Department of Interdisciplinary Studies IDST 1400 Medical Mathematics Revised 2015 by: Marilyn Donahue Course Description This course will provide a review of basic mathematical calculations and will instruct the learner on how to convert equivalents from one system to another and accurately mix and measure drugs. Emphasis will be placed on how these techniques are used in the administration of medications for patient use. Credits/Modes of Instruction This is 3 credit course (~50 hours) that relies on hands-on activities, assignments, and discussion. Should the instructor feel that a class meeting(s) is necessary, she/he will notify all student(s) via email or telephone of the class meeting time and location. The course instructor will organize the class in coordination with Rutgers School of Heath Related Professions syllabus, and communicate requirements with student, either by email or telephone. Pre/Co requisites All math remediation and successful high school completion of Dynamics of Health Care in Society Instructor The instructor will be a Rutgers SHRP faculty (or adjunct) member. Course Goals The goals of this course is to provide a review of basic mathematical calculations, to instruct the learner on how to convert equivalents from one system to another and accurately mix and measure drugs, to provide the learner with the necessary mathematical background needed for pharmacology, and to provide the learner with the theory and skills necessary to administer medication safely. For the purpose of sharpening the learners math calculation skills and to develop a logical sequence of operations in solving complex dosage calculations, No calculators are used during this course 1
Course Objectives The objectives of this course will be met via on site participation/hands on learning, required readings, assignments, and discussions with preceptor. 1. Demonstrate accurately the addition, subtraction, multiplication, and division of fractions and mixed numbers. 2. Read and write decimals with 100 percent accuracy. 3. Add, subtract, multiply, and divide decimals with 100 percent accuracy. 4. Convert common fractions to decimals and decimals to fractions. 5. Convert percent to decimals, fractions to percent, percent to fraction, and decimals to percent. 6. Convert temperature from the Fahrenheit scale to centigrade scale and vice versa. 7. Convert from one unit of measure to another using the metric system, and household measures. 8. Locate and identify dosage information on medication labels and inserts. 9. Identify information listed on physician s order sheet and medication administration record (MAR) 10. Demonstrate knowledge of the 6 Rights of Medication Administration and steps to avoid medical errors. 11. Demonstrate knowledge and skill of safe handling, use, and disposal of hypodermic needles and syringes. 12. Use ratio-proportion calculation method to prepare ordered dosages from prepared medications. 13. Use dimensional analysis and/or the formula method to calculate ordered dosages from prepared medications 14. Calculate medication dosages based on body weight. 15. Calculate medication dosages based on body surface areas. 16. Demonstrate knowledge and ability to accurately calculate flow rates for Intravenous solutions and medications. 17. Demonstrate knowledge and ability to accurately calculate titration ranges for Intravenous medications. 18. Assess calculated answers to determine if the answer obtained is logical; does the answer make sense based on normal, average dosages. 19. Calculate pediatric dosages based on body weight. 2
Requirements for Completion Attendance is required, as well as completion of all activities and assignments. Students will be required to arrange with preceptor a make-up date in case of an absence. Assignments are expected to be submitted on their due date to the course preceptor. Late assignments will be marked down 1 point per day late. Requirements Weight Attendance/Participation/Group Discussion 10% Chapter Assignments/Classwork 10% Chapter Quizzes 15% Course Projects Humanitarian Aid Campaign Design & Research Virtual Medication Administration 25% Unit Tests and Final Examination 40% Total 100% Evaluation and Grading Grade Determination The minimum level of satisfactory performance in this course