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Assessing the calculation skills of child health nursing staff
  1. Z Lansdowne,
  2. A Bevan
  1. Pharmacy department, Southampton University Hospitals NHS Trust, Southampton, UK

Abstract

Objective The aim of this audit was to establish if there is need for a pharmacist-led regular education programme covering the various prescribing scenarios and dose calculations required for nursing staff on our child health wards.

Methods Questionnaires, comprising of 10 questions, were distributed to approximately 25% of our child health nursing staff, across all shift patterns and nursing bands. Nurses were given 15 min during their shift to complete the questions individually and without conferring afterwards; they were returned anonymously via internal mail. All necessary information was included in the question. The questions were rated according to the number of manipulations required: 1, 2 or 5.

Results 80% of the 55 questionnaires distributed were completed and returned, resulting in data from 22% of the total nursing staff. Overall, 87% of questions were answered correctly.

With the exception of question 5, the questions were answered correctly by 90% of band 5, 96% of band 6 and 100% of band seven nurses. This shows that questions with only one or two manipulations were answered well, but the percentage is considerably lower for question 5, which required five manipulations and was more complex. Question 5 was answered correctly by 47% of band 5, 10% of band 6 and 50% of band 7 nurses. Overall the questions, all of the paediatric wards scored 83% or above, except the outpatient department and the day ward.

Conclusion Medication errors are one of the most common types of medical error, and include prescribing, dispensing and administration errors.1 Possible causes of error include individualised dosing, as doses are calculated according to the patient's age, degree of prematurity in neonates, weight, body surface area and clinical condition.2 The lack of appropriate paediatric formulations also results in the need for additional calculations to be completed to ensure that the desired dosage is administered. Simple calculations requiring one or two manipulations were answered well across all nursing bands and inpatient wards, but the percentage of correct answers with the more complex question, was considerably lower. Overall, basic calculation skills across child health appear to be at a high standard, but further work is needed for calculations requiring multiple steps. The majority of these questions related to oral medicines, therefore a follow-up audit focusing on intravenous medicines, either bolus or infusions, should be completed in the near future. Paediatric and neonatal intensive care will also be included.

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