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Evaluation of students' knowledge about paediatric dosage calculations
Nurcan Özyazıcıoğlu1, Ayla İrem Aydın1, Semra Sürenler2
1Department of Pediatric Nursing, Faculty of Health Sciences, Uludağ University, Bursa, Turkey.
Insights
Nursing students demonstrated significant deficiencies in pediatric dosage calculations, particularly with decimal-based problems and basic math skills. Targeted interventions are needed to improve medication safety and patient outcomes.
Area of Science:
- Nursing Education
- Pediatric Pharmacology
- Patient Safety
Background:
- Medication errors pose a significant risk to patient safety, especially in pediatrics where dosages are weight and age-dependent.
- Inaccurate pediatric dosage calculations can lead to severe toxicity, overdose, or delayed treatment, highlighting the critical need for accurate calculation skills.
- Evaluating nursing students' knowledge of pediatric dosage calculations is essential for identifying educational gaps and improving future practice.
Purpose of the Study:
- To assess the knowledge and competency of nursing students in performing pediatric dosage calculations.
- To identify specific areas of difficulty in pediatric dosage calculation among nursing students.
- To determine the correlation between different types of dosage calculation errors and basic mathematical skills.
Main Methods:
- A retrospective study evaluated 148 third-year nursing students' responses to open-ended dosage calculation questions.
- Questions covered dosage calculations based on age, safe dose range, ratio/proportion, and milliliters per day (ml/dzy).
- Statistical analysis included percentage distribution and Spearman correlation to assess accuracy and relationships between calculation types.
Main Results:
- While 87.1% correctly calculated age-based dosages, significant challenges were observed in decimal calculations (ml/dzy), with only 65.5% accuracy.
- Student performance was also suboptimal in determining safe dose ranges (69.6% correct) and applying ratio/proportion (79.1% correct).
- Basic four-operation math skills showed a 68.2% accuracy rate, indicating a foundational deficit impacting dosage calculations.
Conclusions:
- Nursing students exhibit notable weaknesses in pediatric dosage calculations, particularly concerning decimal values and fundamental mathematical operations.
- Errors in one aspect of dosage calculation correlate with errors in others, suggesting a systemic issue with calculation competency.
- Enhanced educational strategies, including additional courses and practice exercises, are recommended to improve students' math proficiency and dosage calculation skills.
Abstract:
Medication errors are common and may jeopardize the patient safety. As paediatric dosages are calculated based on the child's age and weight, risk of error in dosage calculations is increasing. In paediatric patients, overdose drug prescribed regardless of the child's weight, age and clinical picture may lead to excessive toxicity and mortalities while low doses may delay the treatment. This study was carried out to evaluate the knowledge of nursing students about paediatric dosage calculations. This research, which is of retrospective type, covers a population consisting of all the 3rd grade students at the bachelor's degree in May, 2015 (148 students). Drug dose calculation questions in exam papers including 3 open ended questions on dosage calculation problems, addressing 5 variables were distributed to the students and their responses were evaluated by the researchers. In the evaluation of the data, figures and percentage distribution were calculated and Spearman correlation analysis was applied. Exam question on the dosage calculation based on child's age, which is the most common method in paediatrics, and which ensures right dosages and drug dilution was answered correctly by 87.1% of the students while 9.5% answered it wrong and 3.4% left it blank. 69.6% of the students was successful in finding the safe dose range, and 79.1% in finding the right ratio/proportion. 65.5% of the answers with regard to Ml/dzy calculation were correct. Moreover, student's four operation skills were assessed and 68.2% of the students were determined to have found the correct answer. When the relation among the questions on medication was examined, a significant relation (correlation) was determined between them. It is seen that in dosage calculations, the students failed mostly in calculating ml/dzy (decimal). This result means that as dosage calculations are based on decimal values, calculations may be ten times erroneous when the decimal point is placed wrongly. Moreover, it is also seen that students lack maths knowledge in respect of four operations and calculating safe dose range. Relations among the medications suggest that a student wrongly calculating a dosage may also make other errors. Additional courses, exercises or utilisation of different teaching techniques may be suggested to eliminate the deficiencies in terms of basic maths knowledge, problem solving skills and correct dosage calculation of the students.
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