is a C or better. To receive a C or better, students must first complete ALL course requirements specified above, including meeting the minimum attendance expectation. Based on the evaluations methods and criteria previously described, each requirement is then scored on a 0-100 point scale. The final letter grade is based on the weighted average of all requirements. Upon successful completion of the course students will be eligible to take the Health Science Careers standardized exam to determine college credit. All students must attain a C (74) or better to earn college credits. Minimum passing standardized exam grade for all students must be at least 70 before calculations of college transcript grade can be determined. The Rutgers grade listed on the student s transcript will be comprised of 50% of the Rutgers-SHRP standardized exam grade and 50% of the high school course grade. 3
Health Science Careers Program Grading System Weighted Average of All Requirements Final Letter Grade 94-100 A 90-93 A- 87-89 B+ 84-86 B 80-83 B- 77-79 C+ 74-76 C Unsatisfactory Performance/Progress Unsatisfactory performance which may include late assignments and/or attendance or progress problems will be discussed individually on an as needed basis. Honor Code and Academic Integrity (Refer to your SHRP Student Handbook at http://shrp.rutgers.edu/current_students/handbook.pdf) The faculty of Rutgers School of Health Related Professions believes that students must observe and support high standards of honesty and integrity. For this reason, all students in this course are expected to abide by the School's Honor Code and uphold its Code of Academic Integrity. As described in detail in your Student Handbook, violations of the Code of Academic Integrity include cheating, plagiarism, fabrication and/or academic misconduct. All such violations will be considered with gravest concern and may be punishable with sanctions as severe as suspension or dismissal. If you have not previously affirmed the School's Honor Code (either in writing or electronically), you must submit a signed and dated copy of the Honor Code to the instructor by the end of the first week of the semester. The Honor Code form is provided in the current SHRP Student Handbook. 4
General Learning Resources Required Textbook(s) Curren s Math for Meds: Dosages and Solutions. by Anna M. Curren and Margaret H Witt. (2015). 11 th edition. Or newest edition. ISBN -13:978-1- 1115-4091-3. Cengage Learning, 200 First Stanford Place, 4 th Floor, Stamford, CT Practice Software Site http://www.delmarlearning.com/companions/content/1428310959/s_resources/mathformeds11/mathformeds.html Recommended Textbook/Software Pharmacy Technician Handbook, by Lee Gootblatt. (2005). 1 st ed. Or newest edition. Privately Published. Contact Mr. Gootblatt at gootblattl@mcvts.org or LinkedIn Excellent resource for practice questions and alternative explanation of dosage calculations. Virtual Clinical Excursions: Online and Print Workbook for Medical- Surgical Nursing. 9 th Edition. 2014. Sharon Lewis, Shannon Ruff Dirksen, and Margaret M. Heitkemper. Elsevier/ Mosby. ISBN 9780323221832 The Virtual Software that comes with the print workbook is an excellent project for learners to become familiar with Medication Administration Records, professional duties, and virtual medication administration. It gives feedback at the end of the virtual shift. Recommended Laboratory Supplies Sterile safety needles for subdermal, subcutaneous and intramuscular injections Syringes: TB, Insulin, 3 ml, 10 ml Medical Waste container Alcohol swabs 2X2 gauze pads Practice vials of bacteriostatic water Practi-Powder vials Practi-insulin vials Practi-Ampules IV Fluids 1000mL, 500 ml, and 50 ml IV Pole to demonstrate gravity fed IV lines IV Volumetric Pump/ Electronic Infusion Device New Jersey Core Curriculum Content Standards (CCCS) are referenced and available at these links: http://www.state.nj.us/education/cccs/2014/career/careerreadypractices.pdf Career Readiness http://www.state.nj.us/education/cccs/2014/career/91.pdf Career Awareness, Exploration, and Preparation http://www.state.nj.us/education/cccs/2014/career/93.pdf Career and Technical Education http://www.state.nj.us/education/aps/cccs/math/ccssguidance.pdf K-8 Math Standards for review section http://www.corestandards.org/math/content/hsf/if/ Math: High School Functions/ Interpreting Functions http://www.corestandards.org/math/content/hsf/bf/ Math: High School Functions/ Building Functions 5
