This document provides information on performing dosage calculations using dimensional analysis. It outlines the components, advantages, and steps of the dimensional analysis method. Examples are provided to demonstrate setting up and solving dosage calculation problems using this method. Converting between units and knowing equivalencies are essential skills required to set up and solve the equations successfully. Resources for additional practice are included.
Many nurses have difficulty with drug calculations. Mostly because they don’t enjoy or understand math. Practicing drug calculations will help nurses develop stronger and more confident math skills. Many drugs require some type of calculation prior to administration. The drug calculations range in complexity from requiring a simple conversion calculation to a more complex calculation for drugs administered by mcg/kg/min. Regardless of the drug to be administered, careful and accurate calculations are important to help prevent medication errors. Many nurses become overwhelmed when performing the drug calculations, when they require multiple steps or involve life-threatening drugs. The main principle is to remain focused on what you are doing and try to not let outside distractions cause you to make a error in calculations. It is always a good idea to have another nurse double check your calculations. Sometimes nurses have difficulty calculating dosages on drugs that are potentially life threatening. This is often because they become focused on the actual drug and the possible consequences of an error in calculation. The best way to prevent this is to remember that the drug calculations are performed the same way regardless of what the drug is. For example, whether the infusion is a big bag of vitamins or a life threatening vasoactive cardiac drug, the calculation is done exactly the same way.
Many nurses have difficulty with drug calculations. Mostly because they don’t enjoy or understand math. Practicing drug calculations will help nurses develop stronger and more confident math skills. Many drugs require some type of calculation prior to administration. The drug calculations range in complexity from requiring a simple conversion calculation to a more complex calculation for drugs administered by mcg/kg/min. Regardless of the drug to be administered, careful and accurate calculations are important to help prevent medication errors. Many nurses become overwhelmed when performing the drug calculations, when they require multiple steps or involve life-threatening drugs. The main principle is to remain focused on what you are doing and try to not let outside distractions cause you to make a error in calculations. It is always a good idea to have another nurse double check your calculations. Sometimes nurses have difficulty calculating dosages on drugs that are potentially life threatening. This is often because they become focused on the actual drug and the possible consequences of an error in calculation. The best way to prevent this is to remember that the drug calculations are performed the same way regardless of what the drug is. For example, whether the infusion is a big bag of vitamins or a life threatening vasoactive cardiac drug, the calculation is done exactly the same way.
Curtis HillHA3110D - Quality Improvement and Risk ManagementLP.docxdorishigh
Curtis Hill
HA3110D - Quality Improvement and Risk Management
LP03.2 Assignment Self-Improvement Project
Self-improvement Project Worksheet
HA3110
Healthcare Quality Improvement & Risk Management
1. Perhaps the most widely used improvement model is the PDSA model which is what you will use for your self-improvement project in this course.
2. You have the autonomy to choose your project from this list:
a. accepting criticism
b. budgeting (personal or family)
c. communication skills
d. healthy Lifestyle (includes weight loss, diet and exercise)
e. smoking cessation
f. stress reduction
g. stress related to time management
h. time management.
3. Due to time constraints and the scope of this course, your measures and resulting data display has been done for you.
Use this form for your work: Just click in the box and type, although with extensive dialogue, the format might change, but it will not affect the content of the document.
1. What is it you want to improve: (Also referred to as your Aim Statement)
(
Smoking cessation.
)
(
Full smoking cessation
) (
By
t
KLH
he
end of the year.
)
2. How much: 3. By when:
3. (
Plan
)By completing the above, you have described how you will know if the changes create
an improvement.
4. (
I will use a 7 weeks
likert
survey and a line graph.
)What Likert Survey and run chart will you use?
Complete to here for LP3.2 Drop Box: Project Topic
This is where you continue your planning stage (perhaps the most important phase of the PDSA cycle). Find evidence-based information on best practice related to your topic. Remember, in quality improvement it is not always up to you to reinvent the wheel. What works for others and supported by studies and research should work for you. (However, always give them credit when credit is due). Although you will be using the Likert survey, you are required to provide the “theory” behind you work.
