Comparison of the accuracy of medication calculations in nursing between traditional methods and the mobile application
DOI:
https://doi.org/10.14528/snr.2026.60.1.3321Keywords:
education, digital technology, mathematical skills, safety deviationAbstract
Introduction: Calculating medication doses and flow rates represents a critical component of nursing practice, directly impacting treatment safety and patient health. Expert estimates indicate that nursing calculations are accurate in 60–90% of cases. Digital technology holds significant potential to minimise medication calculation errors. The aim of this study was to determine whether the NurseCal mobile app enhances the accuracy and speed of medication dosage calculations among nursing students compared to traditional calculation methods.
Methods: To evaluate the impact of the NurseCal mobile app, this study used a quantitative, quasiexperimental, non-equivalent control group post-test-only research design and was conducted among second and third-year nursing students (n = 198) in April 2022. The control group completed seven calculations manually, while the experimental group used the NurseCal app. Data were analysed using the Shapiro-Wilk test and the Mann-Whitney U test.
Results: Students using the NurseCal mobile app completed the calculations more quickly (U = 619, p = 0.001) and with statistically significantly greater accuracy (U = 7372, p < 0.001).
Discussion and conclusion: The study confirmed the usability of the NurseCal mobile app for calculating medication doses and flow rates among students, which could reduce errors. There is potential for the use of this mobile app in both educational and healthcare settings, but further research is needed to explore its use in clinical practice with other populations and larger samples.
Downloads
References
Abbas, A., & Faiz, A. (2013). Usefulness of digital and traditional libraries in higher education. International Journal of Services Technology and Management, 19(1/2/3), 149–161. https://doi.org/10.1504/IJSTM.2013.054203
Aiken, L. H., Sloane, D., Griffiths, P., Rafferty, A. M., Bruyneel, L., McHugh, M., Maier, C. B., Moreno-Casbas, T., Ball, J. E., Ausserhofer, D., & Sermeus, W. (2017). Nursing skill mix in European hospitals: Cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Quality & Safety, 26(7), 559–568. https://doi.org/10.1136/bmjqs-2016-005567 PMID:28626086; PMCID:PMC5477662
Al-Nbabteh, K. E., Al-Qaaneh, A. M., Al-Shatnawi, F. E., Abdullah, F. O., Hudhud, H. N., & Al-Kharabsheh, M. S. (2024). Medication calculations competency among nurses: A cross-sectional study. Malaysian Journal of Nursing, 16(02), 136–149. https://doi.org/10.31674/mjn.2024.v16i02.014
Bagnasco, A., Galaverna, L., Aleo, G., Grugnetti, A. M., Rosa, F., & Sasso, L. (2016). Mathematical calculation skills required for drug administration in undergraduate nursing students to ensure patient safety: A descriptive study. Nurse Education in Practice, 16(1), 33–39. https://doi.org/10.1016/j.nepr.2015.06.006 PMID:26347449
Cho, S., Mark, B. A., Knafl, G., Chang, H. E., & Yoon, H. (2017). Relationships between nurse staffing and patients' experiences, and the mediating effects of missed nursing care. Journal of Nursing Scholarship, 49(3), 347–355. https://doi.org/10.1111/jnu.12292 PMID:28388827
European Commission. (2015). Patient safety and quality of care in the EU. https://health.ec.europa.eu/system/files/2019-11/2015_patient_safety_quality_care_en_0.pdf
Govasli, L., & Solvoll, B. (2020). Nurses' experiences of busyness in their daily work. Nursing Inquiry, 27(3), e12350. https://doi.org/10.1111/nin.12350 PMID:32133740
Grugnetti, A. M., Bagnasco, A., Rosa, F., & Sasso, L. (2014). Effectiveness of a clinical skills workshop for drug-dosage calculation in a nursing program. Nurse Education Today, 34(4), 619–624. https://doi.org/10.1016/j.nedt.2013.05.021 PMID:23810339
Güneş Özünal, Z., Boran, T., & Saglam, E. (2020). Investigation of drug dose calculation skills and self-ratings among nursing students. Medical Journal of Bakirkoy, 16(1), 71–75. https://doi.org/10.5222/BMJ.2020.68077
Güneş, U. Y., Baran, L., & Yilmaz, D. (Kara). (2016). Mathematical and drug calculation skills of nursing students in Turkey. International Journal of Caring Sciences, 9(1), 220–227.
Helo, S., & Moulton, C.-A. E. (2017). Complications: Acknowledging, managing, and coping with human error. Translational Andrology and Urology, 6(4), 773–782. https://doi.org/10.21037/tau.2017.06.28 PMID:28904910; PMCID:PMC5583051
Karabağ Aydin, A., & Dinç, L. (2017). Effects of web-based instruction on nursing students' arithmetical and drug dosage calculation skills. CIN: Computers, Informatics, Nursing, 35(5), 262–269. https://doi.org/10.1097/CIN.0000000000000317 PMID:28045702
Kim, E. J., & Seomun, G. (2023). Exploring the knowledge structure of patient safety in nursing using a keyword network analysis. CIN: Computers, Informatics, Nursing, 41(2), 67–76. https://doi.org/10.1097/CIN.0000000000000882 PMID:35293361; PMCID:PMC9907707
Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije. (2014). Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.
