Sounds simple enough, but it's not in the cards. We do take a
calculations quiz as part of our initial licensure exam, but there are
no mandatory continuing education requirements for an annual or even
period repeat of a pharmaceutical calculations exam. Some states require
pharmacists to take a continuing education program in pharmacy law as
part of their annual continuing education requirements for relicensure,
but I have never seen a mandate for a closed-book periodic
re-examination of calculations skills.
What had happened in the instance that I once mentioned here was that
the technician was mixing a chemotherapy product, which is done so
carefully that even a different unit of measurement causes a tiny bit of
confusion. She wanted to see 600 mg, not 0.6 g, on the label, and I had
labeled it just the way the doctor ordered it: 0.6 g. We customarily
label the product with the same name and the same units ordered by the
physician. I was a bit surprised that she could not accept 0.6 g as a
unit to work with.
kilopascal wrote:
>
> 2001-01-06
>
> Maybe the only way to solve this problem is to revoke the licenses of
> pharmacists or pharmacy techs that do not show a working knowledge in SI.
> Those who are in training must show both written and oral knowledge of the
> workings of SI in order to get a license and those already licensed must be
> tested yearly to show they can function in proper units, symbols and
> inter-conversions. Those that can't are OUT!
>
> This lack of knowledge may be a source of pride to those opposed to metric,
> but it is a danger to those who could die from the wrong dosage. Why
> doesn't anyone see the seriousness of this? Why isn't someone at the top
> seeing a crisis situation here? It seems we as a nation are priding
> ourselves in our freedom to be stupid, and we get angry when someone tries
> to educate us and make us smarter.
>
> And to think if medicines were in the old system, the situation would be
> worse. Maybe there isn't enough lawsuits to force the issue.
>
> Glückliches Neues Jahr!
> Happy New Year!
>
> John
>
> Keiner ist hoffnungsloser versklavt als derjenige, der irrtümlich glaubt
> frei zu sein.
>
> There are none more hopelessly enslaved then those who falsely believe they
> are free!
>
> Johann Wolfgang von Goethe (1749-1832)
>
> -----Original Message-----
> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On
> Behalf Of Paul Trusten
> Sent: Saturday, 2001-01-06 15:22
> To: U.S. Metric Association
> Subject: [USMA:10296] leading decimal
>
> I can state from experience that a leading decimal point can be harmful
> of even fatal in healthcare. But, there is a general decimal illiteracy
> in US society, one that affects doctors and nurses. In fact, as I
> mentioned on this list in the recent past, a co-worker of mine, in
> pharmacy, could not easily convert grams to milligrams and vice versa.
> The decimal illiteracy usually shows up in the dosing of levothyroxine,
> a thyroid hormone supplement, which is often ordered in both milligram
> and microgram doses. Often, the dose 0.025 mg gets mis-transcribed as
> 0.25 mg, or the drug is ordered as 250 milligrams instead of 250
> micrograms. Despite being the innovators in decimalizing currency, we
> Americans have a clear lack of facility in thinking decimally.
>
> But, I think I was lucky in attending the Boston Public Schools when I
> did (1956-64). We received an extensive arithmetical education, both in
> decimal numeration and in the use of expressed fractions (i.e., the
> WOMBAT system of numeration). I don't know if schools are as tough today
> as they were then, but my elementary-school contemporaries were made to
> run the mathematical gauntlet of the times.
>
> Another poor prescription writing practice is the use of a trailing zero
> when it is not a significant digit. If the decimal point is not clearly
> legible, and there is a ten-fold strength of the drug available, 2.0 mg
> can become 20 mg. There is NO reason to write "2.0 mg"!!! "2 mg" is all
> that is required.
>
> A few (VERY few) prescribers write ALL of their prescriptions in grams,
> i.e., if there is a 1 mg dose, the order is written as 0|001, and 25 mcg
> is written as 0|000|025. This would be a good safeguard if everybody did
> it as a standard notation, but few do it, and it probably raises more
> questions than it answers when it appears.
>
> The best solution to this communication problem is mathematical facility
> in using decimals and in using SI, so the writer writes either 0.025 mg
> OR 25 mcg (sorry, I don't have a "mu" handy) and the reader can
> understand either notation.
>
> I must also confess that use of the SI "mu" prefix for "micro" can cause
> confusion in medication orders, since a careless writer will make the
> "mu" look like "m", so we have to read between the lines and/or call the
> prescriber to verify (time for electronic order entry in all medication
> orders!).
>
> --
> Paul Trusten, R.Ph.
> 3609 Caldera Boulevard, Apt. 122
> Midland TX 79707-2872 USA
> [EMAIL PROTECTED]
--
Paul Trusten, R.Ph.
3609 Caldera Boulevard, Apt. 122
Midland TX 79707-2872 USA
[EMAIL PROTECTED]
