• Exploring Numeracy for Nursing

    Student nurse administering an injectionWelcome to the Numeracy Moodle page for the School of Health and Human Sciences.

    The resources on this page have been designed to address the numeracy requirements for the BSc in Nursing (Adult & Mental Health).

    There is also a resources page containing a reading list and links to some websites that you might find useful in supporting your studies.

    Don't forget, you've also got access to, where you can practise some of these calculations at your own pace and in your own time.

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    Welcome to the Numeracy Moodle page! This site contains resources, tutorials, screencasts, exercises and other links that will help you to develop your skills and your confidence in your ability to use numeracy as a key nursing skill.

    You may already be very confident with your numeracy skills, and looking forward to applying them in the clinical context. 

    On the other hand, maths may be a subject that you've always struggled with and something that you're dreading having to face again at university. If this sounds more like you, don't panic! Here at the University of Essex, we have plenty of ways to support you throughout your studies.

    It may interest you to know that if you're worried about maths, you're definitely not alone! About 80% (four out of every five) of adults in the UK have some difficulties with practical numeracy skills; this includes plenty of people who already have a GCSE at grade C or above!

    The good news: As long as you're prepared to work at your skills and to engage with the resources and the opportunities provided to help you, we're certain that you'll be absolutely fine.

    This short video gives more information about adults who struggle with numeracy. It's a lot more common than you might think.

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    The table below shows a very wide range of numeracy skills, mapped to specific nursing tasks. You will cover many of these, both in university and on placement, during your first year. Your numeracy assesssment for HS541, at the end of Year 1, will focus only on Medication Dosages and Unit Conversions, as detailed in the NMC's Essential Skills Cluster 33.

    You will see that the same skills - arithmetic, decimal place value and fractions occur repeatedly.

    Taxonomy of nursing tasks and associated numeracy skills

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      Chinn S (2011) The Fear of Maths: How to Overcome It London: Souvenir Press Online Book - Albert Sloman Library

      Coben D & Atere Roberts E (2005) Calculations for Nursing and Healthcare (2nd edition) Basingstoke: Palgrave Macmillan

      Haylock W & Warburton P (2013) Mathematics Explained for Healthcare Practitioners London: Sage


      Gatford JD & Phillips N (2002) Nursing Calculations London: Churchill Livingstone Online Book - Albert Sloman Library

      Hutton M (2008) Essential Calculation Skills for Nurses, Midwives and Healthcare Practitioners Maidenhead: Open University Press Online Book - Albert Sloman Library

      Lapham R & Agar H (2009) Drug Calculations for Nurses (3rd EditionLondon: Hodder Arnold Online Book - Albert Sloman Library

      Scott WN & McGrath D (2009) Dosage Calculations Made Incredibly Easy London: Lippincott, Williams and Wilkins

      Starkings S & Krause L (2015) Passing Calculations Tests for Nursing Students (3rd edition) London: Learning Matters Companion Website - Student Resources

      Wright K (2011) Drug Calculations for Nurses – Context for Practice Basingstoke: Palgrave Companion Website


      Olsen JL, Giangrasso AP, Shrimpton DM, Dillon PM & Cunningham S (2010) Dosage Calculations for Nurses Harlow: Pearson

      Selected Online Resources - General Adult and Clinical Numeracy

      Baxter Healthcare - Good Practice for Drug Calculations

      BBC GCSE Bitesize Maths - Number

      BBC Skillswise Maths

      Citizen Maths

      Flinders University - Basic Drug Calculations

      Flinders University - Metric SI Units and Conversions

      Khan Academy

      National Numeracy Challenge

      Nursing Numeracy Info

      Queen's University Belfast - Numeracy Skills for Drug Calculations

      RMIT University - Online Learning Module for Drug Calculations

      RMIT University - Resources for Nursing Students

      SN@P - NHS Standard Numeracy Assessment Process

      University of the West of England Bristol - Online Numeracy Course for Health & Social Care

      Essential Calculation Skills For Nurses, Midwives And Healthcare Practitioners
      by Hutton, Meriel
      Price to Student £5.99 *
      * VAT included
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        There are many strategies for solving number problems. The method that you were taught at school may still work well for you. However, if maths just didn't 'click' at school and you still find mental and/or written arithmetic confusing, then this section is here to help. It contains:

        • quick guides to the essential strategies for basic arithmetic
        • short screencasts and supporting resources for brushing up your skills
        • topics presented in order of difficulty, starting with some quite basic revision materials, working through to more complex and challenging calculations. 

