Background:
Maths qualifications are a pre-requisite for entry into nursing education, however due to nursing attracting a more mature student population it could be many years since maths was last studied in the classroom and typically comes with a lack of self-confidence or anxiety which affects performance.
Last academic year 34.5% of students on a pre-registration undergraduate degree programme within the organisation failed to achieve the required pass mark for a drug calculation-based assessment. Whilst research informs that additional support and teaching are needed to improve student outcomes and attrition rates, experience informs that even when additional support is offered to students, this is generally poorly accessed and those with the greatest need are usually amongst those who do not access it.

Methodology:
Face to face and online support sessions were already available for students to access. These sessions focused on the different mathematical processes and skills required to complete drug calculations and included practice related scenarios as practice opportunities with real time feedback for reflection and improvement during the session.
To supplement these sessions, a pocket guide to drug calculations was created and distributed to all learners undertaking a medicines management module to try to improve student outcomes. The pocket guide contains information about when each type of calculation is used, the formula used to undertake the calculation and a worked example of the formula. The guide was developed in an attractive style, designed to be easily read by all, including those with dyslexia by appropriate use of coloured backgrounds for different sections for easy differentiation between calculations.
The aim of the pocket guide was to provide a resource to support learning which would improve motivation to learn and build self-efficacy leading to more confident and competent practice of safe drug calculations.

Findings:
Of the 34.5% of students who did not meet the required pass mark, only 23.6% of these accessed the support sessions. The support sessions were effective in improving student achievement and outcomes, however they were not enough on their own.
Provisional evaluation results of the pocket guides show that they were used in a variety of settings to support improving drug calculation skills including during university classroom sessions to aid understanding of the curriculum, during self-directed study and revision for exams, and also used in clinical practice to support patient safety and improve confidence in safe medication administration.
Most respondents thought this resource would remove the need for additional support, with minimal suggesting that more support would be needed and most respondents said they would either buy or consider buying the resource if they were able to with minimal suggesting they would not buy it.
Student outcomes improved after additional support sessions and circulation of the pocket guide with first time pass rates of drug calculation exams improving from 82% to 88%.

Future Research:
The impact of the pocket guides will continue to be measured to determine the effectiveness these have on improving student success, including measuring the improvement in first time pass rates in bigger sample sizes and considering changes to course completion rates as well as identifying changes in confidence levels and self-efficacy of learners.

Keywords: Nursing Education, Pocket Guide, Motivation, Self-Efficacy, Drug Calculations.