Online Program Highlights

The importance of safety in medication administration has received much attention since the publication of the Institute of Medicine's (IOM) report, To Err is Human, in 1999. Current standards, such as the Quality and Safety in Nursing Education (QSEN) standards, highlight patient safety. With the current changes in the healthcare system, it is the nurse who will be central to ensuring that patients and families receive quality, safe care. (See the IOM's 2010 report, The Future of Nursing: Leading Change, Advancing Health.)

The goal of this online course is to present you with all of the tools you will need to calculate drug doses and administer medications and IV fluids safely to patients in the clinical setting.

Here are the highlights

Content of Modules

The online course is divided into 13 modules. Each module contains learning objectives, tutorials, interactive practice exercises, section quizzes, a module review, and two module tests. There are tools to assist you in your learning, such as a calculator, a glossary of terms for each module, and information about the High Alert medications included in the modules. Move from beginning to end, or jump to a specific section—it's designed to fit your individual needs.

Focus on Patient Safety and Critical Thinking

Throughout the course, there is an emphasis on patient safety and critical thinking. Problems are presented in a way that will help you think like a nurse, rather than to just do math calculations in a rote fashion. Special sections called Focus on Safety present realistic clinical situations in which the nurse must make a clinical decision that promotes patient safety.

Comprehensive Review

A module of 200 review questions covers topics from throughout the course and provides extra practice problems.

Media Library

The Media Library contains four different media resources: Audio Glossary, Audio Terms, Videos, and Animations.

Choice of Calculation Method

One of the best aspects of this course is that you have a choice about how to do the math. You can choose the method of calculation that is most comfortable to you: ratio and proportion (either linear or fractional), dimensional analysis, or the formula method.

Navigation Tips

Click the following buttons to navigate through the course:

The NEXTbutton moves you forward one page.

The PREVbutton moves you back one page.

Three buttons at the top-right of the program allow you to access the page navigation menu (the table of contents), the Media Library, and the calculator. You will also find the Search box here.

TOC (Table of Contents): Clicking the navigation icon will show the list of topics covered in the course. You can navigate to any topic you wish to study.

The MEDIA LIBRARY button opens the Media Library. You can open the Media Library at any time while you are going through the course but you will need to close it to return to your current screen.

Search: You can type any word in the search box. Clicking the magnifying glass icon will take you to a search-results page displaying the pages on which your search term appears.

The HELP link is available in a dropdown list at the top-right corner beside "Welcome, [Your Name]"; it provides you with information about how to use the course. Look in Help for other topics, as well.

To begin using the course content, select a Module listed on the Home Page. Each Module is divided into sections and each section covers certain topics. Click on a particular topic to get started.

At the bottom left you will see for icons:

The REVIEWS icon opens a popup screen listing review material specific to the module being viewed.

The MODULE TERMS icon opens the glossary section of the course.

The MODULE TEST icon brings you to the final tests for each module.

The HIGH ALERT MEDICATION icon opens a popup screen listing high risk medications specific to the module being viewed.

Types of Exercises

About the Exercises

The course features a number of different exercises, including multiple choice, fill-in-the-blank, and "drag and drop" matching questions, as well as syringe pulls and other activities.

Using the Media Library

About the Media Library

Click the media library icon to launch the Media Library program. Click on Audio Glossary, Audio Terms, Videos or Animations from the navigation to access the content. Then click on any of the files to access related media content.

Click the exit button at top right to return to the course.

Using the Calculator

About the Calculator

Click the calculator icon to launch the program calculator. This calculator performs the basic functions of addition [+], subtraction [-], multiplication [*], and division [/]. The calculator is available for use throughout the program.

To move the calculator, click and drag it to any place on the screen. To turn off the calculator, click the button at the top right hand corner of the calculator.

Module Terms

About Module Terms

The modules contain a glossary that lists words and definitions used in the module. Important conversion tables and formulas are included.

Using Module Terms

Click the Terms button to view the glossary screen.

Taking Module Reviews and Tests

Module Reviews

At the end of every module, there is a Module Review. Each review may contain 5 to 20 questions divided into multiple parts. When you complete a review, you will receive feedback about how you scored on the review exercise. You will also be given a rationale for each question based on your response.

Module Tests

At the end of every module, there are two Module Tests. Each test contains 20 questions. When you complete a test, you will receive feedback about how you scored on the test. You will also be given a rationale for each question based on your response.

View Grades

You can view your module review and module test results. Click the My Gradebook link, which appears your Home page under the "Welcome, [Your Name] menu.

Math Anxiety

About Math Anxiety

Some people have a feeling of anxiety whenever they are faced with a math problem. Math anxiety is common, but it can be overcome. As a nurse, you want to be comfortable with the math concepts that you use in the clinical setting.

