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Pharmacology knowledge and drug calculation skills among nurses and upper-semester nursing students in special care units in Iran: a cross-sectional study
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DOI：10.1186/s12912-026-05230-6.png)
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Abstract
En 中文
Medication safety in special care units requires nurses to integrate pharmacology knowledge with accurate drug calculation. Evidence on these competencies among nurses and upper-semester nursing students in Iranian special care units remains limited. This study assessed pharmacology knowledge and drug calculation skills among nurses and upper-semester nursing students working or undertaking clinical placement in special care units affiliated with Hamadan University of Medical Sciences, Iran, and examined their associations with selected demographic, educational and occupational characteristics. This observational cross-sectional study was conducted from May to August 2021 among nurses and upper-semester nursing students in intensive care, coronary care, and dialysis units. A total of 272 completed questionnaires were analysed using a 50-item instrument assessing pharmacology knowledge across four domains and drug calculation skills. Item responses were recoded as correct (1) or incorrect, incomplete, or unanswered (0), and outcomes were reported as the number and percentage of correctly answered items. Descriptive statistics, non-parametric tests, Spearman’s rank correlation, false discovery rate correction, and robust multivariable linear regression were used. The mean overall pharmacology knowledge score was 25.95 ± 6.85 correct responses out of 40, corresponding to 64.9% correct responses. The mean drug calculation skills score was 5.40 ± 2.37 correct responses out of 10, corresponding to 54.0% correct responses. Drug calculation skills were positively correlated with overall pharmacology knowledge (Spearman’s rho = 0.428, 95% confidence interval: 0.326–0.520, p < 0.001). In adjusted models, upper-semester nursing students had fewer correct responses than permanent nurses in nursing care of medications (β = -1.08, 95% confidence interval: -2.00 to -0.16, p = 0.022) and adverse drug effects (β = -1.41, 95% confidence interval: -2.57 to -0.25, p = 0.017). No independent predictor was significantly associated with drug calculation skills after adjustment. Given the limited internal consistency of the adverse drug effects domain (KR-20 = 0.66), this adjusted association should be interpreted cautiously. Participants correctly answered approximately two-thirds of the pharmacology knowledge items and slightly more than half of the drug calculation items, indicating important opportunities for improvement. Pharmacology knowledge and drug calculation skills were positively related but should be considered distinct dimensions of medication-related competence. Clinically integrated, competency-based medication-safety education may strengthen pharmacological reasoning, drug calculation and medication-related nursing care in special care units.
Keywords:
Pharmacology knowledge
Drug calculation skills
Medication safety
Nurses
Upper-semester nursing students
Intensive care units
Cross-sectional study
Iran
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