Children S Nursing Numeracy Workbook

Children’s Nursing Numeracy Workbook

BSc (Hons) BSC / Dip He Children’s Nursing

Pre registration

Numerical Assessment in practice workbook

Name:

Cohort group:

The purpose of this workbook is to help you practice your numeracy skills. These are required by the NMC for the achievement of Practice Learning Outcomes relating to competence in numeracy, calculation and the safe administration of medicines. This workbook may be used as supportive evidence of your preparation and therefore can be used in your discussions with your mentor.

Introduction - NMC requirements p 3

Professional Competencies –Ongoing Achievement Record p 6

The Role of Child Student Nurses in Medicine Administration p 7

The Role of Mentors in Practice p 9

Ongoing Achievement Record - CFP Domain learning outcomes, skills sets p11

Numeracy and Calculation Practice Examples

The Metric System p12

Unit Conversions p13

Decimals p14

Fractions p15

Daily Fluid Requirements p16

Oral Fluids p18

Drug Dosages for Injection p19

Drug Doses According to Body Weight p20

Drug Doses According to Surface Area p22

Commonly used Drugs in 1st and 2nd Placements p23

Ongoing Achievement Record -Year 2 Domain learning outcomes, skills sets p25

Commonly used Drugs in 3rd and 4th Placements p27

Ongoing Achievement Record Year 3 Domain learning outcomes, skills sets p29

Commonly used Drugs in 5th and 6th Placements p31

References p33

Notes p34

Introduction - NMC requirements

“For entry to the register, programme providers will use the (Essential Skills Clusters) ESCs to inform the nature and content of numerical assessment where a 100% pass mark is required and all assessment must take place in the practice setting. The number of attempts is to be determined by the education provider.”

NMC Circular 07/2007.

The Essential Skills Cluster states:

Summative health related numerical assessments are required to test skills identified within the ESCs of medicines management, accurate recording of fluid input and output, accurate measurement of height, weight and body mass index.

For calculations associated with medicines management a 100% pass mark is required and assessment must take place in the practice setting. In order to meet the NMC’s directive that students’ numerical assessment must take place in the practice setting and that the students meet the following requirements:

First Progression Point- End of year 1 Common Foundation Programme(CFP).

CFP Learning Outcome

3.5 Demonstrates skills of measurement used within Nursing practice accurately and safely (Ongoing Achievement Record)

ESC skill / Requirement / Assessment / Pass mark
Essential skills clusters requiring numerical assessment
9,27,28,29,31,32,33,38
NMC Circular 07/2007 / 1. Completion & pass of on-line numeracy assessment / Students must achieve 19 out of 25 questions and the test may be taken a maximum of 5 times in order for the standard to be achieved. / 75 %
2. Completion/pass of identified CFP domains and relevant skills sets within Ongoing Achievement Record in clinical practice / Evidence to be assessed within practice and will include a drugs calculation test. / 100%

As preparation for the practice assessment to be conducted by the mentor, students will be required to show evidence of achievement in the UWE on-line numeracy test. Students must present the on-line results prior to undertaking and demonstrating their achievement of the essential skills cluster to their Mentor at progression point one.

Second Progression Point: for entry to the register. (Mid point/end of year three Child Programme).

Child Branch Learning Outcome

3.8 Demonstrates skills of measurement used within Nursing practice accurately and safely (Ongoing Achievement Record)

ESC skill / Requirement / Assessment / Pass mark
Essential skills clusters requiring numerical assessment
9,27,28,29,31,32,33,38
NMC Circular 07/2007 / 1. Completion & pass of on-line numeracy assessment. / Students must achieve 20 out of 25 questions and the test may be taken a maximum of 5times in order for the standard to be achieved. / 80%
2. Completion/ pass of identified Child Branch domains and relevant skills sets within Ongoing Achievement Record in clinical practice / Evidence to be assessed within practice and will include a drugs calculation test. / 100%

Students must achieve a pass in both of the above components in order to meet the NMC requirements. This specific numeracy related workbook will be available as an additional supportive resource for students at the start of the programme. Whilst this is not assessed by mentors the Sign-off Mentor may utilise it as further evidence in the assessment of the student’s numerical competency.

