Safety checks, monitoring and documentation in medication process in long-term elderly care–Nurses' subjective perceptions

Objective: Elderly people often use several medicines, which increases risks for side effects and adverse effects. Moreover, most reported adverse events in healthcare are associated with medication. The aim was to describe nursing staffs’ perceptions about and the factors related to the actualization of safety checks, monitoring and documentation in the medication process in long-term elderly care.Methods: This was a cross-sectional quantitative, questionnaire-based study. The response rate, among all nurses working in long-term elderly care wards in a Finnish healthcare district, was 39.4% (n = 492).Results: The results indicate that some safety checks and monitoring guidelines are often violated during the medication administration process, but most nurses self-reportedly maintained good practice in medication documentation.Conclusions: The results suggest needs to review training in pharmacology, infection control, and medication calculations during pre-qualification and continuing education, and to ensure nurses’ awareness of attitudes and ethical considerations for medication safety.

Teaching and Learning Medication Calculations: A Grounded Theory of Conceptual Understanding

Objective: The purpose of this study was to identify the process of nursing students’ attainment of conceptual understanding when learning medication dosage calculations.Design: This study utilized a grounded theory research design with a blended theoretical framework of constructivism and symbolic interaction.Results: A process of conceptual understanding began with the teaching and learning experiences in the classroom and progressed to students’ reengagement with the course content outside of the classroom. Confusion was the core category of the process. Students who were able to work through the confusion and solve problems were able to attain conceptual understanding and progress to more complex problem solving.Conclusions: Nurse educators need to identify teaching and learning strategies that promote conceptual understanding. Helping students to get beyond memorization and move to understanding of medication calculations can help students’ critical thinking and problem solving ability and lead to conceptual understanding.

Constructivist Philosophy and Nursing Student Medication Calculations

Prelicensure nursing students often have difficulty performing medication calculations (MCs). Faculty at one baccalaureate nursing program wanted to use nursing theory to guide the development of a teaching–learning approach related to MC’s. Finding little theory related to the topic of MCs, a constructivist-based teaching–learning approach was used instead. The purpose of the study was to assess whether nursing students who received an MC review class that used a teaching–learning approach based on constructivist philosophy had better results on an MC examination than students who received their review via traditional teaching–learning methods. The study participants consisted of two cohorts of first-semester junior-level nursing students from one university-based school of nursing in the Midwestern United States. The results indicated that students in the simulation review class had higher mean scores on an MC examination than students who received their review via more traditional means. Teaching–learning strategies related to MCs based on constructivist philosophy have the potential to improve student learning outcomes, but more research is needed before middle-range theory related to this critically important area of nursing education can be developed.

Efficacy of a Programmed Calculator for Constant-Infusion Medication Calculations

A program for calculation of constant-infusion vasoactive medications on a hand-held programmable calculator was evaluated in terms of accuracy and time saved v conventional means of calculation. All groups, with the exception of the pharmacists, showed a statistically significant improvement in accuracy and time saved when using the programmable calculator. These results indicate that use of the programmable calculator may significantly save time and reduce errors on dose calculation of potentially dangerous drugs in pediatric and neonatal intensive care units.