In your update for Week 4, provide a review of how you have implemented the Plan stage of the PDSA Improvement Model (250-350 words). Copy any paste your response to the LP4.2 drop box.
(
The first step of
quiting
smoking is having a reason why one really wants to
quit .There
are a number of reasons of wanting to quit smoking which include:
Improving health-this is mostly the main
reason.In
some
cases,quiting
smoking because of health issues comes from the doctor’s advice but most times it is a self
madedecision.oking
increases once risk of throat
cancer,lungcancer,heartdisease,emphysema
gumdisease,ulcers
and high blood
pressure.In
some instances the victim just wants to feel healthier by avoiding smoke caused
coughing,sore
throats and poor athletic ability thus the urge to quit.
Better looks-smoking can result to stained
teeth,dull
skin and wrinkles
therefore an urge to quit.
)
(
Plan
)
In the ideal situation, you would begin the DO stage by testing on a small scale.
Here you wi.
NUTR 100 – Diet Analysis Project Template (Parts I, II & III)P.docxcherishwinsland
NUTR 100 – Diet Analysis Project Template (Parts I, II & III)
Part I: 24-hour Food & Beverage Recall with Predictions
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Dietary Analysis Project-Part I: Food Recall (20 Points)
Rubric Name: Dietary Analysis Project_PartOne
Interview Process
Excellent
12 points
Good
9 points
Fair
6 points
Not Completed
0 points
Score and Feedback
This pertains specifically to 24 hour recall (interview) collected by the student. Part 1 of assignment.
Interview is complete with times, foods, product names and portion sizes. (8 pts)
Student has listed the height, weight, age and gender. (4 pts)
Interview is incomplete with some information missing on the food items and times. (5 pts)
Student has listed the height, weight, age and gender. (4 pts)
Interview is incomplete with most information missing on the food items and times. (3 pts)
Student has not listed the height, weight, age or gender. (3 pts)
Student has not submitted any work. (0 pts)
9 points
Predictions
Excellent
8 points
Good
6 points
Fair
4 points
Not Completed
0 points
Score and Feedback
This pertains specifically to 24-hour recall (interview) collected by the student. Part 1 of assignment.
Predictions are made on the interview and include appropriate comments on required aspects of the diet. Includes comments on
food groups and nutrients.
Some predictions are made on the interview and include some appropriate comments on required
aspects of the diet. Includes comments on either food groups and nutrients but did not discuss items from both.
Few predictions are made on the interview and include some appropriate comments on required
aspects of the diet. Lacks discussion on food groups and/or nutrients.
Student has not submitted any work.
4 points
Overall Score
Level 4
16 or more
Level 3
11 or more
Level 2
1 or more
Level 1
0 or more
Score and Feedback
Overall Score
13 points
Part I of the project is on the right track, but is missing a portion of the assignment and has some incomplete info in the diet recall.
For the diet recall, was there any milk with the oatmeal? If so, please include what kind and how much. Any toppings on the oatmeal? Include the name of the pizza if applicable, ex. Pizza Hut. List out the ingredients of the cesar salad. These details are important for the SuperTracker nutrient report. Please add them to the diet recall with your Part II submission later this week.
Nice work completing the predictions table but I do not see your predictions write-up. Please take a look at the template instructions again for part 2 of the predictions and include this information in your Part II submission.
Use this template in conjunctio.
Diet Analysis Project Part II Due October 22nd, 2013 OVERV.docxduketjoy27252
Diet Analysis Project
Part II
Due October 22nd, 2013
OVERVIEW OF ACTIVITIES:
· Activity 3: Calculating and Analyzing Energy Balance
· Activity 4: Analyzing Intake and Comparing to National Cholesterol Education Program, American Heart Association, and Food and Nutrition Board Recommendations
· Activity 5: Analyzing Vitamin and Mineral Intake and Comparing to DRIs
Note! You must make corrections to Part I before beginning Part II!
