Calculation Skills for Nurses E-Book

Claire Boyd

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: Student Survival Skills
• Sprache: Englisch

Seitenzahl: 129

Veröffentlichungsjahr: 2013

Beschreibung

Providing nursing students with words of wisdom and advice from real-life student nurses, Calculation Skills for Nurses enables you to calculate drug dosages with ease, boosting your confidence and competence in this core area of nursing practice. The book takes away the fear of calculations, making it approachable, easy and fun, and ties in with the NMC standards for pre-registration education and the Essential Skills Clusters. It is filled with examples and questions based on real life nursing and healthcare situations and includes key information displayed on the inside back cover for quick look-up on clinical placements.

Leseprobe

Contents

Cover

Half Title page

Title page

Copyright page

Preface

Introduction

Acknowledgements

Latin Abbreviations

The 24-Hour Clock

Part 1: Diagnosis

Chapter 1: Calculations Revision

Feeling a Bit Rusty?

Decimal

Metric Measures

Percentages

Fractions

Ratios

Averages

Chapter 2: Calculations Self-Assessment

Part 2: Understanding Nursing Calculations

Chapter 3: Metric Units and Conversions

Chapter 4: Tablets and Capsules

Chapter 5: Liquids and Injectables

Calculators

Chapter 6: Syringes and Meniscus

The Syringe

Injections

Chapter 7: Displacement Values

Chapter 8: Dosages According to Body Weight

Chapter 9: Drip Rates

Chapter 10: Drip-Rate Duration

Chapter 11: Syringe Drivers and Pumps

Syringe Drivers

Chapter 12: Paediatric Nursing

What’S the Difference Between Nursing Calculations for Children and Adults?

Working Out Drug Dosages

Working Out Weight Conversions

Working Out Fluid Balance Calculations

Working Out Fluid Drug Calculations

Drug Dosages According to Body Weight

Dosages According to Surface Area

Part 3: Putting It All into Practice

Chapter 13: Fluid Charts

Chapter 14: Malnutrition Universal Screening Tool (Must) Assessment

Chapter 15: Early Warning Score (Ews) Assessment

Chapter 16: Waterlow Assessment

Chapter 17: Prescription Charts

Chapter 18: Looking at Budgets

Chapter 19: Interpreting Data

Chapter 20: Employment Services

Chapter 21: Body Mass Index

Bmi Guidelines

Part 4: Testing Your Knowledge

Chapter 22: Knowledge Tests

Knowledge Test 1

Knowledge Test 2

Knowledge Test 3

Knowledge Test 4

Answers to Activity Questions

Part 5: Appendices

Appendix 1: Fluid Chart

Fluid Chart

Appendix 2: Malnutrition Universal Screening Tool

Appendix 3: Bristol Observation Chart

Appendix 4: Waterlow Pressure Ulcer Prevention/Treatment Policy

Appendix 5: Conversion Tables

Kilograms to Pounds

Pounds to Kilograms

Stones to Kilograms

Bibliography

Websites

Index

CALCULATION SKILLSFOR NURSES

Student Survival Skills Series

Survive your nursing course with these essential guides for all student nurses:

Calculation Skills for NursesClaire Boyd9781118448892

Medicine Management Skills for NursesClaire Boyd9781118448854

Clinical Skills for NursesClaire Boyd9781118448779

This edition first published 2013© 2013 by John Wiley & Sons, Ltd

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Library of Congress Cataloging-in-Publication DataBoyd, Claire.Calculation skills for nurses / Claire Boyd, RGN, cert. ed., practice development trainer.pages cm. – (Student survival skills series)Includes bibliographical references and index.ISBN 978-1-118-44889-2 (pbk. : alk. paper) – ISBN 978-1-118-44891-5 (epub) – ISBN 978-1-118-44893-9 (mobi) – ISBN 978-1-118-44895-3 (epdf/ebook) 1. Nursing–Mathematics. 2. Pharmaceutical arithmetic. I. Title.RT68.B67 2013615.1’401513–dc232012039434

A catalogue record for this book is available from the British Library.

