Do calculation errors by nurses cause medication errors in clinical practice? A literature review.

Area of Science:

• Nursing
• Patient Safety
• Medication Management

Background:

• Medication errors are a significant concern in healthcare.
• Previous research has focused on nurses' calculation skills, often in academic settings.
• A gap exists in understanding the causes of medication errors in clinical practice.

Purpose of the Study:

• To review existing literature to determine if medication errors in clinical practice stem from nurses' miscalculation of drug dosages.
• To identify the primary causes of medication errors in nursing practice.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (Medline, CINAHL, BNI, JAMA, Cochrane reviews).
• 33 articles reporting on the incidence or causes of drug errors in clinical practice were reviewed.
• Studies were examined to identify if nurses' calculation errors were cited as causes of medication errors.

Main Results:

• No studies specifically examined nurses' drug calculation errors in clinical practice.
• Insufficient evidence was found to support the claim that medication errors are caused by nurses' poor calculation skills.
• Only five articles recorded information on calculation errors, with only two using direct observation.

Conclusions:

• The current focus on nurses' numeracy skills may be misplaced.
• Other aspects of medication preparation and administration likely contribute more significantly to medication errors.
• Further research, particularly direct observational studies in pediatric nursing, is needed to understand calculation errors in practice.