (2013)
[2] M. Sabin, K. Weeks, D. Rowe, B.M. Hutton, D. Coben, C. Hall, and N. Woolley, “Safety in numbers 5: Evaluation of computer-based authentic assessment and high fidelity simulated OSCE environments as a framework for articulating a point of registration medication dosage calculation benchmark,” Nurse Education in Practice, vol.13, pp.e55-e65, (2013)
[3] Canadian Patient Safety Institute, “The safety competencies framework,” Ottawa, ON, (2009)
[4] Canadian Institute of Health Information, Measuring patient harm in Canadian hospitals, Retrieved from https://secure.cihi.ca/free_products/cihi_cpsi_hospital_harm_en.pdf, (2016)
[5] S. Stolic, “Educational strategies aimed at improving student nurse's medication calculation skills: A review of the research literature,” Nurse Education in Practice, vol.14, no.5, pp.491-503, (2014)
[6] J.D. Beall, T. Roebuck, and P. Penkalsky, “The relationship among math anxiety, mathematical performance, and math education in undergraduate nursing students,” Honors Research Projects, Paper 76, Retrieved from https://ideaexchange.uakron.edu/honors_research_projects/76, (2015)
[7] M. McMullen, R. Jones, and S. Lea, “Patient safety: Numerical skills and drug calculation abilities of nursing students and registered nurses,” Journal of Advanced Nursing Practice, vol.4, pp.891-899, (2010)
[8] P. Warburton, “Poor numeracy skills must be tackled to cut medication errors,” Nursing Times, vol.106, no.9, pp.13, (2010)
[9] K. Wright, “Barriers to accurate drug calculations,” Nursing Standard, vol.20, no.28, pp.41-45, (2006)
[10] K. Wright, “The role of nurses in medication administration errors,” Nursing Standard, vol.27, no.44, pp.35, (2013)
[11] R. Meechan, H. Jones, and T. Valler-Jones, “Do medicines OSCEs improve drug administration ability?” British Journal of Nursing, vol.20, no.13, pp.817e822, (2011)
[12] S. Young, K. Weeks, and B. Hutton, “Safety in numbers 1: Essential numerical and scientific principles underpinning medication dose calculation,” Nurse Education in Practice, vol.13, pp-e11-e22, (2013)
[13] M. Hodge, “Do anxiety, math self-efficacy and gender affect nursing students’ drug dosage calculations?” Nurse Educator, vol.24, no.4, pp.36-41, (1999)
[14] S. Arkell and P. Rutter, “Numeracy skills of undergraduate entry level nurse, midwife and pharmacy students,” Nurse Education in Practice, vol.12, pp.198-203, (2012)
[15] K. Roykenes and T. Larsen, “The relationship between nursing students’ mathematics ability and their performance in a drug calculation test,” Nurse Education Today, vol.30, pp.697-701, (2010)
[16] E. Coyne, J. Needham, and H. Rands, “Enhancing student nurses’ medication calculation knowledge: Integrating theoretical knowledge into practice,” Nurse Education Today, vol.33, pp.1014-1019, (2013)
[17] American Association of Colleges of Nurses, “Baccalaureate nursing programs,” Retrieved from https://www.aacn.nche.edu/education-resources/bsn-article, (2017)
[18] K. Weeks, M. Sabin, D. Pontin, and N. Woolley, “Safety in numbers: An introduction to the nurse education in practice series,” Nursing Education in Practice, vol.13, pp.e4-e10 (2013)
[19] K. Weeks, B. Hutton, S. Young, D. Coben, J. Clochesy, and D. Pontin, “Safety in numbers 2: Competency modelling and diagnostic error assessment in medication dosage calculation problem-solving,” Nurse Education in Practice, vol.13, pp.e23-e32, (2013)
[20] S. Varma, “Preliminary item statistics using point-biserial correlation and p-values,” Educational Data Systems, Inc. Morgan Hill, CA. Retrieved from https://eddata.com/wp-content/uploads/2015/11/EDS_Point_Biserial.pdf, (2015)
[21] M. Tarrant and J. Ware, “A comparison of the psychometric properties of three-and four-option multiple-choice questions in nursing assessments,” Nurse Education Today, vol.30, 539-543, (2010)
[22] M.S. Trevisan, G. Sax, and W.B. Michael, “The effects of the number of options per item and student ability on test validity and reliability,” Educational and Psychological Measurement, vol.51, pp.829-837, (1991)
[23] S.M.H. Revell and M.K. McCurry, “Effective pedagogies for teaching math to nursing students: A literature review,” Nurse Education Today, vol.33, pp.1352-1356, (2013)
[24] National Patient Safety Agency, “Safety in doses London: National reporting and learning service,” Retrieved from https://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=61626&, (2007)
[25] S. Latimer, J. Hewitt, R. Stanbrough, and R. McAndrew, “Contemporary issues. Reducing medication errors: Teaching strategies that increase nursing students’ awareness of medication errors and their prevention,” Nurse Education Today, vol.52, pp.7-9 (2017)