And when using long division it is essential to get it the right way round.

The latest guidelines for the administration of medicines (UKCC, 2000) state that the use of calculators ‘should not act as a substitute for arithmetical knowledge and skill’.ĭeveloping calculation skills relies on understanding decimals to make conversion easier. The opinion of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) (now the Nursing and Midwifery Council) is that nurses should not rely too heavily on calculators. Hutton (1998b) argues that calculators are usually available in areas where calculations are complex, and that their use should be encouraged. There is some debate over calculator use. Written accounts obtained from students in the study revealed that many felt unable to perform calculations such as long division and fractions without using a calculator, as they had come to rely on these at school. Her research into students’ competence in drug calculations demonstrated a marked improvement on initial test results after a structured revision programme. Hutton (1998a) suggests that a degree of ‘de-skilling’ has resulted from the increasingly user-friendliness of drug preparations and widespread use of electronic drip counters. Nursing competence in drug calculations has been a cause for concern (Duffin, 2000 Coombes, 2000).

Wheatley et al (2001) call for routine use of pre-filled epidural infusion bags to avoid the risk of calculation error when ward staff prepare infusions. If given in too high concentrations, local anaesthetic used in epidural infusions can cause extensive motor blockade, leading to immobility and pressure ulcers, which is distressing to the patient (Lee, 1991). If opiates or, indeed, most drugs, have been calculated incorrectly, the consequences for patients can be serious. Postoperatively, the epidural route is now common for infusions of opiate and local anaesthetic.

Nursing math practice