The need to address poor numeracy skills in the emergency department environment

Abstract

Substantial evidence exists for lack of numerical skills among many health professionals. Although poor numeracy has long been recognised as a contributor to medication error, other activities for which numerical literacy are required, such as interpretation of diagnostic results, have been largely ignored. Poor self-awareness of lack of numerical literacy increases the risk, especially in the busy and hurried emergency environment. System changes, such as standardising units and improving number presentation, reduce the potential for misinterpretation; however system changes do not address the underlying deficiencies in mathematical skills. The training of doctors in numeracy has been largely ignored. In contrast, education for nurses frequently occurs during both pre-and post-registration programmes. Interventions have had mixed success, although additional emphasis in increasing conceptual understanding of numbers is encouraging. The consequences of poor numerical literacy should be addressed in all clinical staff, not only by practice change to remove the potential for errors to be made, but also complemented by self-awareness and education.

Exploring southeast US mobile and manufactured home residents’ anchoring decisions

“…Studies in the health threat domain have shown individual differences such as anxiety [35], need for cognition [36], and numeracy [37,38] impact different types of decision-making among both the public and healthcare providers. As it pertains to weather-related decision-making, numeracy has also been shown to be an important individual difference to consider, especially when talking about probabilistic forecast understanding and usage.…”

An Evaluation of Health Numeracy among Radiation Therapists and Dosimetrists

“…Additional questions regarding basic demographics and preferences for units were added. As proposed by the developers of the NUMi, health numeracy scores were categorized as follows: "low" (0-7), "average" (8-17), or "high" (18)(19)(20); "average" is further divided as "low average" (8)(9)(10)(11)(12) and "high average" (13)(14)(15)(16)(17). For reference, the average NUMi score of the general population is 13.2(20); those with no college education scored 9.8, those with some college education scored 11.3, and those with four years or more of college scored 16.3 (20).…”

“…This is further separated into objective numeracy, which is a performance-based measure of numeric skill, and subjective numeracy, which is a self-reported ease with numbers. Inadequate objective numeracy has been identified as a source of medical error (8)(9)(10). The Radiation Oncology Incident Learning System (RO-ILS) aggregate reports describe numerous prescription incidents that might reflect suboptimal performance related to objective numeracy (11,12), such as incidents where the number of fractions and dose per fraction were switched, or calculation errors during emergency treatments.…”

The relationship between math personality, math anxiety, test preparation strategy and medication dose calculations in first year nursing students

“…[1,[18][19][20][21] Errors in calculation when administering medication often result in significant harm to patients. [21][22][23][24] Despite the importance of this skill, there is evidence that nursing students often lack a solid foundation in the ability to accurately calculate medication doses. [4-7, 15, 25, 26] Effective education to ensure accurate medication dose calculations can play a key role in reducing medication errors.…”