Activity 3 – ENERGY BALANCE
Overview:
To evaluate the extent to which you are in energy balance, you need to calculate your estimated energy (kcal) requirement (EER) and compare it with your energy (kcal) intake (already calculated for you from your computer nutrient analysis). See chapter 10 in the textbook for a discussion of energy balance. For this activity, complete the worksheet below on energy balance.
Calculations:
1. Enter the following information showing all work):
Conversions
1 in = 2.54 cm
100 cm = 1 m
or 1 in = .0254 m
example: 55 in x 2.54 cm/in = 139.7 cm and 55 in x .0254 m/in = 1.397 m
1 lb. = 2.2 kg
example: 130 lb / 2.2 kg/lb = 59.09 kg
Complete the following data/ calculations:
age (years) =
gender =
height in inches =
height in meters =
weight in pounds =
weight in kilograms =
2. Determine your Estimated Energy Requirement (EER) by using the appropriate equation below. (See page 320 in the textbook for an example of how to use this method to calculate kilocalorie requirements.)
Estimated Energy Requirement Formulas:
Men 19 years of age and older:
EER = 662 – (9.53 x Age[years]) + PA x [(15.91 x Weight[kg]) + (539.6 x Height[m])]
Physical Activity (PA):
PA=1.00 Sedentary (typical daily activities only)
PA=1.11 Low Active (equivalent to walking 2 mile/day at 3-4 mph)
PA=1.25 Active (equivalent to walking 7 mile/day at 3-4 mph)
PA=1.48 Very Active (equivalent to walking 17 mile/day at 3-4 mph)
Women 19 years of age and older:
EER = 354 – (6.91 x Age[years]) + PA x [(9.36 x Weight[kg]) + (726 x Height[m])]
Physical Activity (PA):
PA=1.00 Sedentary
PA=1.12 Low Active
PA=1.27 Active
PA=1.45 Very Active
Calculate your Estimated Energy Requirement showing all calculation steps:
3. Compare the actual kilocalorie intake ChooseMyPlate calculated for you in the “Nutrients Report” for Day 1 and Day 2 with your estimated energy requirement from the above question. Show all calculations and include appropriate units. First, total actual Day 1 and Day 2 kilocalorie intake then divide by 2 to obtain an average kilocalorie intake for both days.
Average kilocalorie intake, Day 1 and Day 2
Estimated Energy Requirement (EER)
Difference (in kilocalories) between actual intake and estimated requirement
Are you consuming fewer (negative energy balance), the same number of (energy balance), or more (positive energy balance) calories than the estimated requirement?
Assuming.
MSL 5080, Methods of Analysis for Business Operations 1 .docxgertrudebellgrove
MSL 5080, Methods of Analysis for Business Operations 1
Course Learning Outcomes for Unit I
Upon completion of this unit, students should be able to:
1. Differentiate the steps of the quantitative analysis approach.
1.1 Apply quantitative analysis in a real-world situation.
1.2 Perform a break-even analysis.
Reading Assignment
Chapter 1: Introduction to Quantitative Analysis
Unit Lesson
Quantitative Analysis
As good an opening as any to a postgraduate quantitative analysis course is to confirm that yes, mathematics
is involved to improve situations and outcomes and also to stress that leadership has always been the
foundation for quantitative analysis. The answer will not make you prosper, but leading the effort in deciding
what quantitative analysis measurements mean and what to do after seeing these numbers may indeed
benefit your organization. There will be a bit more discussion on what leaders may do with quantitative
analysis after introducing some fundamentals.
