Medication Variance Report: Authentic Assessment Exercise
RN, MSN, FNP, CNE
The University of South Dakota
Quality Improvement, Safety
Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN
This experience does not affect the learner’s exam or course grade, but it does emphasize the consequences of dosage calculations that are wrong. The initial consequence of completing a variance report signifies the importance of any dosage error, in any setting. While the original activity is based on short answer exam questions, the activity can also be used with multiple choice questions. During the 1:1 learner and faculty interaction, both qualitative and quantitative data can be used to assess the activity. Qualitative questions that students have responded to include:
- What would be the impact to a client if this error were made in the practice setting?
- What preparation will you do to prevent a similar error in the future?
- What is your responsibility in administering medications as a student nurse?
- What have you learned from this experience?
Quantitative data includes tracking of the number of repeat errors, the specific type of calculation error (conversion, decimal point, etc), and the communication process that would need to be followed in the practice setting (contact charge nurse, notify physician, inform client and client family, etc.).
Outcomes of this experience include: 1. Increased awareness of the actual outcome of dosage errors. 2. The importance of quality improvement tracking devices to prevent future dosage errors. 3. Learner accountability for the dosage calculations that they perform. 4. Collaboration with faculty to identify knowledge gaps in dosage calculation. 5. Learner awareness of communication pathways. 6. Verbalized statements of the need for greater caution when calculating even routine medication doses. 7. Increased accuracy on unit exams for dosage calculation questions.