Thousands of patients die every year and millions of patients are harmed due to medication errors. Patient safety is of the upmost importance. Improving patient safety through prevention and educational strategies is the focus. Nursing education programs use high-fidelity simulation to enhance medication administration and dosage calculation.
Medication errors plague our healthcare system. Thousands of patients die every year and millions of patients are harmed due to preventable medication errors. Patient safety is of the upmost importance specifically when related to medication administration. Nurses are responsible for safe medication administration on a daily basis as a primary responsibility. There has been great emphasis on improving patient safety through prevention and educational strategies. Professional nursing organizations value the use of blended learning to develop nursing students’ clinical judgment. Nursing education programs, especially associate degree nursing programs, use high-fidelity simulation to enhance medication administration and dosage calculation. First year nursing students are expected to pass a dosage calculation exam with accuracy to assess safe medication practices.
The purpose of this quantitative, quasi-experimental ex post facto design study was to examine the causal relationship between the medication administration simulation and the dosage calculation test scores in first year, associate degree nursing students. Benner’s Novice to Export theory served to demonstrate levels of proficiency in skills acquisition and clinical knowledge development through progression. First year nursing students who participated in the high-fidelity medication administration had statistically significant differences in their dosage calculation test scores and the odds of passing the dosage calculation test on the first attempt. The aim of the research study was to examine which education intervention is effective in improving dosage calculation test scores in first year nursing students. This research study clarifies for nursing educators and curriculum designers that high-fidelity simulation scenarios should be designed and implemented in associate degree programs beginning with the first-year nursing students. Implementation of high-fidelity simulation experiences can improve dosage calculation exams scores and contribute to a safer nursing workforce. This is impactful to reduce medication errors and safe patient lives.
Nurse educators are tasked with developing and testing educational interventions to measure nursing students' outcomes related to medication administration safety. The skills of medication are demonstrated by instructors for students to visualize how to give medication effectively. Drug calculations are taught and performed by educators to enhance student’s math ability related to medication administration. Medication safety is discussed in the classroom or virtual environment, laboratory, simulation, and clinical settings so students understand the adverse effects and complications that go along with medication administration. To better prepare future nurses, curriculum changes need to be implemented. Specifically, positive learning experience and active learning strategies will greatly influence student knowledge, attitude, and skills in medication administration.
Medication safety competencies including dosage calculation exams should be embedded into nursing curricula from the first year of the student’s education. It is important to develop knowledge and skills from the beginning of nursing education, so students have time within the program to advance in their understanding and confidence. Having instruction on this information imparted to students in the first semester highlights the importance of the concept and allows for continual development throughout the program. Developing the nursing knowledge and skills at the beginning of the nursing program and holding student accountable for safe and responsible medication administration will lead to healthy professional habits. Nursing students continually reinforce their knowledge and skills throughout the nursing program with experiential learning. This advancement of medication administration safety will increase the efficacy of the student nurse and carry over into their professional work.
Simulation education is designed to enhance the learning needs of the student. Nursing students learn a tremendous amount of knowledge and skills throughout the program. The opportunity to put this knowledge into practice using an active learning technique will enhance clinical judgement over time. There are basic tenets that must be used for simulation education and have been further defined in the International Nursing Association for Clinical Simulation and Learning (INASCL) Standards of Best Practice. With the priority of patient safety, the use of simulation can assist with the development of the skills. Active learning allows practicing nurses and nursing students to reproduce clinical exercises that will experience in a safe practice environment. Simulations in a practice setting create a student-centered learning experience that can enhance skills and improve confidence. A study on baccalaureate nursing students revealed that students that were exposed to simulation and active learning in their nursing education performed better on exams, were motivated to learn, and expressed a feeling of competence.
Nursing programs offer different strategies for instruction and remediation of basic math and dosage calculation skills. Didactic lecture is used as a teaching strategy for dosage calculations. Face to face, virtual, and recorded lectures are presented to students for defined class hours. The blended learning technique combines the traditional teacher centered didactic lessons with technology assisted or psychomotor skill training for a student-centered approach. This teaching technique stives to provide the students with the best of face-to-face and online instruction. Strategies involve lectures, demonstrations, textbooks, worksheets, online calculation resources, self-study resources, and lab and simulation sessions. Blended learning studies has the most favorable results with significant improvement in the mean scores of their dosage calculation exams. The study results state that active involvement helps learners to develop procedural knowledge and experiential learning. Achieving knowledge retention and stimulating clinical judgment skills has positive effects on student nurses and their ability to grow into a safe and competent nurse.
The use of blending learning and high-fidelity simulation allows a student-centered approach to learning and enhances cognitive knowledge and psychomotor skills while improving clinical judgment skills. These education efforts will benefit student nurses as they prepare to enter the professional workforce with real-world challenges. The goal of patient safety is embedded into nursing curricula and this combination of active learning creates a strong nursing workforce ready to meet the demands of patient care.