To quote the authors from the textbook, “Quantitative analysis is the scientific approach to managerial
decision-making” (Render, Stair, Hanna, & Hale, 2015, p. 2). A scientific approach means calculating with
numbers. Conversely, perhaps you have worked for leaders who used guesswork or a gut feeling to decide a
numbers-based, quantitative issue. Perhaps the leader chose fortunately, and that is good; but pursuit of
good fortune becomes hazardous if you are using hope and chance to gain a good outcome. You may have
noticed this does not work well for most Las Vegas vacationers who enjoy themselves by gambling against
high odds that favor the casinos. So, quantitative analysis can have a valuable place as a decision tool if you
can make the analysis properly fit the situation.
The use of quantitative analysis to keep track, measure, analyze totals, and forecast, is older than language
itself. Sumerians, and other peoples in the Middle East, used it for grain and livestock categories. Exploration
of mathematics theory (i.e., learning how to add, subtract, multiply, and divide) made quantitative analysis
possible. Now, apply mathematics to estimate probability to see what might happen, determine averages and
percentages to see how much might be involved, and address many specific situations. As you can imagine,
just knowing a number (e.g., how much livestock a person has) may not mean much by itself. This is where
mathematics helps: The purpose of quantitative analysis is to turn raw data into meaningful information.
Formulas turn that data into something leaders can use along with considering qualitative factors such as
weather and customer demand. In theory, good leadership should do the rest.
Business Analytics
The textbook covers the terms below that you are intended to recall throughout the course:
Business analytics uses (usually large amounts of) data to make better business decisions. There are
three catego ...
MSL 5080, Methods of Analysis for Business Operations 1 .docxpoulterbarbara
MSL 5080, Methods of Analysis for Business Operations 1
Course Learning Outcomes for Unit I
Upon completion of this unit, students should be able to:
1. Differentiate the steps of the quantitative analysis approach.
1.1 Apply quantitative analysis in a real-world situation.
1.2 Perform a break-even analysis.
Reading Assignment
Chapter 1: Introduction to Quantitative Analysis
Unit Lesson
Quantitative Analysis
As good an opening as any to a postgraduate quantitative analysis course is to confirm that yes, mathematics
is involved to improve situations and outcomes and also to stress that leadership has always been the
foundation for quantitative analysis. The answer will not make you prosper, but leading the effort in deciding
what quantitative analysis measurements mean and what to do after seeing these numbers may indeed
benefit your organization. There will be a bit more discussion on what leaders may do with quantitative
analysis after introducing some fundamentals.
To quote the authors from the textbook, “Quantitative analysis is the scientific approach to managerial
decision-making” (Render, Stair, Hanna, & Hale, 2015, p. 2). A scientific approach means calculating with
numbers. Conversely, perhaps you have worked for leaders who used guesswork or a gut feeling to decide a
numbers-based, quantitative issue. Perhaps the leader chose fortunately, and that is good; but pursuit of
good fortune becomes hazardous if you are using hope and chance to gain a good outcome. You may have
noticed this does not work well for most Las Vegas vacationers who enjoy themselves by gambling against
high odds that favor the casinos. So, quantitative analysis can have a valuable place as a decision tool if you
can make the analysis properly fit the situation.
The use of quantitative analysis to keep track, measure, analyze totals, and forecast, is older than language
itself. Sumerians, and other peoples in the Middle East, used it for grain and livestock categories. Exploration
of mathematics theory (i.e., learning how to add, subtract, multiply, and divide) made quantitative analysis
possible. Now, apply mathematics to estimate probability to see what might happen, determine averages and
percentages to see how much might be involved, and address many specific situations. As you can imagine,
just knowing a number (e.g., how much livestock a person has) may not mean much by itself. This is where
mathematics helps: The purpose of quantitative analysis is to turn raw data into meaningful information.
Formulas turn that data into something leaders can use along with considering qualitative factors such as
weather and customer demand. In theory, good leadership should do the rest.
Business Analytics
The textbook covers the terms below that you are intended to recall throughout the course:
Business analytics uses (usually large amounts of) data to make better business decisions. There are
three catego.