Practice makes perfect. Nothing overcomes math anxiety better than the self-confidence gained from successfully working problems.

Overcoming Math Anxiety

Here are some ideas to help you overcome your math anxiety:

• Work with a friend.
• Join a study group.
• Learn the math formulas.
• Always set up the problem correctly and work the problem thoroughly.
• Get rest and exercise before a math exam.
• If you get stuck, take a deep breath and go on to another problem. Come back to the difficult problem after a few minutes.

Positive affirmations really work! Choose a positive mantra for yourself: "I can do math." or "I really enjoy drug dosage calculations!" After a while you will believe your own words.

Critical Thinking

Critical Thinking and Medications

Critical thinking is important in all areas of nursing, especially while preparing medications. Solving drug calculations is only the first step. Safety requires the use of critical thinking skills throughout the process of medication administration.

Using Critical Thinking

To use critical thinking skills in medication administration, ask yourself the following questions:

• "Does the answer that I calculated make sense?" Most drugs are packaged so that a standard amount is given, such as 1 tablet or 2 mL. If your calculation leads to an answer of 10 tablets, you need to recheck your work.
• "Is this dosage appropriate for a child, an adult, an elderly patient?" Dosages can vary depending on the patient's age, size, and condition. Always use critical thinking skills and double-check any medication order or dose that seems questionable.

Patient Advocacy

Be a patient advocate! Before giving any medication, do the following: check the medication order, know the recommended dosage, calculate the ordered dose accurately, and ask yourself if the answer makes sense. Always apply the Six Rights of Medication Administration.

Patient Safety

Giving medications to a patient is an important part of nursing practice. Remember, if you are not sure about the medication order or the calculated dose, always clarify the order with the MD or double-check the calculated dose with another professional nurse or the pharmacist.

Word Problems

About Word Problems

Word problems can be intimidating. When you see a word problem, don't panic—just approach the problem logically, and you will most likely be successful.

Steps for Approaching a Word Problem

• First, read the problem to get a general idea about what the problem is asking you to solve.
• Read the problem again to be sure that you understand the terminology. Ask yourself, "What information do I need to solve the problem?"
• Eliminate any unnecessary information that is in the word problem. Read the problem a third time.
• Work the problem.
• Check your work. Double-check your math. Then ask yourself, "Does the answer make sense?"

Helpful Hints for Word Problems

• Do your math neatly. Use paper and pencil. Line up decimals, and always put in the units of measurement. That way, you will be less likely to make a mistake.
• Use whatever resources (e.g., conversion tables, or memorized standard equivalent measurements) that you need to help you solve the problem.
• If you are stuck, take a break. Come back to the problem and start again. Review the tutorial or get help from your instructor.

If you do all of this, you should be successful!

Credits

The authors wish to acknowledge and thank the companies who allowed the reproduction of their drug labels and medication equipment:

Abbott Laboratories

American Pharmaceutical Partners, Inc. (APP)

Baxter Healthcare Corporation

Bayer Corporation

Becton, Dickinson and Company

Bedford Laboratories

Eli Lilly & Company

GlaxoSmithKline

Novo Nordisk, Inc.

Pfizer, Inc.

Precision Dynamics Corporation

Retractable Technologies, Inc.

Sagent Pharmaceuticals, Inc.

Smiths Medical

Teva Pharmaceutical Industries

The authors also wish to thank the publishers who gave us permission to use materials from their publications:

Vallerand A, Sanoski, C. Davis's Drug Guide for Nurses. 14th ed. Philadelphia: F. A. Davis; 2015.

Venes D, Ed. Taber's Cyclopedic Medical Dictionary. 22nd ed. Philadelphia: F. A. Davis; 2013.

Kliegman R, et. al., ed. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: W.B. Saunders; 2011.

To the staff at F. A. Davis Company, thank you! Your support and collaboration made this revision happen. Special thanks to:

Tom Ciavarella, Sandy Glennie, Liz Hart, and Meghan Ziegler for their guidance and support during the editing process.

The authors would also like to express their sincere thanks to everyone who supported the development of this COURSE.

Special thanks to the students in Nursing 205 for teaching us what we needed to teach.
— Sandra and Maryanne

Nothing is ever possible without the loving hand of God showing the way. To Richard, my children, and grandchildren, thank you for your love.
— Sandra

To Megan and Tracy, you have made such a difference in my life. And to Ron, for more than you will ever know.
— Maryanne

This project is dedicated to all present and future nursing students. May you enjoy and master drug dosage calculations, and administer medications with accuracy and safety.