Æ

Accreditation 2023 - Communication

Dangerous Abbreviations - Do Not Use by Erin VanAllen

qtip logo


Find the Q-Tip & Quiz below! There is a Q-Tip hidden in this article. Find it by reading the article and clicking on the link. Once you find it, the Q-Tip will automatically download so you can save it to your collection. Everyone who collects all of the Q-Tips will have the chance to win great prizes.


Click Here to complete the self-reflection quiz for a chance to win the weekly gift card!

 

Dangerous abbreviations are abbreviations (shortened words, symbols and dose designations) that have been identified by the Institute for Safe Medication Practices (ISMP) Canada as easily misinterpreted or involved in medication incidents leading to harm and should be avoided in medication-related documentation. Up to 4.7% of all medication errors are attributed to the use of medical abbreviations [2004-2006 data] (Tariq & Sharma, 2022).


All clinicians need to be familiar with these abbreviations to ensure that they are not used in any form of written or electronic documentation including medication orders, general documentation (clinic notes, letters, etc.) for medication related communications, pre-printed forms, and pharmacy generated labels and forms. Due to the potential for harm with use of these abbreviations, the “Do Not Use” list of abbreviations is a Required Organizational Practice of Accreditation Canada.

 

Although many medical orders are written by physicians and residents, other healthcare providers have equal responsibility not to write or use these abbreviations. This includes order entry into computer systems. For example, a nurse writing a telephone physician order, or a nurse or unit clerk transcribing or processing orders. Click here for the ‘Quick Tip’.

 

Example scenarios:

 

 

  • Inappropriate use of U and/or u with a line above it: 

 

           The "u", for insulin "units" was misinterpreted                              written example of wrong usage

            as "60" and the patient inappropriately received

            60 units of regular (short-acting) insulin instead

            of 6 units as intended. (ISMP Canada, 2022).
            Proper format: Write the word “units”

 

 

  • Inappropriate use of QD: 

  

            The “QD” (every day) was misinterpreted at “QID”                           written example of wrong usage

            (four times a day). This error was caught prior to

            reaching the patient. (ISMP US, 2022)

            Proper format: Write the word “daily”

 

To help reduce the number of errors due to incorrect use of abbreviations, PRH uses the following strategies: 


  • PRH has an organizational policy ‘Abbreviations- NOT Acceptable' in the policy procedure manual, which applies to all medication-related documentation (e.g. physician orders, Medication Administration Records (MARs) etc.).
  • All pre-printed order sets (PPO) are free of ‘Do Not Use’ abbreviations
  • Any labels or documents created/generated by pharmacy are free of ‘do not use’ abbreviations
  • A culture of patient safety is established, and the expectation is for healthcare staff who are involved in writing, processing, or fulfilling orders to clarify and take steps to correct any unclear orders to prevent any patient harm
  • Nursing orientation checklists have been updated to include ‘Do Not Use’ abbreviations to ensure staff are aware of PRH policies and ISMP Canada recommendations
  • The ISMP Canada ‘Do Not Use’ list is at the front of each admitted patient chart
  • ISMP Canada’s ‘Do Not Use’ list is visually available at each nursing station and near physician stations.
  • PRH regularly audits compliance with the ‘Do Not Use List’

 

For more information on the use of Dangerous Abbreviations visit, ‘Do Not Use’ List, ISMP Canada, List of Error-Prone Abbreviations, the “Abbreviations- NOT Acceptable” and “Abbreviations- Acceptable” policy documents and supporting research.

 

 

 

 

 


 

Get In Touch