Course Units/Schedule Note: this schedule is a plan only, subject to change by the instructor as deemed necessary to achieve the course goals. Whenever possible, you will be notified in advance of any changes, especially those affecting course requirements or grading. Unit / Week Unit 1 Topical Outline Review of Arithmetic for Medical Dosage Relative Value, Addition and Subtraction of Decimals. Convert decimals to fractions, Convert fractions to decimals. Round decimals to desired place value. Assignments/ Field Activities/Resources All problem solving to be completed without the use of calculators. Curren: Chapter 1 Lecture, worksheet Review of basic math Evaluation Unit 1 Test NJ CCCS Review of Basic Mathematics 3.NF.1 Fractions Multiplication and Division of Decimals Multiply and divide decimals. Multiply and divide fractions. Simplify complex fractions.. Curren: Chapter 2 Lecture, worksheet Review of basic math 4.NF.5, 4.NF.6, 4.NF.7 Decimal Fractions Unit 2 Solve Common Fraction Equations Whole number equations Decimal number equations Multiple number equations Introduction to Drug Measures Metric System Identify metric system units of measure. State abbreviations for metric system. Complete metric conversion equations. Curren: Chapter 3 Lecture, worksheet Review of basic math Curren: Ch. 4, Metric Conversion Table Unit 2 Handout #1 Gootblatt: Problem Set Metric Conversion Worksheet Unit 2 Test 4.NF.3, 4.NF.4 Number and Operations - Fractions Review of Math, Measurements 3.MD.2 Measurement using Metric Unit, Percentage, meq, Ratio, & Household Measures, Temperature Recognize dosages measured in: Curren: Ch 5 Unit 2 Handout #2 Household Conversion Chart & Temperature 6
Marking Period 1 Project Unit 3 International Units (units). Identify household units of measure. State abbreviations for household systems. State equivalents for household system. Convert within household system. Write percentages as decimals and fractions. Estimate an answer. Convert Fahrenheit to Celcius, and vice versa. Apply use of ratio and proportions to applied math concepts. Solve practical problems encountered by health care workers. Identify apothecary system units of measure. Project Assignment Global Health Issue Medications/ Medical Supplies o dose per person o how many people o cost of dose Distribution Medication Administration Oral Medication Labels & Dosage Calculation Locate information on oral medications, solid and liquid. Locate Dosage Strengths on labels Calculate average Dosages Conversions Chart Conversions Worksheet Laboratory: Measure liquids using a medicine cup, syringes (without needles) various teaspoons and tablespoons from home. Compare for accuracy. Read the correct liquid measure in a measuring cup at eye level. Humanitarian Aide Campaign: Research, Design and Present an International Medical Relief Project Handout: Assignment description Powerpoint example Curren: Chapter 6 Images of Medication Labels in text Practice Questions on StudyWare Project Presentation Grade Due : 1-2 week timeline Unit 3 Test 4.MD.1, 4.MD.2 Measurement using metric & Household measures 3.MD.2 Measurement of liquids & solids Career Awareness: 9.2.12.C.5, 9.2.12.C.6 CRP7. Employ valid and reliable research strategies CTE Standards for Healthcare Science: Support Services 9.3.HL SUP.1-5 Safe Medication Administration Read Medication Administration Record (MAR) to identify meds Documentation of Meds given Curren: Chapter 7 Copies of MAR available Discussion of the 6 Rights of Medication Administration. YouTube Link Beyond Blame about medical CTE Standards for Healthcare Science: Therapeutic Services 9.3.HL THR.1-4 Diagnostic Services 7
