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“Probably, no human experience
cuts deeply into the centre
of one’s heart as the loss of a
child” -A. Joy Ingalls (1991).
Drug administration is a vital
part in the care of children and
all the more in critically ill children.
The nurse is wholly responsible
for the drugs administered
by her during the emergency
situations of child care.
The students of final year Basic
B.Sc. Nursing may soon find
themselves responsible for the
care of children. Administration
of emergency drugs and the calculation
of drug doses in paediatric
settings is different from
that of the other settings and
even a minor medication error
can pose a life threatening consequence
in the care of critically
ill children. Hence, it becomes a
mandate for the graduate nurses
to be equipped with adequate
knowledge on paediatric emergency
drugs and proper calculation
of drug doses.
“Medicines are nothing in
themselves if not properly used,
but the very hands of God if
employed with reason and prudence”.
- Herophilus
A comparative study to assess
the knowledge of final year Basic
B.Sc. nursing students on
Paediatric Emergency Drugs
and Calculation of Drug Doses
in selected Colleges of Nursing
in Bangalore was therefore
undertaken for preparing an information
booklet.
The author is Principal In-charge, Brite
College of Nursing, Bangalore.
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Objectives
The study sought :
1. To assess the knowledge of
final year Basic B.Sc. nursing
students on paediatric
emergency drugs and the
calculation of drug doses.
2. To compare the knowledge
scores of final year Basic
B.Sc. nursing students belonging
to selected colleges
of nursing with and without
own hospital.
3. To find out the association
of knowledge scores with
selected variables.
4. To prepare an information
booklet on paediatric emergency
drugs and the calculation
of drug doses.
Research Hypothesis
The knowledge score of the final
year Basic B.Sc. Nursing
students of Colleges of Nursing
with own hospital is significantly
different from those studying
in the Colleges of Nursing without
own hospital at 0.05 level.
Conceptual Framework
Conceptual framework adopted
for this study is based on General
Systems theory with Input,
Throughput/ process, Output,
Feedback and environment as
essential components, which
was first introduced by Von
Bertalanffy (1968).
Input consisted of demographic
characteristics of the respondents
and the available resources.
Process refers to the
utilisation of self-administered
questionnaire to assess the knowledge
of final year B.Sc. Nursing
students on paediatric emergency
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emergency
drugs and the calculation
of drug doses. The assessment of
knowledge is essential because the
cognitive processes have their motivational
and dynamic forces
which direct the system’s
behaviour. The system returns the
output to the environment in the
form of change of behavior in the
desired direction after the processing
of input. If there is adequate
knowledge, it leads to high quality
care of critically ill children. An
inadequate knowledge leads to
poor and hazardous medication administration
in the nursing care
of critically ill children.
The feedback is the process
whereby the output of the system
is redirected as part of the
input of the same system. The
input provided by the information
booklet can contribute towards
enriching knowledge of
paediatric emergency drugs and
the calculation of drug doses for
student nurses learning paediatric
nursing, thus leading to
improved care of critically ill
children. Individual’s environment
is the fixed constraint that
influences the knowledge of final
year B.Sc. Nursing students
on paediatric emergency drugs
and the calculation of drug doses
Methodology
A comparative research approach
was employed in this
study. The study was undertaken
in selected colleges in
Bangalore. The total sample size
for the study was 100 final year
Basic B.Sc. Nursing students
with 50 students from colleges
of nursing with own hospital and
50 students from colleges of
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nursing without own hospitals.
The colleges of Nursing were
selected by purposive sampling
and the respondents were selected
using simple random sampling
by draw method. The tool
used for data collection was structured
questionnaire which was
developed by the researcher.
The pilot study was conducted
to check the feasibility
of this study and establishing the
reliability of the tool. The collected
data was organised and
analysed according to the objectives
of the study using descriptive
and inferential statistics.
Findings of the Study
I. Findings related to assessment
of knowledge on Paediatric
Emergency Drugs and
calculation of Drug Doses
 The mean knowledge
score was 23.13 for a total of
50 statements and a maximum
score of 50. The mean
knowledge of the respondents
was 46.26 percent.
In relation the knowledge of
the various aspects of Paediatric
emergency drugs and
the calculation of drug doses,
the mean knowledge of the
respondents was above 50
percent in the categories
such as action of drugs, side
effects and nurse’s responsibility
whereas the mean
knowledge of the respondents
in the other categories
was below 50 percent. It was
also found that the mean
knowledge was the highest
(61.2%) in the category of side
effects of Paediatric emergency
drugs and the lowest
(33.17%) in the category of indications
of Paediatric emergency
drugs.