Explains two basic types of optimization problems for blends, namely the simpler where total contents have requirements, and the slightly more complicated where final concentrations have requirements. Both are linear programs that can reliably be solved in a spreadsheet, we walk through this process. The point is that you can save money on making mixtures or blends, it is very important and not too difficult.
2. Understand the learning components needed
in order to perform dosage calculations.
Apply dimensional analysis method when
calculating dosages for medication
administration.
OUTCOMES
3. FORMULA METHOD:
RATIO AND PROPORTION:
LINEAR: 250 mg : 1 tab :: 1.5 g : x tabs
FRACTIONAL:
OTHER METHODS:
Disadvantages: Must remember the extra step of changing D and H to same unit of
measurement. May have many steps and variables.
250mg
1tab
=
1.5g
xtabs
5. ADVANTAGES:
Organized and simple structure
Set up in one step so all information is in one problem
Easy to see if set up is incorrect
REQUIRED ELEMENTS:
Need to anticipate what units your answer needs to be in
What your given quantity is and what units need to be converted
Conversion factors – to convert given quantity and units into your
desired answer units
DIMENSIONAL ANALYSIS METHOD
6. What is being ordered?
IN SIMPLER TERMS
What do we have on hand?
Do we need any equivalents, or do we need to convert into
equivalents?
Where are we going, what are we looking for?
7. Determine the label you want your answer to be in (desired
answer units) and write it on the right side of your equation.
(your book also tells you to put ‘desired answer units’ on the left
side of your page, Mulholland, p.46)
Put the known values (given quantity and units) of the problem in
fraction form on the left side of your equation. Remember, the
desired answer unit must be in the numerator. (Mulholland, p.47)
Put in any conversion factors you will need to work towards the
desired label.
Cancel out all labels that are both in numerator and
denominator.
Do the math: reduce, multiply the numerators, multiply the
denominators; then divide the numerator by the denominator.
IDEAS TO HELP YOU
8. Basic math functions / Fractions
Adding, Subtracting, Multiplication, Division
Decimals -
King Henry Doesn't [Usually] Drink Chocolate Milk with a Microscope
The first letters stand for the prefixes, with "Usually" in the middle
standing for the "unit", being meters, grams, or liters. Many memory
phrases omit the "Usually", and consequently students forget where the
basic unit goes, messing up their conversions. Leave the "Usually" in there
so you can keep things straight:
kilo- hecto- deka- [unit] deci- centi- milli- ^- ^- micro-
Must know equivalents / conversions (no apothecary items).
Using Estimation (Mulholland, p.136) and Estimated Dose to
anticipate your answer, then do your DA equation.
THINGS YOU WILL NEED TO KNOW
9. Let’s not make this too complicated: We know that there are
72 hours in 3 days, this is how it would look using D.A. -
SOME THINGS ARE COMMON SENSE
24hr
1day
x
3days
1
= 72hr
10. LET’S START WITH A CONVERSION
40 L = ______ gal
?
gal:
1gal
4L
´
Desired
Answer
Units
Starting
(Conversion)
Factor
40L
1
= gal10
Given
Quantity
and Units
1
10
11. SAME PROBLEM DIFFERENT SETUP
40 L = ______ gal
1gal
4L
=
Desired
Answer
Units
Starting
(Conversion
) Factor
40L
1
´ gal
Given
Quantity
and Units
1
10
10
12. Give Aspirin 0.65 g PO q 4 h prn headache
Bottle: 325 mg per tablet (1 tablet = 325 mg)
How many tablets will you give per dose?
Conversion factor: 1000 mg = 1 g
What are we looking to give? Tablets
What is dose on hand? 325 mg per tablet
What is the ordered dose? 0.65 g dose
How will we set this up using Dimensional Analysis?
ORDER:
13. What are we looking for?
What is dosage on hand?
What is the conversion factor and what is the order?