The 6 Rights of Medication Administration Partnering with the Patient Avoiding Medical Errors Hypodermic Syringe Measurement Read the amount of liquid in a syringe correctly OSHA Safety rules for handling syringes and needles safely Proper technique for drawing medications from vials Proper disposal and accounting of syringes and needles. Parenteral Medication Labels and Dosage Calculation Read parenteral solution labels Identify dosage strengths Calculate average dosages from the label Dosages in ml, meq, units, percentage and ratio strengths Reconstitution of Powdered Drugs Prepare solutions from powdered drugs using directions on the vial label or package insert Determine the expiration date and time for reconstituted drug Calculate dosages for reconstituted drugs. errors 6 minutes https://www.youtube.com/watch?v=okticy3qjjk Curren: Chapter 8 Laboratory: demonstration and use of syringes: standard 3 ml, Tuberculin, 5 ml & 10 ml; Sterile safety needles for intradermal TB, subcutaneous, and intramuscular injections. Technique for drawing medication from practice vials, and glass ampules Curren: Chapter 9 Read the images of the labels in text and answer the end of chapter questions. Complete StudyWare Chapter 9 quiz Curren: Chapter 10 Laboratory: Using a 3 ml syringe with safety needle to reconstitute a vial of practi-powder with bacteriostatic water. Practice dosage calculations 9.3.HL DIA.4 Career Awareness 9.2.12.C.7 Ethics 9.2.12.C.8 Laws CTE Standards for Healthcare Science: Support Services 9.3.HL SUP.1-5 CRP2- Academic & Technical Skill CRP2- Academic & Technical Skill CTE Standards for Healthcare Science: Support Services 9.3.HL SUP.1-5 Career Readiness CRP2- Academic & Technical Skill Measuring Insulin Doses Identify insulins in current us read insulin labels to identify type read calibrations on Insulin syringe Curren: Chapter 11 Insulin Types and Actions Handout Laboratory: Using insulin syringes and needles CTE Standards for 8
Unit 4 Unit 5 100units/mL Measure single insulin dose measure combined insulin dosages Discuss injection sites and techniques Dosage Calculations Ratio and Proportion Define ratio, define proportion Solve dosage problems using ratio and proportion Assess answers obtained to determine if they are logical Dimensional Analysis/ Units Conversion Use Dimensional Analysis to calculate dosages Formula Method Use the Formula Method to calculate dosages Dosage Calculations from Body Weight and Body Surface Area Adult and Pediatric Dosages based on Body Weight Convert body weight from pounds to kilograms Convert body weight from kilograms to pounds Calculate dosages using mcg/mg per kg, or per lb. Determine if dosages ordered are within the normal range to draw up a single insulin dose and draw up a combination dose of NPH and Regular insulin using proper procedure. Worksheet/Quiz on content. Curren: Chapter 12 Practice sheets Assess answers to determine if the answer makes sense according to average dosage amounts and strengths. Curren: Chapter 13 Practice Sheets Assess answers to determine if the answer makes sense according to average dosage amounts and strengths. Curren: Chapter 14 Practice Sheets Assess answers to determine if the answer makes sense according to average dosage amounts and strengths. Curren: Chapter 15 Practice calculations Determine if dosages ordered are within the normal range Unit 4 Test Unit 5 Test Healthcare Science: Support Services 9.3.HL SUP.1-5 Career Readiness CRP2- Academic & Technical Skill Math Standards 7.EE.1, 7.EE.2 Expressions and Equations High School Functions: HSF.IF.B.4 HSF.BF.A.1 CRP8. Utilize critical thinking to make sense of problems and persevere in solving them. Math Standards Expressions and Equations 7.EE.1, 7.EE.2 High School Functions: HSF.IF.B.4 HSF.BF.A.1 CRP8. Utilize critical thinking to make sense of 9
Unit 6 Adult and Pediatric Dosages based on Body Surface Area describe how and why body surface area is used for dosage calculation Use the body surface area in m 2 to calculate dosages Assess the accuracy of dosages prescribed on the basis of BSA Intravenous Calculations Intro to IV Therapy Primary, Secondary, Peripheral and Central IV lines IV Drip chambers, roller and slide clamps, on-line and indwelling injection ports Heparin flush, heparin admixture, and dosage strengths Volumetric pumps/ electronic infusion device (EID), syringe pumps, and Patient Controlled Analgesics (PCA) Flow Rate Calculations IV Tubing set calibrations drops/minute (gtt/min) calculate flow rates using ratio and proportion Calculate flow rates using DA Calculate flow rates using Formula method Recalculate flow rates to correct offschedule infusions Curren: Chapter 16 Without the use of a calculator, use