An evaluation of nurse preparation and practice in administering medicine to children
Administering medicine to children is a part of everyday nursing practice that is complex and multifaceted. However, medicine errors are prevalent in all areas of nursing. One means for strengthening a system of safe medicine administration might lie in developing student nurse preparation for registered practice. This thesis evaluated nurse preparation for administering medicine to children using a multi-stage descriptive design. Preparation through one Diploma in Nursing was evaluated over a period of two years. 20 registered nurses were initially interviewed, and 201 activities characterising practice in administering medicine to children were identified. Activities were formulated into a questionnaire and were rated by 66 students and newly registered nurses according to their perceived involvement. In a second data collection, student perceptions of their involvement were compared with those of their practice-based assessors. Respondents viewed themselves as highly involved in activities requiring simple practice tasks and communication with families and children, while they were less involved in decision-making, teaching of peers and a small number of more advanced ‘adventuring’ activities. At qualification, although nurses had completed all theoretical and practical outcomes they still perceived themselves as not fully involved in 25% of practices relating to medicine administration. This supports existing work in relation to the transition of students to registered practice, but is unique in providing specific evidence related to medicine administration. Perceptions of the level of involvement varied between the practice based assessors and their students, but no significant difference was established between the responses of students who were assessed by assessors and those who were not. Student self-perception may not therefore be consistent with observed practice assessment, and should be explicated as an important part of progress evaluation. To determine whether course material corresponded to student learning, teaching materials were analysed and compared with student involvement in the role. In medicine administration process and in legal implications there was an increase in student perception of involvement that corresponded with the time they received teaching. They were less immediately involved in activities requiring mathematical skill and pharmacological knowledge, suggesting learning may need greater facilitation in these areas. In conclusion, nurse preparation should seek to address the breadth of role activities within the domains found in this work. Consideration of factors influencing effective role function and transition, as well as competence, should be included in a strategy for enhancing future practice.