Koehn, A. R., Ebright, P. R., & Draucker, C. B. (2016). Nurses' experiences with errors in nursing. Nursing Outlook, 64(6), 566–574. https://doi.org/10.1016/j.outlook.2016.05.012 PMID:27380739
Krick, T., Huter, K., Seibert, K., Domhoff, D., & Wolf-Ostermann, K. (2020). Measuring the effectiveness of digital nursing technologies: Development of a comprehensive digital nursing technology outcome framework based on a scoping review. BMC Health Services Research, 20(1), 243. https://doi.org/10.1186/s12913-020-05106-8 PMID:32209099; PMCID:PMC7092516
Krishnan, P. (2019). A review of the non-equivalent control group post-test-only design. Nurse Researcher, 26(2), 37–40. https://doi.org/10.7748/nr.2018.e1582 PMID:30226337
Loureiro, F., Sousa, L., & Antunes, V. (2021). Use of digital educational technologies among nursing students and teachers: An exploratory study. Journal of Personalized Medicine, 11(10), 1010. https://doi.org/10.3390/jpm11101010 PMID:34683151; PMCID:PMC8541222
Luokkamäki, S., Härkänen, M., Saano, S., & Vehviläinen-Julkunen, K. (2021). Registered nurses' medication administration skills: A systematic review. Scandinavian Journal of Caring Sciences, 35(1), 37–54. https://doi.org/10.1111/scs.12835 PMID:32168398
Männistö, M., Mikkonen, K., Kuivila, H., Virtanen, M., Kyngäs, H., & Kääriäinen, M. (2020). Digital collaborative learning in nursing education: A systematic review. Scandinavian Journal of Caring Sciences, 34(2), 280–292. https://doi.org/10.1111/scs.12743 PMID:31487063
Minty-Walker, C., Wilson, N. J., Rylands, L., Pettigrew, J., & Hunt, L. (2024). Assessing numeracy and medication calculations within undergraduate nursing education: A qualitative study. Nursing Open, 11(7), e2226. https://doi.org/10.1002/nop2.2226 PMID:38946052; PMCID:PMC11214913
Nordhus, G. E. M., NaNongkhai, P., & Hofseth Almås, S. (2022). Self-efficacy beliefs among baccalaureate nursing students: A cross-sectional, comparative study. International Journal of Nursing Education Scholarship, 19(1), 20210157. https://doi.org/10.1515/ijnes-2021-0157 PMID:35436394
O'Connor, S., & Andrews, T. (2018). Smartphones and mobile applications (apps) in clinical nursing education: A student perspective. Nurse Education Today, 69, 172–178. https://doi.org/10.1016/j.nedt.2018.07.013 PMID:30096510
Owegi, R., Burdick, K., Cannon, E., McQuiston, L., & Arvin, S. (2021). Medication math dosage assessment anxiety in undergraduate nursing students: A systematic review. Journal of Professional Nursing, 37(4), 735–740. https://doi.org/10.1016/j.profnurs.2021.05.003 PMID:34187672
Oyebode, F. (2013). Clinical errors and medical negligence. Medical Principles and Practice, 22(4), 323–333. https://doi.org/10.1159/000346296
PMID:23343656; PMCID:PMC5586760
Ozan, Y. D., & Duman, M. (2020). Nurses' perceptions regarding the use of technological devices in nursing care practices. International Journal of Caring Sciences, 13(2), 901–908.
Pennbrant, S., Nilsson, M. S., Öhlén, J., & Rudman, A. (2013). Mastering the professional role as a newly graduated registered nurse. Nurse Education Today, 33(7), 739–745. https://doi.org/10.1016/j.nedt.2012.11.021 PMID:23260623
Petrović, M., Prosen, M., Ličen, S., & Karnjuš, I. (2023). Odnos zaposlenih v zdravstveni negi do predpisovanja zdravil: raziskava z rabo mešanih metod. Obzornik zdravstvene nege, 57(2), 89–99. https://doi.org/10.14528/snr.2023.57.2.3163
Pinto, M., & Leite, C. (2020). Digital technologies in support of students learning in higher education: Literature review. Digital Education Review, 37, 343–360. https://doi.org/10.1344/der.2020.37.343-360
Pravilnik o registru in licencah izvajalcev v dejavnosti zdravstvene ali babiške nege. (2020). Uradni list Republike Slovenije, št. 152/20 in 195/21. https://pisrs.si/pregledPredpisa?id=PRAV14015
Shelton, C. (2016). Students who developed logical reasoning skills reported improved confidence in drug dose calculation: Feedback from remedial maths classes. Nurse Education Today, 41, 6–11. https://doi.org/10.1016/j.nedt.2016.03.007 PMID:27138475
Wennberg-Capellades, L., Fuster-Linares, P., Rodríguez-Higueras, E., Fernández-Puebla, A. G., & Llaurado-Serra, M. (2022). Where do nursing students make mistakes when calculating drug doses: A retrospective study. BMC Nursing, 21(1), 309. https://doi.org/10.1186/s12912-022-01085-9 PMID:36357884; PMCID:PMC9648043
Westman, J., Johnson, K. D., Smith, C. R., & Kelcey, B. (2024). The contributors to dosage calculation ability and its applicability to nursing education: An integrative review. Journal of Professional Nursing, 50, 8–15. https://doi.org/10.1016/j.profnurs.2023.10.006 PMID:38369376
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 PMID:24141714
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Slovenian Nursing Review

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
As the author undersigned hereby, I transfer, assign, or otherwise convey the following authorship rights as comprised in the Copyright and Related Rights Act (CRRA) to the Slovenian Nursing Review, Ob železnici 30A, 1000 Ljubljana: the right of reproduction - the exclusive right to fix the work in a material medium or in another copy directly or indirectly, temporarily or permanently, by any means and in any digital form, in whole or in part (CRRA, Article 23); the right of distribution (CRRA, Article 24); the right of making a work available and accessible through the internet (CRRA, Article 32a); the right of transformation, especially the exclusive right to translate a pre-existing work (CRRA, Article 33). The transfer of author rights applies to the article in its entirety, including pictorial and/or graphic works and possible supplements. The transfer of rights is exclusive and unlimited in duration or territory.