II. Findings related to the comparison
between the knowledge
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scores of final year Basic
B.Sc. Nursing students studying
in Colleges of Nursing with
and without own hospital
The knowledge scores of final
year Basic B.Sc. Nursing
students of Colleges of Nursing
with own hospitals was
significantly different from
those studying in the Colleges
of Nursing without own hospital
at 0.05 level. Thus the hypothesis
was accepted. It is
also inferred that the knowledge
on Paediatric emergency
drugs and the Calculation
of Drug Doses among the
students studying in Colleges
of Nursing with own hospital
is more than those studying
in Colleges of Nursing without
own hospital.
There is a significant relationship
between knowledge
of the respondents and
the presence of own hospital
in the realms of action
of drugs, indications and
precautions whereas there
is no significance in the
other areas under study.
III. Findings related to Association
between knowledge scores
and the demographic variables.
The study revealed a nonsignificant
association between
the age and the
knowledge level of final
year Basic B.Sc. Nursing
students.
As for choice of subjects in
PUC, the chi-square test established
a non-significant
relationship (0.16) between
the choice of subject in
PUC and the knowledge
level of final year Basic
B.Sc. Nursing students.
The association between
the presence of other medical
courses in the institution
and the knowledge
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level of final year Basic
B.Sc. Nursing students is
non-significant.
The association between
the availability of post graduate
teacher in Paediatric
Nursing and the knowledge
level of final year Basic B.Sc.
Nursing students was established
to be significant.
There was a significant relationship
between the theory
hours conducted on Paediatric
emergency drugs and the
calculation of drug doses and
the knowledge level of final
year Basic B.Sc. Nursing students.
Chi-Square test established
an association between
the clinical hours attended
by the respondents
and the knowledge level of final
year Basic B.Sc. Nursing
students.
Conclusion
In the realm of knowledge on
Paediatric emergency drugs
and the Calculation of drug
doses, the mean knowledge of
the respondents (less than 50%)
indicates that the final year Basic
B.Sc. Nursing students have
inadequate knowledge on Pediatric
emergency drugs and the
calculation of drug doses.
Thus in this study it is found
that there is a significant relationship
between the availability of a
post graduate teacher in Paediatric
Nursing (10.71), duration of
theory classes on the topic of study
(17.45) and the number of clinical
hours in Paediatric Nursing (16.0)
and the knowledge score of the
respondents on Paediatric emergency
drugs and the calculation
of drug doses at 0.05 level. There
is no significant relationship between
the ages of the respondents,
choice of subjects in PUC
and the presence of other medical
courses in the institution and
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their knowledge score of Paediatric
emergency drugs and the
calculation of drug doses.
Recommendations
The study could be replicated
on a larger sample thereby the
findings could be generalised
better. A comparative study can
be conducted between the students
of different universities, a
study can also be done to assess
the skills of nursing students in
administration of Pediatric
emergency drugs and the calculation
of drug doses. Problems
encountered by the students
in the realm of acquiring
adequate knowledge on Paediatric
emergency drugs and the
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calculation of drug doses and
assessment of the effectiveness
of the information booklet thus
prepared as the outcome of this
study are also other areas in
which studies can be undertaken.
References
1. Behrman Richard E, Robert M.
Kliegman, Ann M Arvin (1996).
Nelson Text Book of Pediatrics,
15th edn, Bangalore: WB
Saunders Co, pp 259-60
2. Leape LL, Brennan TA, Laird NM
(1991). The Nature of adverse
events in hospitalized patients:
Results from the Harvard Medical
Practice Study II. New England
Journal of Medicine, 324: 377-84
3. Thomas EJ, Studdert DM, Burstin
HR (2000). Incidence and types
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of adverse events and negligent
care in Utah and Colorado. Journal
of Medical Care, 38: 261-71
4. Brennan TA, Leape LL, Laird N
(1991). Incidence of adverse
events and negligence in hospitalized
patients: results from the
Harvard medical Practice Study I.
New England Journal of Medicine,
324: 370-76
5. Potts MJ, Phelan KW (1996). Deficiencies
in calculation and applied
mathematics skills in pediatrics
among primary care interns. Archives
of Pediatrics and Adolescent
Medicine. 150: 748-52
6. Rowe C, Koren T, Koren G (1998).
Errors by pediatric residents in calculating
drug doses. Archives of
Diseases in Children, 79: 56-58
7. Kozer E, Scolnik D, Keays T
(2002). Large errors in the dosing
of medications for children. New
England Journal of Medicine. 346:
1175-76
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