Anne - some Nursing programs require even Statistics for clinical nursing practice, let alone dimension analysis. These things give an idea on the good quality nursing training.

I am sure this dimension analysis of calculating medications it is a part of a resolve medication error, but if they mix it with a technological advance that help mitigate medication errors and the guidelines for safe medication administration. I think if we mixt with what it say in this document than we will solve medication errors problem.

https://opentextbc.ca/clinicalskills/chapter/6-1-safe-medication-adminstration.

The short answer is Yes, because dimensional analysis (standard in resolving mathematical "solve for x" equations) that are common in physics and chemistry. Medication administration and the associated calculations are absolutely both physics and chemistry of the highest order. But you raise a deeper fundamental nursing education issue that transcends math, chemistry and physics. Professional nursing (as well as all of the other health care professions) continues to struggle, as it should, to operationally define the "best practice", that will be internally adopted and widely regarded as the golden standard of professional behavior. Nursing is not just an art, it is a science. A minimum skill-set and exhibited attributes of having a "scientific conscience" and well developed mental discipline and behaviors that are appropriate in a laboratory environment, are required prerequisites for anyone who would become a student nurse. Successful completion of a battery of courses (math, chemistry, physics, biology, etc.) are highly recommended before any nursing student should ever be required to actually calculate and administer the prescribed dose for any medication (even under direct observation/supervision of a preceptor). That said, one of the most valuable scientific insights that prepared nursing students have is the understanding that there are multiple valid methods that result in the correct answer. Perhaps your question could be more precisely answered by expanding it to include the issue of cognitive styles. The "best" (most efficient, most comfortable, valid, accurate, flexible) method for student nurses may well be a function of their individual "cognitive style". My suggestion would be to intentionally require and provide instruction of the several different well known methods to resolve dosage and solution problems in a given nursing curriculum designed to develop a universal and standardize professional nursing skill set inventory. Even so, as a bioinformatics data scientist, I have a stern warning for all (especially health care providers) that it is quite possible that "apps" (algorithms, Alexa, Cortana, A.I., etc.) although quite useful, may introduce "decision support bias" in such a way, that the provider's independent judgement is not actively engaged during the process of delivering care (i.e. medication administration) in a manner that results in an adverse event! This is one of the well known issues currently in health care that involves the human-computer interface, human factors, and "unintended consequences". Human factor accidents continue to happen, in spite of our best efforts to "hard wire" them out of existence. Who takes the damage for the medication error? The patient does, every time. Even when the error is a "system error" that is beyond the providers control, the provider takes the blame, and the resulting professional consequences, if the error is sufficiently catastrophic. Excellent question, thank you for posting.

Hi Dr. Gilder,

Your response was highly appreciated. I agree that nursing is both an art and a science. We have to be diligent in our pursuit for accurate science and math knowledge as it involves the welfare and safety of our patients. I appreciate your thoughts regarding the cognitive efforts of the students being able to put together the math calculation piece as part of medication administration (IV, IM and oral routes). I agree that success in the areas of math, chemistry, possibly physics and biology help develop the mindset and rigor needed for the nursing focus. I think being able to have several acceptable methods of calculation are a good idea (as the NCLEX registering exam does not ask for a certain method). I only teach dimensional analysis to keep things simple and understandable. I think this is an area that that is important to do this. It seems that dimensional analysis can be applied to many different types of nursing problems (simple conversions, tablet problems, 2 step problems involving weight, IV rate problems, mg/kg/day problems, advanced drip problems, pediatric dosage problems to name a few).

It was so interesting that you talked about "apps". Some of the IV pumps will be preloaded with dosage information, but I always tell my students to do the problems so that you and the IV pump can agree. There is a big concern about medication safety in the world of Nursing. The Institute of Medicine has published studies related to this concern. They have tried to pinpoint why there is a high rate of medication errors. It is an older study but still relevant, I believe.

To Err is Human: Building a Safer Health System - PubMed

pubmed.ncbi.nlm.nih.gov

Thanks again for the information and time.