WORK IT
Tablet(s)
dose
1tab
325mg
´
0.65g
dose
=
1000mg
1g
´
Mulholland, pg 115-116 for similar problem
14. Cancel out and do the math:
WORK IT
Tablet(s)
dose
1tab
325mg
´
0.65g
dose
´
1000mg
1g
=
650
325
=
2
So, you will give the patient 2 tablets as needed every 4 hrs
15. You have an order for Daypro 1200 mg po bid:
A SIMPLE EXAMPLE
1cap
600mg
´
2
1
cap2
Mulholland, pg 138, problem 5 for similar problem
Desired Answer Units
1200mg
dose
=
16. The order reads Estratab 3125 mcg po daily:
ANOTHER COMPLEX EXAMPLE
tab
1
1.25
´
3125
1
´
1
1000
=
3125
1250
= 2.5
1tab
1.25mg
´
3125mcg
1dose
´
1mg
1000mcg
=
Desired Answer
Units
2.5 tab
17. Order: Azithromycin 12 mg/kg PO daily dose. Patient weighs
22 lbs. Pharmacy sends a 240 mL bottle of Azithromycin
labeled 200mg/5mL. How many mL will you pour for each
dose?
HOW ABOUT A MORE COMPLEX PROBLEM
ml
dose
12mg
kg / dose
´
5ml
200mg
´
1kg
2.2lbs
´
22lbs
1
=
3
Desired Answer UnitsMulholland, pg 160, 147 for similar problems
1
10
1
60ml
20dose
=
18. PRACTICE
Your patient may receive Dilaudid 3 mg IM q3h for pain. At
this hospital Dilaudid is supplied in 1-ml ampules containing
4 mg. How many milliliters will you administer?
m
l
0.75
3
4
=
3mg
1dose
=
1ml
4mg
x
19. Mulholland, J. M. (2011). The nurse, the math, the meds:
Drug Calculations Using Dimensional Analysis. (2nd ed.).
St Louis, MO: Elsevier Mosby.
Moore, S.G. (2011). Nursing math simplified: Math magic. (5th
ed.). Clearwater, FL: H&H Publishing.
Horntvedt, T. (2012). Calculating Dosages Safely: A
dimensional analysis approach. Philadelphia, PA: F.A.
Davis.
RESOURCES
Editor's Notes
Mulholland Ch 1 – 4 and working on 5, after this move on to orders, labels, errors, oral dosages.
DA for med order calcs – makes life easier
What is the doctor ordering or prescribing, 650 mg Tylenol PO q6h prn headache? 1 mg Dilaudid IV q3h prn moderate to severe pain? Lasix 20 mg PO bid ? Did u read p101 med freq, abbrev?
Tylenol 325 mg tablets, or Dilaudid 2 mg / ml, or Lasix 40 mg tablets ?
What if he ordered 0.65 g Tylenol ? Or drug x 5 mg per kg and pt wt in pounds
What are you being asked to give? What unit are we being asked to give for the ordered dose? Are we looking for mL? mg? g,? Or tablets? We are looking for what is the DESIRED UNIT DOSE
Look at without fancy terminology – Class can look at page 46 for book terminology
LABEL – DESIRED ANSWER UNITS - How many hrs are in 3 days? What want to know? HOURS
KNOWN VALUES – GIVEN QTY UNITS – What were we given to figure out? 3 days
CONVERSION FACTORS, What do we need to convert to get the answer? We know 1 day = 24 hrs
30 days / 1 x
Using Estimation – example of hours in 3 days, or 650 mg tylenol with 325 mg tabs, get idea of what answer is,
Do exercises pages 137 – 150 in Mulholland.
2. Also, don't forget to tell them to ignore the apothecary items (which I think this book leaves out entirely or it might be in there, I can't remember).
3. The book addresses "approximate equivalents" which is always confusing, maybe you could add something about that too.
CONVERSIONS – NEED TO KNOW
1 gallon = 4 Liters (according to Mulholland’s approximate
English conversions) but really is 3.785 L or 3.79
If students bring up discrepancy, tell them re pg 66 & 81
Household measurements