Numeracy and Calculations Advice to Students

These have been devised to help you to understand and practice the calculations required to administer medicines safely to children.

Work your way through this workbook, working on the practice questions as you go. Always show how you have worked out a particular question – this helps you identify any errors you might make and could help you and a reviewer understand how you have arrived at the answer.

Try wherever possible not to rely on using a calculator. By working things out on paper and using your own numeracy skills you are more likely to be able to spot where an answer seems to be wrong – for example, you know ‘in your head’ that the answer is likely to be 1ml and yet the calculator answer suggests 10mls.

Students are advised to read the following in conjunction with this workbook and before they start becoming involved in the process of giving medicines

· Ongoing Achievement Record

· Local and trust policies related to numeracy and medicine management

· Nursing and Midwifery Council Standards for Medicines management (2008). Standard 8 in particular.

· National Service Framework for Children Young people and Maternity Services (2004). Standard 10.

· Theory and practice lecture notes.

· http://learntech.uwe.ac.uk/numeracy

· If you experience difficulty in working through the calculations please seek help via the online numeracy facility above and contact

This pack is a further development of the Safe Administration of Medicines Workbook by the Nursing Practice Group from Bristol Children’s Hospital and agreed for use by all Trusts that support UWE children’s nursing students in August 2006.

Thank you to colleagues for help in preparing this workbook

Katrina Maine

Senior Lecturer in Children’s Nursing

Professional Competencies

The following tables shows the progressive nature of assessed clinical competencies within the Student Ongoing Achievement Record as part of the BSc (Hons)/BSc/DipHE Children’s Nursing programme.

This is reflected in the evidence required for the Domain learning outcomes which can include designated skills sets e.g Domain 3 - Care Management learning outcome 3.5 Demonstrates skills of measurement used within nursing practice accurately and safely. Must have completed skills set [3.1, 3.2, 3.3, 3.4, 3.5] to achieve.

The Ongoing Achievement Record

CFP (Year one ) Outcomes to be achieved for entry to the branch programme.

DOMAIN 3 : CARE MANAGEMENT con’t
Demonstrates literacy, numeracy and computer skills needed to record, enter, store, retrieve and organise data essential for care delivery
OUTCOME CRITERIA
3. Demonstrates the ability to record clear, legible and accurate nursing documentation
4. Demonstrates the ability to use available information systems to retrieve data essential for care delivery
5. Demonstrates skills of measurement used within nursing practice accurately and safely Must have completed administration of medicines skills set [3.1, 3.2, 3.3, 3.4, 3.5] to achieve The student will need to have demonstrated a pass in numerical test from the University before this outcome can be achieved.

Year One - Common Foundation Skills Sets for access to branch programmes

Each skill contributes toward achievement of the outcome criteria under the relevant domain of care and must be completed before the domain can be considered achieved for the year.
DOMAIN 3 – CARE MANAGEMENT- ADMINISTRATION OF MEDICINES
Is able to demonstrate application of national and local policies that control the administration of medicines, and the NMC standards and guidelines, appropriately through discussion and questioning during the placement period when participating in and/ or preceding/following medication administration activities and demonstrate evidence of a pass in a designated calculations test undertaken in the university
3.1 Demonstrates ability to accurately calculate simple drug dosages under direct supervision in practice with a qualified practitioner (must show a pass in numerical test from UWE)
3.2 Under direct supervision – Participates in the preparation and administration of agreed non controlled drugs using a variety of routes except intravenous, as used in the practice setting.
3.3 Demonstrates ability to read prescription charts and demonstrates an understanding of the importance of accurately maintained drug records
3.4 Demonstrates knowledge and understanding of commonly used drugs in the practice setting and their potential side effects and/or adverse reactions
3.5 Demonstrates the ability to safely dispose of equipment needed to draw up/administer medication

The Role of Child Student Nurses in Medicine Administration

Child Branch students entering nurse education at the University of the West of England all meet NMC entry requirements of GCSE maths or equivalent. During the programme all Child Branch students receive theory and practical sessions on the administration of medicines and the importance of numeracy.

