Looking for Med Math guidelines on rounding off

[BeenThereDoneThat74, MSN, RN]

Hello all,

I know many nursing programs are struggling with the issue of med math competencies. I am one of the key faculty players in my program, attempting to streamline the math calculation eduation. One of the big issues we are facing is inconsistancies (one prof teaches it one way, then they move on to another professor that contradicts them, then in practice it is different). Amongst faculty, we can't even agree. i go by what I know, and as a Peds nurse, I know that a) we round off as little as possible, and b) we need to know how to round correctly (like, you don't round 1.7mls up to 2mls).

Anyway, I am searching for guidelines on rounding; up, down, when to round, etc. I am not looking to hear what each of you have been taught (because I know it will differ), or what your hosptial says (again, they will all vary), but if anyone knows of a legitimate, reputable source with a guideline. As you know, students want specifics (and will hold us to them). I also know that students do not have the critical thinking ability to figure out when it is ok to round (like giving an extra 0.1ml of multivitamin to a baby is ok, but not if they are getting Digoxin )

I searched the NCSBN website, and all i got was "only the final answer should be rounded off" (or something like that). yeah, thanks . If it's peds-specific, that's fine too. Thanks!!

[iteachob, MSN, RN]

I can tell you what we do:

On dosage exams, our students are taught to round to the nearest tenth for most calculations. They are counted wrong if it is not nearest tenth. The only time we differ is for IV calculations by drop (not mL/hr....that's still nearest tenth), and nearest hundredth for calculations with answers that could be measured in a TB syringe.

[ParkerBC,MSN,RN, PhD, RN]

I can tell you what we do:

On dosage exams, our students are taught to round to the nearest tenth for most calculations. They are counted wrong if it is not nearest tenth. The only time we differ is for IV calculations by drop (not mL/hr....that's still nearest tenth), and nearest hundredth for calculations with answers that could be measured in a TB syringe.

I teach my students the same thing. If you have an answer that is less than 1ml, round to the nearest hundredths. If an answer produces more than 1 ml of medication to be administered, it is rounded to the nearest tenth. It only makes sense. Here is why. If using a TB syringe, the marks on the syringe go out to the hundredths place. The same is true for 3ml, 5ml, and larger syringes. The marks only go to the tenths place. In other words, you can draw up 1.7ml in a 3ml syringe, but you cannot draw up 1.72 because there isn't a hundredths place to go to. As far as drop factor, I round up or down to the nearest whole number. If the dosage answer is 21.3 drops, I have the students to round down to 21 drops because one cannot count 21.3 drops.