GCSE maths blamed for nurses' blunders

Nurses have to make complex calculations to measure out drugs

Nurses are at risk of making potentially fatal mistakes in calculating medicine doses because their maths is not up to scratch, it has been claimed.

Some nursing experts say a "general weakness" in maths in the profession means some do not even get doses right when using a calculator.

They have suggested that the problem lies with the GCSE maths curriculum, which they say is not equipping nurses to deal with calculations used in the profession - particularly the complex sums needed to measure out drugs for children.

A 16-year-old with a C grade maths GCSE is not expected to go into a position and apply that without further training and advice

Qualifications and Curriculum Authority

Decimal points put in the wrong place mean that some doses have been calculated at 10 times too little or too much.

The concerns were raised at a council meeting of the nursing regulatory body, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC), where members were discussing forthcoming guidance for nurses administering medicines.

About 6% of misconduct cases heard by the body are linked to maladministration of drugs.

UKCC president Alison Norman said: "Where I work we have nurse cadets with maths GCSE who find calculation without a calculator very difficult. Even with a calculator some are not secure."

A UKCC spokesman said that a poor grasp of maths was a problem for many people - not just nurses.

Using a calculator does not guarantee safety

But he acknowledged that mathematical mistakes made by nurses could put lives in danger.

The Qualifications and Curriculum Authority, which oversees the national curriculum and public exams, denied that GCSE maths was to blame.

He said GCSEs were not seen as a preparation for work.

They provided students with a grounding in subjects, so they had skills they could develop further, either through A-levels, professional training or professional qualifications.

"A 16-year-old with a C grade maths GCSE is not expected to go into a position and apply that without further training and advice, and possibly, qualifications," he said.

The GCSE curriculum covered calculations involving decimal places and fractions, both mentally and using a calculator.

Pressures of work

A spokesman for the nursing union, the Royal College of Nursing, said calculation errors made by nurses were "not usually due to an inability to calculate basic sums".

"Rather, they can arise when the nurse or doctor is placed under unacceptable pressure in a difficult working environment," he said.

"It is absolutely vital that nurses and doctors are given the professional support and safeguards to minimise the risk of error.

"Safeguards to ensure errors are picked up before patients are put at risk could include a requirement for a second calculation by a colleague.

"A strong focus in pre-qualification training on the use of maths to calculate correct doses of drugs and a uniform calculation system across hospitals will help to minimise error. NHS hospital managers need to standardise methods of calculation. "

Computer program

At Cardiff University, a computer programme written by a research student is now being used to help develop trainee nurses' mathematical skills.

Professor Laurie Moseley, of Glamorgan University, where the research is being carried out, said the programme helped students conceptualise problems .

It also helped rectify computation errors.

Cardiff students were taught to work out calculations without calculators, so that they properly understood mathematical concepts.

They had to pass assessments with 100% scores before they were allowed to practise as nurses.

"Incompetent nurses are not going out from Cardiff to kill people," he said.

He added: "It seems that the students are being taught properly at school.

"What they need to do for their nursing jobs was covered at school, but they have got rusty - it has not stuck in their heads and they need to get up to speed."