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Preface

This book is designed to assist student healthcare workers in the field of calculations. All exercises are related to practice and the healthcare environment. Chapter 1 takes the student through the basics, with Chapter 2 incorporating a pre-assessment quiz to identify any areas needing to be revisited (referring the reader back to specific sections in Chapter 1). The book then goes through the ‘bread and butter’ of everyday calculations used on a daily basis in health care.

The book incorporates many activities to check understanding, and is laid out in a simple to follow step-by-step approach. It ends with four Knowledge tests that relate everything the reader has learned to practice situations. The book also incorporates an example of an Employment Services calculations test paper, as students are often asked to complete a calculations test when being interviewed for a job. All answers can be located at the back of the book.

The aim of this book is to start the individual on a journey through many healthcare-related exercises in order to build confidence and competence. It has been compiled using quotes and tips from student nurses themselves; it is a book by students for students.

Claire BoydBristolOctober 2012

Introduction

Hello, my name is Claire.

Working as a Practice Development Trainer for a large NHS trust, it was with sadness that I came across experienced, competent nurses who were paralysed with fear while sitting their calculations test (a prerequisite for being able to attend the Intravenous (IV) Study day in my trust, and administer IV drugs, including IV fluids). Many NHS trusts follow this maxim. Fifty per cent of those sitting the IV test were referred, not necessarily through incompetence, but more likely through a fear of maths. Combine this with a fear of exams and we have a recipe for failure.

Since instigating Calculations Master Classes and, for those too embarrassed or shy, individual tuition, the pass rate has risen to 98% on first attempts. This proved that with a little nurturing, a sprinkling of fun and a dollop of blood, sweat and tears we could all pass this test. Fear of maths was the biggest hurdle and once removed, these nurses were flying! Many of the nurses coming to see me explained how they had had bad experiences since school and how many had compensated by avoiding anything to do with solving difficult maths problems in their clinical areas. This is quite amazing because in the healthcare profession maths confronts us on a daily basis, be it converting a patient’s weight from stones to kilograms, totting up fluid charts or dispensing tablets and capsules. Difficulty with maths is not peculiar to the health profession: the Moser Report (DfEE, 1999) suggested that as many as 40% of UK adults have some numeracy problems. The problem in nursing is that if we make a calculations error we could seriously harm our patients, or even worse.

Trained nurses or student nurses, why is it that we always feel that everyone else is a maths genius and we alone are struggling? Even old Einstein struggled with his maths, and he was a genius! I have not yet met a nurse who is incapable of passing a calculations test in preparation for administering IV drugs. First, remove the fear factor. Second, add some humour. Third, break down each question and ‘see’ what is required to solve the problem. Start with the basics and from this we can build up to more complicated problems, and support our colleagues in the workplace, helping them to gain competence and confidence.

I was asked to include student nurses in the Calculations Master Classes and thus our working relationship was forged. It was by listening to their comments – their wants and needs – that this book came to fruition. The book has four parts. Part 1 tests your ability and gives you pointers for revision. Part 2 gets to grips with the basics that you will meet in the healthcare environment. Part 3 puts the basics into practice and shows how the calculations you have learned may be applied. Part 4 then lets you test everything you have learned.

The book aims to relate practice to theory. What is the point of using examples in a healthcare-orientated calculations book that talk about the cost of a bag of sugar, or how many people are getting on and off a train in certain stations (unless, of course, they are going to work in a healthcare setting)! Let’s make it specific and relevant.

I believe firmly in using formulas for working out drug dosages, but I am aware that an understanding of how these formulas work must first be established, and a rough estimate of the correct answer should always be at the back of our minds. It is also with this principle that we need to start with the basics, to gain understanding, and from this we can build up to more complicated problems. It is for this reason I have produced the formulas in a handy format on the inside back cover for you to photocopy and laminate (for infection control, to be wiped clean) and keep in your pocket. No more writing these out on tongue decompressors: we’ve all seen it!

