MedAbbrev.com
St. Mary’s Hospital“Unapproved/Do Not Use” Abbreviations, “Discouraged” Abbreviations and Dose designations/Interval RangesUpdated 10/2014 Unapproved Abbreviations:Abbreviation(s)Intended MeaningMisinterpretationCorrectionIUinternational unitmistaken as "10" or "IV"use "units"MgSO4magnesium sulfatemistaken as morphine sulfateuse complete drug nameMS, MSO4morphine sulfatemistaken as magnesium sulfateuse complete drug nameQD; qdevery daymistaken as "QID" (four times daily)use "daily"QOD; qodevery other daymistaken as "QD" (daily) or "QID" (four times daily)use "every other day"U, uunit(s)mistaken as the number "0" or "4”; mistaken as "cc"use "unit"?gmicrogrammistaken as "mg"use "mcg"Lack of leading zeros (ie: .5 mg)0.5 mgmistaken as 5 mg if the decimal point is not seenuse zero before a decimal point when the dose is less than a whole unitTrailing zeros (ie: 1.0 mg)1 mgmistaken as 10 mg if the decimal point is not seendo not use trailing zeros for doses expressed in whole numbers Discouraged Abbreviations: suggested abbreviations to avoid due to the potential for misinterpretationAbbreviation(s)Intended MeaningMisinterpretationCorrectioncccubic centimetersmistaken as "u" (units)use "mL"QOWevery other weekmistaken as "QD" (daily) or "QOD" (every other day)use "every other week"NOACnovel oral anticoagulantmistaken as "no anticoagulation"use complete nameSC, SQ, sub qsubcutaneousmistaken as “5 every” or SL (sublingual); “Q” can be mistaken as “every”Use “subcut” or “subcutaneously”Dosage Designations/Interval Ranges: St. Mary’s Hospital has implemented the following medical staff approved protocol for interpretation of range orders to ensure the physician, pharmacist, and nurse have the same understanding about patient treatment.Dose administration will always start with lowest dose in the range. If the desired effect has not been achieved and no adverse reactions have been observed, the dose may be increased to a higher dose within the specified range. If the ordering practitioner provides specific indications for each dosage within the range, these indications will be utilized to guide medication administration (refer to APM policy 9.46).The dose, dosage interval, or prn indication can vary within an order but not more than one of these components can vary within the same order. Example: an order can say “morphine 2-4 mg IV every 4 hours for moderate pain” but cannot say “morphine 2-4 mg IV every 4-6 hours for mild to moderate pain?????? B.? Recommended alternatives to range orders include the following:Break-through pain orders????????????? Example: “morphine 4 mg IV every 4 hours for moderate pain.” The nurse may administer morphine 1 mg IV every 1 hour for break-through pain.May-repeat ordersExample: “trazodone 25 mg PO every night at bedtime for sleep; may repeat x 1 in 30 minutes if still awake.”Titration orders for continuous infusions which are individualized based upon patient assessment are not considered range orders, e.g., titrate dopamine to SBP of 120 mmHg.Vague directions are not acceptable. Directions will be explicitly stated. The following medication orders are NOT acceptable:“Continue medications from home”“Continue medications from nursing home”“Take as directed”“Discontinue above order”“Resume orders”“Hold (medication name)” without a specified time or action Other nonspecific medication orders, e.g. "increase correctional scale insulin by 2 units" E. The following medication orders will not be carried out if attempts to contact the prescriber for clarification are unsuccessful:Illegible order(s)Orders that do not appear to be indicated for a patient’s conditionOrders where the prescribed dosage is potentially incorrectOrders where the medication prescribed is contraindicated per package insert or medical staff established maximum doses or policiesReferences1. Institute for Safe Medication Use Practices (ISMP), “ISMP’s List of Error-Prone Abbreviations, Symbols, and Dose Designations.” . The Joint Commission. “Facts about the official ‘Do Not Use’ List.” . St Mary’s Hospital Quantros Medication Event Reports: October 2013-November 2014. c: Abbreviations SMH 2014 ................
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