Dosage Miscalculations at the Point of Care: An Innovative Look at Why
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Incorrect medication administration, a well-documented problem in the United States, can be linked to bedside nursing issues such as forgetting doses, giving additional doses, or giving incorrect doses. Nurse educators are addressing this concern through integration of dosage courses and paper-and-pencil examinations. Students must pass dosage exams with 100% accuracy prior to clinical courses, leading faculty to believe that students possess the mathematical skills necessary for safe medication administration. However, research suggests that students are not competent with calculations needed at the point of care. Videos recorded using Google Glass (GG) technology revealed students’ remedial mathematical problems, including the inability to correctly calculate infusion rate and medication dosage. In fact, 30% of senior students made egregious calculation errors in simulation and proceeded to administer medication incorrectly during the simulation scenario. While students have consistently shown an inability to calculate doses correctly during simulation, it wasn’t until the GG videos showed the miscalculations that faculty were better able to appreciate the students’ real time thought processes and deficient math skills. This presentation will demonstrate the technology used to identify the mathematical deficiencies and, through interactive discussion, will formulate effective strategies to improve dosage calculation proficiency at the point-of-care.