Drug calculation ability of qualified paramedics: A pilot study

Abstract

BACKGROUND:The inability of paramedics to perform accurate calculations may result in a compromise of patient safety which may result from under or over dosing of drugs, incorrect joules for defi brillation, or a major adverse event such as death. The objective of this study was to identify the drug calculation and mathematical ability of qualifi ed operational paramedics. METHODS:The study used a cross-sectional design with a paper-based calculation questionnaire. Twenty paramedics enrolled in an intensive care paramedic course were eligible to participate in the study. The questionnaire consisted of demographic, drug calculation (seven questions), and mathematical (fi ve) questions. Students were given no notice of the impending study and use of a calculator was not permitted. RESULTS:All eligible students participated in the study. The average time employed as a paramedic was 7.25 years, SD 2.5 years, range four years to twelve years. Four (20%) students got all 12 questions correct, and fi ve (41.6%) got 50% or less. The average score was 8.6 (71.7%) correct, SD 2.8 correct, range 3 to 12 correct questions. There were eight (40%) conceptual errors, 12 (60%) arithmetical errors, and fi ve (25%) computational errors. CONCLUSION:The results from this study supports similar international studies where paramedic's ability to undertake mathematical and drug calculations without a calculator varies, with some results highlighting the paramedics mathematical skills as a potential risk to patient safety. These results highlight the need for regular continuing mathematical and drug calculation practice and education to ensure a lower error rate.

Determining the Ability of Paramedic Students to Do Drug Calculations

“…Coupled with the dynamic encounters and clinical challenges of the environment that paramedics operate within, the abilities of the attending paramedics to perform basic calculations are principle to best practice (2,7,8). This study, like similar international studies, was undertaken in a low stress classroom situation where the pressure of a sick patient requiring rapid administration of a drug or procedure was nonexistent (1,3,6,9,12,19,20).…”

“…While convenient, there is limited data to support these advancements in the promotion of best practice (4,17). Though the technological advancements have been perceived to reduce the risk of error, paramedics are now less inclined to maintain basic mathematical knowledge that was once paramount for the role because of the ready availability of tablet and phone applications (1,4,(16)(17)(18). This study demonstrated that conceptual errors occur when the math concepts are misunderstood and formed a considerable number of the errors made.…”

“…There is a community expectation that healthcare professionals will conduct drug calculations with complete accuracy. However, previous research has identified many undergraduate and qualified healthcare professionals, including nurses and paramedics, are unable to conduct basic mathematical operations sufficiently to achieve 50% or higher in classroombased tests (1)(2)(3)(4)(5)(6).…”

“…That same study found conceptual errors, which are the inability to formulate an equation from the information given, made up the majority of all calculation errors (2). This was followed by arithmetical errors, which are the inability to operate an equation, and computational errors, which are basic errors of addition, subtraction, multiplication and division (1)(2)(3)(4)(5)(6). The most common errors were conceptual.…”

“…There is a paucity of research investigating the mathematic capability of undergraduate paramedic students in Australia, with the existing literature having come from one source (1,2,7,8). The objective of this study was to ascertain the mathematical and drug calculation ability of undergraduate paramedic students at an Australian university.…”