1. Harne-Britner, Sarah MSN, RN, CCRN

Article Content


This collaborative research study examined medication calculation skills of nurses and students in the practice and academic settings. The purposes of the study were to (1) assess the medication calculation skills of practicing nurses and senior baccalaureate students and (2) test the effectiveness of a teaching strategy to improve computational skills.



The CNS has a key responsibility to assess and monitor the practice of safe medication administration. The National Coordinating Council for Medication Errors Reporting and Prevention (NCC-MERP) found that 7% of reported medication errors were related to miscalculation (Thomas, Holquist, & Philips, 2001). Previous research on the medication calculation skills of practicing nurses showed that the majority of nurses were unable to calculate medications at a 90% level of proficiency (Ashby, 1997; Bindler & Bayne, 1991; Bayne & Bindler, 1988).



The CNS collaborated with the Chair of the Department of Nursing at a local college, staff nurses, and nursing students to design and implement the study. A pretest/posttest design was used. A convenience sample of 21 practicing nurses and 32 senior nursing students participated in the study. Subjects completed a demographic questionnaire and medication calculation pretest. Participants then chose 1 of 3 educational strategies to improve calculation skills: (1) classroom tutorial session, (2) self-study workbook, or (3) self-study using own references. A medication calculation posttest was administered 4 weeks later.



The mean RN pretest score was 77.3 and the mean post-test score was 93. The mean student pretest score was 79.5 and the mean post-test score was 86.9. Both groups improved with all of the interventions; however, the increases weren't statistically significant (P < .05).



Postscore trends in both groups support the use of the 3 educational strategies to improve medication calculation skills.


Implications for Practice

The CNS is working with the Professional Development Council and Clinical Education Committee to implement a medication calculation test for all new nurses. The medication calculation pretest/posttest and education strategies will be used as a standardized remediation plan for nurses with poor calculation skills. The academic setting is reviewing results with the Curriculum Committee and is going to incorporate more time for classroom instruction and practice of medication calculations.


Section Description

This year's annual NACNS conference is planned for Orlando, Fla, March 9-12, 2005. Over 300 clinical nurse specialists (CNSs) are expected to attend, and as with past conferences, attendees will also include graduate faculty from CNS programs, nurse administrators, and nurse researchers. The theme of the conference, CNS Leadership: Navigating the Healthcare Environment Toward Excellence, was selected to showcase the many ways CNSs acquire and disseminate knowledge and innovative practices in their specialty areas. Two preconference sessions are scheduled. One session, sponsored by NACNS Legislative/Regulatory Committee, targets information for CNSs interested in understanding the legislative/regulatory process as it deals with the practice of nursing, and will also help build skills CNSs need to engage in the process. The second session, sponsored by NACNS Education Committee, focuses on CNS education issues, and as with the education preconferences of past years, anticipates informative dialogue and much sharing among CNS educators around curriculum design, teaching strategies, and indicators of quality in the curriculum that link to the NACNS education standards to program review and excellence. The conference planning committee is proud and pleased to have Jeanette Ives Erickson, MS, RN, CNA, Senior Vice President for Patient Care Services and Chief Nurse Executive of Massachusetts General Hospital as the opening keynote speaker. She will begin the conference by highlighting the importance of CNS practice on patient safety. The planning committee is equally proud and pleased to have NACNS past-president Rhonda Scott, PhD, RN, Chief Nursing Officer of Grady Health System as the closing speaker. Dr Scott will challenge attendees to use the information from the conference to shape quality care delivered in a safe environment and to advance the profession of nursing through direct care to clients, influencing standards of care delivered by other nurses, and influencing the healthcare delivery system to be to support innovative, cost-effective, quality nursing care. A total of 64 abstracts for podium and poster presentations were selected in addition to graduate student posters. The abstracts address the 3 spheres of CNS practice with a strong emphasis on clinical practice improvements. As you will note from the abstracts published in this issue of the journal, specialty practice areas represented in the abstracts include children, adults, and gerontological patient groups; hospital, outpatient, and home care settings, and community health. In addition, a wide variety of specialty topics including smoking cessation programs, end-of-life care issues, and protocols outlining nursing approaches to improved diabetes, cardiovascular and ventilator management. A number of the abstracts described hospital and healthcare system level innovations that resulted from CNS practice. Collectively, these abstracts reflect the breadth, depth, and richness of CNS contributions to the well-being of individuals, families, groups, and communities. The following abstracts are from those presenters who elected to have their work published in the journal so those who are unable to attend this year's conference can share in the knowledge of the conference. As you read each abstract, consider the talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to improved outcomes for patients and healthcare organizations. You may want to contact individual presenters to network, collaborate, consult, or share your own ideas about these topics. Watch for next year's call for abstracts and consider submitting an abstract for presentation at NACNS's next conference in Salt Lake City, Utah, March 15-18, 2006.