This workbook has been developed by the Child Team in collaboration with the Trusts and incorporates information from the Safe Medication Administration Workbook (2006). All Trusts that support UWE children’s nursing students have agreed to use this pack as the self directed learning tool that all students are required to complete and discuss with their placement mentors. All students from their first day of supervised practice should be involved in the Administration of medicines but confusion often exists as to what students can and cannot do;

First and Second year students:

Should be involved in the process of administering medicines to children, after observing practice and developing skills in administration such as calculations, communication and preparation of the child to take medicines. Their role is not at this stage to be checkers or responsible in any way for checking and signing for the medicines given, that responsibility rests with the registered practitioner.

Third year students:

Will develop competency in checking once they have completed a self directed learning tool that will ensure mathematical theory and numeracy is applied to the practice of administering medicines to children. Students are able to act as second checker in their third year after completion of this self directed tool, as long as this is supported by their mentor and that the policy guidance in placement. The responsibility for completing the self directed learning tool lies with the student and they must discuss with their mentor when they are ready to begin practice.

It is the mentor’s responsibility to support the student in developing competence in applying the theory to practice.

Remember

Safe medication means giving the correct medication, to the right person, in the right amount, at the right time and by the correct route.

More than 10% of all reported medication errors occur in children under 4 years (National Patient Safety Agency 2007).

The Role of Mentors in practice

The NMC have introduced Standards to support learning and assessment in practice (2006) in which the requirements of a mentor undertaking this role are clearly outlined. In order to assist mentors in meeting these standards the following document has been developed, in liaison with practice, students and educators.

(The following points are some of the statements from the NMC standards publication, for further information please see the standards document, available on the NMC website, http://www.nmc-uk.org)

NMC Requirements:

· Every student has a named mentor for each period of practice

· Mentors would not normally support more than three students, from any discipline, at any point in time

· Whilst giving direct care in the practice setting at least 40% of a student’s time must be spent being supervised (Directly or Indirectly) by a mentor/practice teacher.

· When in the final placement this 40% of the students time is in addition to the protected time (1 hour per week) to be spent with a sign off mentor

· An Ongoing Achievement Record including comments from mentors, must be passed from one placement to the next to enable judgements to be made on the students progress

· The mentor should have access to a network of support and supervision to enable them to fulfil their mentoring responsibilities, assist them in making complex judgements regarding competence such as failing a student and to support their professional development

http://hsc.uwe.ac.uk/practicesupport/

Assessing learning in practice:

· Most assessment of competence should be undertaken through direct observation in practice

· Mentors should be involved, wherever possible, when competence is assessed through simulation

· Mentors should consider how evidence from various sources might contribute to making a judgement on performance and competence

· Mentors should seek advice and guidance from a sign off mentor or practice teacher when dealing with failing students

Confirmation of proficiency:

· The NMC has identified progression points within each approved programme where confirmation is required that students have met specified outcomes and competencies i.e. end of year one and end of programme for pre-registration students

· All mentors may assess specific competencies throughout the programme

· Mentors must keep sufficient records to support and justify their decisions on whether a student is, or is not competent/proficient

· In the final placement (year three F/T) of a pre-registration programme, mentors are required to be either a sign off mentor, or supported by a sign off mentor or a practice teacher, in order to make final decisions on proficiency

· Sign off mentors must have time allocated to reflect, give feedback and keep records of student achievement in their final period of practice learning, equivalent to one hour per student per week. This is in addition to the 40% of supervised practice time already identified.

Children S Nursing Numeracy Workbook

Contents

Professional Competencies