NEW YORK NURSE: March 2008
by Joely Johnson
Healthcare professionals have traditionally used a system of shorthand that, on the surface, would seem to save time and effort. A recent study has shown, however, that patient safety often suffers when these shortcuts are used. Relying on abbreviations such as “qd” for “once daily” and “U” for “unit” too often can lead to dangerous medication mistakes.
The study, published in the September 2007 issue of The Joint Commission Journal on Quality and Patient Safety, found that abbreviations were to blame for nearly 30,000 medication errors reported to the national database MEDMARX between 2004 and 2006. According to the researchers, communication breakdowns are frequently the problem – abbreviations are likely to be misread, misinterpreted, or processed incorrectly by healthcare personnel, including RNs.
“This really has to do with being able to understand the provider’s handwriting,” said Renée Gecsedi, director of NYSNA’s Education, Practice, and Research Program. For example, the abbreviation “U” stands for units. If written unclearly, however, it could be misunderstood as “m,” the symbol for microns. “Not to mention that we all develop our own shorthand for things,” said Gecsedi. “In one position, I was accustomed to using ‘DNR’ to mean ‘do not resuscitate,’ but when I worked at another organization, the same three letters meant ‘do not renew.’”
An official “Do Not Use” list of abbreviations has been developed by the Joint Commission. Complying with the list is one of the requirements for meeting the commission’s National Patient Safety Goals. The goals state that healthcare facilities must maintain a standardized list of abbreviations, acronyms, and symbols that are not to be used.
According to the 2007 study, nearly a quarter of practitioners do not comply with the “Do Not Use” list requirement. Surveys of hospitals show that their compliance with the restricted abbreviations list has dropped from only 75% to 64% between 2004 and 2006.
These data are a strong reminder to avoid the use of abbreviations in order to minimize medication errors and protect patient safety. But it won’t be easy. “I think this will be a long, difficult transition for some in the healthcare profession,” said Gecsedi. Old habits are hard to break, but in this case, the accreditation of your facility – and the health of your patients – may depend upon it.
To learn more about the “Do Not Use” list and the National Patient Safety Goals, go to www.jointcommission.org/PatientSafety/DoNotUseList.
|Abbreviation not to be used||Use this instead|
|Q.D., QD, q.d., qd||Daily|
|Q.O.D., QOD, q.o.d, qod||Every other day|
|Trailing zero (X.0 mg)||X mg|
|Lack of leading zero (.X mg)||0.X mg|
|MS04 and MgSO4||Magnesium sulfate|