ARTICLE AND REFLECTION

Article and Reflection

Article and Reflection

1. Review of a research article

The article “Numeracy and drug calculations in practice” written by Hutton M. (2009) intended to notify community nurse's who are anxious about their own numeracy skills, specifically around drug calculations.

Paramedics, like many other healthcare professionals, are often required to conduct drug calculations in the daily management of their patients. However, unlike other healthcare professionals, they are often subject to unique pressures due to the dynamic and often unpredictable nature of their working environment. Their role requires them to treat a broad variety of patient complaints, from social issues to life-threatening situations.

Errors associated with medications account for up to 20% of all hospital-based healthcare errors in Australia and cost approximately $380 million to the public hospital system annually. In the U.S. about 7,000 deaths in 1993 were due to medication errors. This number is higher than that of workplace deaths in the U.S., yet little money is spent on preventing this. A study by Barker et al. (2000) found that 17% of the medication errors in 36 healthcare facilities were due to dosage errors. They also found that medication errors occurred in nearly 20% of all medication administrations. It is estimated that medication-related errors cost the U.S. about $2 billion a year for in-patients. While Hutton (2009)found no evidence regarding the cost of drug-dosage miscalculations in the prehospital setting, Vilke et al. (2007) found that there have been reports of both significant injuries and death as a result of prehospital medication errors. Two studies found that between 9% and 43% of paramedic respondents admitted to medication errors, and in one of these studies 63% of the errors were dose-related.

Research into paramedics' abilities to perform drug calculation was first published in 2000 by Hubble et al. (2000). Their findings have been supported by many studies within the field of nursing, dating back to the late 1930s.

A study by Beilock and Carr (2005) on pressure situations found that individuals who are more academically inclined have a larger negative variance in mathematical ability when under pressure. These findings were supported by studies on stress and high pressure situations, which demonstrated a decline in mathematical performance amongst both nurses and paramedics. There is also a correlation between a decline in mathematical ability and time pressures.

The drug calculations required of paramedics are the same as those used throughout the hospital and healthcare system. Paramedics must be able to calculate pediatric patient weights, drug dosages and volumes, weight-based drug doses, infusion rates, and weight and time-based infusion rates. Deficiencies have been found amongst the nursing profession for many years, thus serving as a catalyst in determining if these same deficiencies exist amongst the next generation of university-educated paramedics. No studies to date demonstrate the drug and mathematical calculation ability of undergraduate paramedic students in a classroom environment. The objective of this study was to review the literature and determine the ability of undergraduate and qualified paramedics to perform drug ...