In short, this book is designed to instil confidence and competence in the area of calculations to the student nurse, assistant practitioner, operating department practitioner, newly qualified nurse and anyone else requiring assistance in this field. It is designed to be used as a building block, a platform for the rest of your healthcare career. There is a heavy emphasis on conversions, as changing the dose prescribed on a prescription chart, which may be written in grams, to correspond with the format on the ampoule, which may be written in milligrams, is one of the fundamental skills in which we need to be competent from the outset.

Throughout the book you will come across the Quick Tips feature, which will give you gems, quotes and advice from real student nurses who have trodden the same path that you are now taking.

So, grab a pen, paper and calculator (if you wish to use one). Put on some music or move to a quiet space (if this is how you like to study), make a cup of tea or pour a glass of water (or whatever you fancy), pick up some digestive biscuits, and settle down to some calculations.

First, let’s have some fun with numbers. Use a calculator if you wish. I will tell you your age. Do you believe me?

The answer you have is your age! Clever or what?

OK, so this is a maths trick that anyone can do, but I just wanted to show you that maths can be fun and let’s start removing the fear factor.

Reference

Department of Education (1999) The Moser Report. HMSO, London.

Acknowledgements

I, along with the publishers, would particularly like to thank all the students who helped develop this book into what it is. In particular Carla Mosser, Sami-Jo Joyce, Claire Bishop and Roxanne Barrington, and all the nursing students from the University of the West of England for the use of their tips and quotes.

Acknowledgements also go to North Bristol NHS Trust: Jane Hadfield (Head of Learning and Development) and Dr Karen Mead (Specialist Practitioner of Transfusion for NBT). Thanks also go to the NBT Library Staff for their assistance.

Special thanks also go to North Bristol NHS Trust for allowing the reproduction of the Bristol Observation Chart and drug prescription chart.

I would also like to extend my thanks to Magenta Styles (Executive Editor) for her guidance and direction and to Catriona Cooper (Project Editor), both at Wiley-Blackwell.

I dedicate this book to my loving family: husband Rob (for the use of his photographs), and Simon, Louise and David for all their assistance in helping to develop this book.

Latin Abbreviations

Here is a list of some Latin abbreviations that you may see on prescription forms.

AC

ante cibum

(before food)

BD

bis die

(twice daily)

OD

omni die

(every day)

OM

omni mane

(every morning)

ON

omni nocte

(every night)

PC

post cibum

(after food)

PRN

pro re nata

(when required)

QDS

quater die sumendus

(to be taken four times daily)

QQH

quarta quaque hora

(every 4 hours)

STAT

immediately

TDS

ter die sumendus

(to be taken three times daily)

TID

ter in die

(three times daily)

The 24-Hour Clock

Time

The 24-Hour Clock

1 am

01:00

2 am

02:00

3 am

03:00

4 am

04:00

5 am

05:00

6 am

06:00

7 am

07:00

8 am

08:00

9 am

09:00

10 am

10:00

11 am

11:00

12 midday

12:00

1 pm

13:00

2 pm

14:00

3 pm

15:00

4 pm

16:00

5 pm

17:00

6 pm

18:00

7 pm

19:00

8 pm

20:00

9 pm

21:00

10 pm

22:00

11 pm

23:00

12 midnight

24:00

Part 1

DIAGNOSIS

Chapter 1

CALCULATIONS REVISION

LEARNING OUTCOMES

By the end of this chapter you will have familiarised yourself with the basics of decimals, metric measures, percentages, fractions, ratios and averages.

FEELING A BIT RUSTY?

Don’t worry if picking up this book and the word ‘calculations’ gave you palpitations! We’ll start nice and gently and summarise the basics. You may remember most of this already and feel confident enough to skip the chapter completely, and go straight to the self-assessment test in Chapter 2, or you may need to build up your confidence and reacquaint yourself with the basics.

Seeing this sign / means divided by…

It is a good idea to reacquaint yourself with your times tables.

DECIMAL

Decimal numbers describe tenths, hundredths and thousandths of a number. For example, 1.25 is equal to one whole unit, plus a fraction of one (25 hundredths).

Decimal

A decimal is a number that is expressed in the counting system that uses units of tens.

Rounding Decimal Numbers