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The “DO NOT USE” List of Abbreviations

Required Organizational Practices (ROP)

Key Facts

“DO NOT USE” List of Abbreviations ROP

• Misinterpreted abbreviations and symbols may result in omission errors, extra or improper doses, wrong drug or incorrect manner of drug administration.

• A comprehensive approach to address the use of abbreviations is required and must include a list based on the Institute for Safe Medication Practices (ISMP) Canada’s “Do Not Use List”, as well as education, auditing and processes to ensure any list updates are managed appropriately.

• Some examples of how abbreviations may be misinterpreted:

o D/C used to indicate Discharge or Discontinue and the intended meaning isn’t clear,

o > and < (Greater/LessThan) which can be misunderstood or interpreted incorrectly,

o OD used to indicate Daily can be confused with AD, AS, AU, OU, OS,

o Use of a trailing zero (e.g. 1.0 mg of warfarin misinterpreted as 10 mg),

o Not using a leading zero (e.g. .5 mg of haloperidol misinterpreted as 5 mg or 15 mg).

I need to know

• Health PEI is implementing a Provincial policy specific to the use of “Do Not Use” abbreviations, symbols and dose designations within medication related documentation. Health PEI’s “Do Not Use” list is included below.

• This ROP applies to anyone who documents medication related information in the patient record and those responsible for creating medication related documents such as paper-based or electronic order sets.

• Annual audits of abbreviation use within medication orders are conducted and feedback is provided.

• All healthcare professionals involved in the writing and transcription of medication orders are reminded to avoid the use of abbreviations and when orders are handwritten, ensure that the orders are legible.

Related Standards

Medication Management 14.6

Required Organizational Practices (ROPs) are identified by Accreditation Canada as evidence based-practices, which reduce harm to patients. They are mandatory practices matched to specific Accreditation Canada Standards that organizations must have in place. There are 33 ROPs identified within Health PEI for the September 2017 survey visit.

|Health PEI |

|DO NOT USE |

|Dangerous Abbreviations, Symbols, and Dose Designations |

|Abbreviation |Potential Problem |Correct Term |

|(intended meaning) | | |

|U |Mistaken for “0” (zero), “4”(four) or cc |Unit |

|(unit) | | |

|IU |Mistaken for “IV” intravenous or “10” (ten) |Unit |

|(international Unit) | | |

|Abbreviations for drug names |Misinterpretation because of similar abbreviations for |Do not abbreviate drug names |

| |multiple drugs: e.g. MS, MSO4 (morphine sulfate), MgSO4| |

| |(magnesium sulfate) may be confused for one another. | |

|QD or QOD |QD and QOD mistaken for each other or as “qid”. The Q |Daily and every other day |

|(once daily or every other day) |has also been misinterpreted as “2” (two) | |

|OD |Mistaken for “right eye” (OD = oculus dexter) |Daily |

|(every day) | | |

|OS, OD, OU |May be confused with one another |Left eye, right eye, both eyes |

|(left eye, right eye, both eyes) | | |

|D/C |Interpreted as “discontinue whatever medications |Discharge |

|(discharge) |follow” (typically discharge medications) | |

|cc |Mistaken for “U” (units) |mL or millilitres |

|(for cubic centimeter) | | |

|SC or SQ |Mistaken SL for sublingual, or “5 every” |Sub-Q, subQ, subcut, or subcutaneously |

|(for subcutaneous) | | |

|µg |Mistaken as “mg” (resulting in a thousand fold |Use “mcg” |

|(for microgram) |overdose) when handwritten | |

|Symbol |Potential Problem |Correct Term |

|(intended meaning) | | |

|@ |Mistaken for “2” (two) or “5” (five) |At |

|(at) | | |

|> and < |Mistaken for “7” (seven) or the letter “L”. Confused |Greater than/more than or |

|≥ and ≤ |with each other |Less than/lower than. |

| | |Less than or equal to or |

| | |Greater than or equal to |

|Dose Designations (intended meaning) |Potential Problem |Correct Term |

|Trailing zero |Decimal point is missed leading to tenfold errors |Never use a zero by itself after a decimal |

|(X.0 mg) | |point. Use “X mg” |

|Lack of leading zero |Decimal point is missed leading to tenfold errors |Always use a zero before a decimal point. |

|(.X) | |Use “0.X mg” |

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