The ability to do medication calculations confidently and accurately is exceptionally important for nurses. To do this, Seneca's Nursing Programs have created a mastery approach to increase your confidence and your accuracy!

In each semester (for PND and BScN - NOT Bridge Cohort*), you must achieve 100% on clinical math tests BEFORE being given the opportunity to give medication. This must happen by week 10 of your clinical semester in order to still have 3 opportunities to demonstrate safe medication practices - which is necessary to demonstrate the medication competency to be successful in that semester.

If you have been unsuccessful in your math mastery you will be required to complete mandatory remediation prior to doing another quiz. Re-testing will happen weekly.

There is support in the Seneca College Learning Centre for Math as well as by utilizing the Medication Mathematics Website linked here in your handbook.

Medication math calculations are an essential skill in clinical practice. This essential clinical skill is outlined by the College of Nurses of Ontario in their Entry-to-Practice Requirements. Accommodations (i.e., extra time, exam aids ect.) are not provided for clinical skills. This is to support patient safety and your ability to demonstrate principles of safe medication practice. We, as a school, must be able to sign that you can demonstrate this essential clinical skill in order for you to be eligible to write the regulatory exam for your program after graduation. If this is a challenge for you, please seek support from student services to ensure you have the resources to support achieving this criteria.

*Bridge Cohort is already licensed practical nurses and must already have medication math proficiency. They will be given 3 attempts each semester to demonstrate this. They can give medications without having passed the quiz until they have failed the quiz - then they must not give medications again until they have demonstrated this proficiently.

The following guidelines are recommended to promote safety in medication administration:

• Supervisors and students must be fully aware of agency policies regarding medication administration. 

• Clinical supervisors will determine the number of students that they can safely supervise for medication administration. 

• They will also ensure an appropriate environment to administer medications safely. 

• This includes allowing sufficient time for the designated students to review and research the medications prior to administration.

• Students must successfully pass their medication math test to give medication.

Recommended Guidelines for Students Administering Medications:

• Students are directly supervised and supported by the clinical supervisor during all phases of medication administration. (Preparation to administration).

• Supervisor and student will review patient’s Medication Administration Record and prescriber’s orders prior to medication administration.

• The student must demonstrate knowledge of the patient’s medication(s), and the nursing considerations before, during and after medication administration including relevant vital signs and physical assessment.

• The student will evaluate required patient information, such as pertinent lab results, and any diagnostic tests that may affect medication administration.

• Supervisor and student discuss medications to be given/not given with the staff nurse. This includes the ongoing communication between the student and the staff nurse.

• Supervisor and student complete independent double checks on high alert medications with staff nurse and as per agency policies. (heparin/insulin/narcotics).

• The student will obtain consent from the client.

• The student will demonstrate infection control practices during medication administration.

• The student will assess the patient's response to the medications; report and document any abnormal observations.

• The student will document the medication administration and any health teaching completed

• The student WILL have followed all requirements for medication administration as outlined by the CNO Practice Standard: Medication.

Additional Information:

• Students are not to take responsibility for narcotic keys, PCA pumps, Femoral Blocks, PICC lines, central venous lines or TPN.

• Students are not to perform any procedure that requires advanced training that is not covered in the curriculum and/or requires training of nursing staff, such as IV Bolus and Chemotherapeutic agents etc.

• Students are not to sign for blood products; however, they can assist with the administration and monitoring of the patient during the transfusion.

• In the event of a medication error, immediate notification is required and agency policies and procedures must be followed. Required Hospital/College documentation must be completed. This includes informing the Program Coordinator.