        Please do take the time to explore the resources on the Khan Academy and Maths Doctor websites. Each has a variety of online exercises and worksheets for practising your skills.

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        A sound understanding of fractions and decimals will help you to master the basics of drug calculations quickly and efficiently.

        The following resources will help you to refresh your knowledge of fractions, decimals and percentages, including how to perform calculations with them and how they relate to each other in practice. 

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        In this section, we will cover how to calculate with units of measure within the same system. You will learn about the relationship between units of measure in the metric system - kilograms, grams, milligrams and micrograms, and how to convert between them quickly and easily.

        This skill is very important for avoiding drug errors. An incorrectly placed decimal point could potentially lead to a 10, 100 or even 1000 times overdose or underdose - with potentially fatal implications for the patient.

        The Rules

        unit conversions infographic
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        In this section, we will explore how to use an easy-to-remember formula for solving medication dosage calculations.

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        MDC calculations infographicThese revision resources contain examples of the type of questions tht you can expect in the Numeracy and Medication Dosage Calculations exam for HS541. Accuracy is essential, and it's important to think about your exam technique and to be very aware of the areas that you find most challenging. Remember, these are practise questions only - you may need to go to the other sections to find tutorial resources to help you to develop your skills. Alternatively, get in touch with me if you would like some additional support, either 1:1 or in small groups.

        Click here to request a 1:1 tutorial.

        The questions will cover:

        • SI Unit Conversion
        • Tablets and Capsules
        • Liquid Medicines
        • Injections
        • Unit, Multiple Unit and Sub Unit Doses

        The resources are split into three sections:

        1. In-house resources, developed to help you prepare for University of Essex drug calculation exams.
        2. External e-learning resources
        3. Printable resources
        Good luck!
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        IV dripCalculating a flow rate in ml/hr requires us to learn a second formula: Volume = Rate x Time.

        This can be reduced to the mnemonic VRT (Very Rarely Troubled!)

        Nurses need to be able to calculate any one of the three elements of the formula from the other two:

        • Volume - for calculating how much fluid should be left in a bag after a given amount of time
        • Rate - for setting a flow rate im ml/hr
        • Time - for calculating how long an infusion will take

        You may already be happy with transposing the 3 elements of the VRT formula - in which case, stick with it! If not, then the 3 permutations are as follows:

        1.Volume = Time x Rate
        2.Rate = Volume ÷ Time
        3.Time = Volume ÷ Rate
        Some people find a more visual representation easier to remember. The presentation below introduces a useful triangle menmonic for remembering the formula. If you can remember that 'the bag goes up high', then you will easily be able to construct the rest of the triangle. Remember to cover up the element that you wish to calculate.
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        Drip rates are just as straightforward to calculate as ml/hr flow rates. There is a slightly different formula to remember, but as long as you are comfortable with cancelling and multiplying fractions, plus one of the written division methods, you should have no difficulty - even without a calculator! Use the supporting resources in the Calculation Strategies and Fractions topics, or feel free to request a tutorial or workshop if you need a refresher on these.

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        MDCs infographicThe revision resources below contain examples of the kind of questions you can expect in the Numeracy and Drug Calculations section of the HS563 exam.

        The questions will cover:

        • SI Unit Conversions
        • Tablets
        • Liquid Medicines
        • Injections
        • Unit, Multiple Unit and Sub Unit Doses
        • Complex Calculations
        • Adult Nursing only: Intravenous infusions - flow rates (mLs/hr) and drip rates (drop/min)

        The resources are split into three sections:

        1. In-house resources, developed to help you prepare for University of Essex drug calculation exams. Please note that these resources do not yet cover intravenous infusions or complex calculations
        2. External e-learning resources
        3. Printable resources
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        The resources in this section contain examples NHS drug calculations test questions. When preparing for your recruitment exams, be sure to check whether or not you will be allowed to use a calculator.

        Some NHS trusts will provide some of the standard formulae for you on the day, and will state that you do not need to have memorised them. However, there are many different versions of the formulae, and there is no guarantee that the one they provide will be the one that works well for you. If you can memorise these, it would be wise to do so! A handy printable poster containing the formulae taught at Essex is also included here.

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        Games can be a useful way to develop your maths skills. The following apps are recommended:


        Elevate (Literacy and Numeracy)

        Mr Thorne's Maths Universe - this is a paid app, designed for school student use, but it is one of the best I've seen for multiplication and division.

        MultiFlow - for practising multiplication. More 'grown up' than Mr Thorne, but higher pressure games - good for consolidating more advanced skills.

        DivisionFlow - as above, for division.

        FlowPlus - same series, for addition