the m 2 given for the BSA to calculate dosages on the Practice sheet Gootblatt: Practice Problem Set Curren: Chapter 17 Laboratory: Demonstration of IV fluid administration using gravity lines, primary and secondary lines, and Volumetric Pumps. Worksheet/Quiz on content. Curren: Chapter 18 Worksheet calculations practice Gootblatt Problem Set StudyWare Chapter 18 Assess answers obtained to determine if they are logical Unit 6 Test problems and persevere in solving them Math Standards Expressions and Equations 7.EE.1, 7.EE.2 High School Functions: HSF.IF.B.4 HSF.BF.A.1 CRP8. Utilize critical thinking to make sense of problems and persevere in solving them Infusion and Completion Times Infusion Times Completion times using military time Curren: Chapter 19 Worksheet calculations practice Infusion time = How long the IV bag (or dose) 10
and standard time. Labeling the IV bag takes to empty. Completion Time = What time of day the IV dose is finished. Medication and Titration Calculations Flow rates to infuse ordered dosages Dosage and Flow rate based on kg body weight Dosages and Flow Rate ranges for titrated medications Curren: Chapter 20 Practice Sheets This is the most challenging unit, all of the previous math operations practices are used for the IV calculations. Knowing the order of operations is essential to solving the problems. Assess answers obtained to determine if they are logical. Unit 7 Heparin Infusion Heparin Dosages ml/min flow rates for EID gtt/min flow rate for microdrip and macrodrip IV tubing sets hourly dosage infusing from ml/hr rate. Pediatric Medication Calculations Pediatric Oral and Parenteral Medications Explain how suspensions are measured and administered Calculate pediatric dosages Precautions for IM and Subcutaneous injections for infants and children Calculate pediatric IM and subcutaneous dosages Pediatric IV Medications Preparing and administering IV medications for a solution bag and a calibrated burette Necessity of an IV flush Calculate flow rates for the administration of pediatric IV meds Curren: Chapter 21 Carefully inspect the labels provided in the textbook. Practice problem sets using the preferred method of calculating dosages. Assess answers obtained to determine if they are logical. Curren: Chapter 22 Carefully inspect the labels provided in the textbook. Practice problem sets using the preferred method of calculating dosages. Assess answers obtained to determine if they are logical. Worksheet/quiz on content and dosages. Curren: Chapter 23 Practice problem sets using the preferred method of calculating dosages. Assess answers obtained to determine if they are logical. Worksheet/quiz on content and dosages. Unit 7 Test Math Standards Expressions and Equations 7.EE.1, 7.EE.2 High School Functions: HSF.IF.B.4 HSF.BF.A.1 CRP8. Utilize critical thinking to make sense of problems and persevere in solving them 11
Marking Period 2 Project Use normal and daily ranges to calculate and assess dosages ordered. Project Assignment MAR and Patient medical records Identify and prepare medications ordered for each patient on virtual floor Use the 6 Rights of Medication Administration Experience the pressure of caring for numerous virtual patients during one shift and administering all of their medications correctly before the clock runs out. Virtual Clinical Excursion Software Complete all shifts and receive virtual preceptor s report for each shift. Practice makes perfect, do the shift over until its error free. For the Final Project Grade o Students must select all patients at the beginning of a shift and complete the shift caring for all patients in the same shift session o Screen shots of the virtual preceptor s reports for each patient on each shift to be sent to the course instructor. o Preceptor s report will show a completion times for each patient. These must match, proving the virtual patients were all cared for during the same session. Project Grade Timeframe: 1-2 weeks CTE Standards for Healthcare Science: Diagnostic Services 9.3.HL DIA.2 Health Infomatics 9.3.HL HI.2 9.3.HL HI.3 Support Services 9.3.HL SUP.1 Therapeutic Services 9.3.HL THR.2 9.3.HL THR.3 CRP1. Act as a responsible and contributing citizen and employee. CRP8. Utilize critical thinking CRP11. Use technology to enhance productivity 12