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Nurses' poor maths skills 'putting lives at risk'

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Published Date: 20 October 2008
NURSES' poor maths is putting patients' lives at risk, a Government report has revealed.
A new study carried out in Lothian hospitals reveals "widespread confusion" in the nursing sector over how to calculate correct dosage of powerful intravenous drugs.

Tutors observed 40 nurses in voluntary remedial numeracy workshops at Edinburgh's
Western General and Royal Infirmary and at St John's Hospital in Livingston. They found they had difficulty converting doses from larger to smaller units, adapting doses using fractions or multiplication, calculating flow rates, and applying patients' weight to adjust dosages.

The tutors' report says nurses are putting patients in danger by miscalculating doses because they lack basic numeracy.

The study also found that many on the three-hour courses did not check dosages prescribed by doctors, and those that did had found mistakes.

The report, funded by NHS Education for Scotland, concluded: "The tutor did not imagine . . . that such a wide range of numeracy ability would be exhibited and was amazed to be spending more and more time with the earlier, more basic numeracy problems of metric units and calculator skills."

Student nurses are now being given an online numeracy assessment and offered help.





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  • Last Updated: 20 October 2008 10:06 AM
  • Source: Edinburgh Evening News
  • Location: Edinburgh
 
1

mystic,

Edinburgh 20/10/2008 12:03:14
Oh dear, nurses can't add? I thought maths was a compulsory subject at school. Perhaps, they should use calculators.


www.SeeingEdinburgh.co.uk
2

Finbarr Saunders,

20/10/2008 13:40:11
A visit to the hospital is scary enough without having to worry about innumerate nurses!
3

Scotish Exile,

20/10/2008 13:47:57
These nurses should not be allowed back into a hsopital until they can do "sums". Its not difficult. They are all supposed to have HND's and degrees these days, what the hell are they being taught???
4

danbob,

20/10/2008 14:42:14
4# They are being taught politicly correct rubbish and spend too much of the course time writing pointless essays about things that dont matter.
5

Liz,

Edinburgh 20/10/2008 15:18:29
#2
Since when have all nurses been female?!

Besides we are hardly talking about advanced calculus.
6

Alternative (High-Octane) Fuel Head,

Edinburgh 20/10/2008 16:36:39
I had to explain to a nurse once that the bottle in her medicine trolley labelled "MgOH" was in fact the "Magnesium Hydroxide" the she was struggling to locate. However I will make allowances for her being a trainee, but surely they should be teaching basic stuff like this before they even get on the wards?

7

,

20/10/2008 16:54:32
Comment Removed By Administrator
Reason:
8

linzilou,

edinburgh 20/10/2008 20:58:36
No.4, THIS is what we get taught;

A 65kg patient is prescribed a continuous infusion of dopamine at a rate of 4micrograms/kg/min. One vial of dopamine (200mg/5ml) has been added to 500ml of NaCl 0.9%.

At what rate should the pump be set (ml/hr) to give the required dose?

Just an example........
9

Voldemort,

20/10/2008 23:56:33
10: - 200mg (Milligrams) = 200,000 micrograms (ug) - right ?

Now I don't know what 'NaCI 0.9%' is but I assume it is some sort of saline solution or inert bulking liquid.

So your pump must be set at approx 39 - 40 ml per hour - again assuming an instrument with 1 ml calibration.

----
65kg (person) x 4ug x 60mins = 15,600ug required per hour

505ml of liquid containing 200,000ug of dopamine so 396ug per 1 ml.

So 15600 divided by 396 should give the correct hourly flow rate. 39.4 Ml per hour if the pump is capable of that accuracy.
----

Now I am going to stick my neck on the line here and categorically that this calculation is correct if the assumptions are correct and I have not misunderstood your mg's from your ug's(!) (it took about 30 secs to bash out) and that anyone who looks at the above workings will agree there is nothing complicated here!

It is basic, basic arithmetic - not even a hint of maths and if that is beyond our NHS workforce then it is indeed a sign that the dulling down of qualifications is having a profound effect on peoples ability to their jobs.

If that sort of arithmetic is hard then it is not your fault - the government has used you as a pawn in their frantic drive to get better grades from all ... which is commendable if your strategy was to raise the standard of teaching and achievement but deplorable and dangerous on so many levels (as most things Labour are) if you simply make the tests easier.
10

Voldemort,

Edinburgh 21/10/2008 01:13:35
8 Barge .... Absolutely stunning post - spot on.

Lack of discipline in British schools doesn't help either. They need to bring back the belt or somehow give teachers the means to do their jobs effectively where the pupils respect for the teacher is restored or commanded.

The Government (or the next one) needs to have the balls to face up to falling standards and re-establish fundamental skills. This will be tough for a political party as they will have to endure alot of criticism and apparent further 'falling' standards as the kids (and parents!) adjust.

It will also be thankless as if the Labour party get in again they will simply dull down and create the illusion that everything is improving under their masterful command ... that is until people start dying in hospitals because some nurses can't read, write ,or do basic arithmetic!

What I cannot begin to understand is the sheer selfishness behind dulling our kids down ... but I guess if they were properly educated they would have the sense not to vote for the corrupt and dull Labourites !
11

Teofilio Cubillas,

21/10/2008 11:32:27
#8 While I don't disagree with the general point you make, don't get too carried away with blawing about how great the education is in North America. I'm sure rural Washington State provides an excellent education to the reasonably prosperous population there. I'm not so sure that this is the case in the poverty stricken ghettos of LA or the poor states in the deep south. Having been asked by a charming lady in Louisiana whether English was spoken in Scotland, they could do with some geography and world affairs lessons as well.
12

Teofilio Cubillas,

21/10/2008 11:39:44
#11 Voldemort

Nice answer - if a bit smug - but try doing it after the fourth ten hour shift of the week.

Can you explain why a surgeon (clearly a very intelligent person)is capable of removing the wrong kidney / cutting off the wrong arm etc ? How is it that airline pilots (again, pretty bright people) shut down the wrong engine causing the aircraft to crash?

It's fine doing sums when you're sitting at your PC with a calculator and reading a medical website but try doing it in the real environment. This has nothing to do with intelligence and everything to do with stress and tiredness.
13

Voldemort,

Edinburgh 21/10/2008 16:12:22
14:- Point taken - didn't mean to sound smug ...

I also work in an extremely high pressure environment where my crew rely on judgment calls that are all potentially life or death.

We don't have the luxury of mistakes. We work 2 hours on 2 hours off for four months in a row sometimes and still have to be sharp at the end of it ...never gaining more than 1h 40mins of sleep in a row ....

We ensure that we take the right kit with us to see us through and put systems in place that check all critical items and decisions ... it ain't rocket science but you do have to have a procedure and a plan.

Moreover you have to have well trained personnel to battle it out beside you.

We all make mistakes sooner or later but making a mistake through not being able to muster and check basic arithmetic is symptomatic of a much further reaching problem other than fatigue ....
14

James (1),

23/10/2008 00:06:42
Look it was a choice. Give them acting lessons or arithmetic?
The cannot measure medicine but when they get it wrong they can express real remorse and dance a few steps.

 

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