Dangerous abbreviations presentation


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Dangerous abbreviations presentation

  1. 1. An Animated PowerPoint
  2. 2. OVERVIEW According to The AHDI Book of Style (3rd edition), some abbreviations have proven to be dangerous, particularly with respect to medication orders. For example, the U in insulin 6 U could possibly be misread as a zero, or a medication that is given once a day may mistakenly be given four times a day if q.d. were misread as q.i.d. These types of errors can and do happen and have at times resulted in the death of patients. 1 2 Dangerous Abbreviations
  3. 3. Organizations 3 Organizations involved in identifying dangerous abbreviations and preventing such problems include: • USP: United States Pharmacopeia • ISMP: Institute for Safe Medication Practices • FDA: US Food and Drug Administration • NCCMERP: National Coordination Council for Medication Error Reporting and Prevention ISMP has published a list of dangerous abbreviations and dose designations as reported to the USP-ISMP Medication Errors Reporting Program, and AHDI promotes the adoption of this list. 1
  4. 4. 4 Potential Problem: Mistaken as zero, four, or cc. Preferred Term: Write “unit”
  5. 5. 5
  6. 6. 6 Potential Problem: Mistaken as IV (intravenous) or 10 (ten) Preferred Term: Write “international unit”
  7. 7. 7 Potential Problem: Mistaken for each other. The period after the Q can be mistaken for an “I” and the “O” can be mistaken for “I”. Preferred Term: Write “daily” and “every other day”
  8. 8. (for subcutaneous) Potential Problem: Mistaken as SL for sublingual, or “5 every” and the Q mistaken for “every” Preferred Transcription: Write “subcutaneous” or “subcutaneously” 8
  9. 9. 9 [Note: Prohibited only for medication-related notations]; Lack of leading zero (.X mg) Potential Problem: Decimal point is missed. Preferred Transcription: Never write a zero by itself after a decimal point (X mg), and always use a zero before a decimal point (0.X mg).
  10. 10. Intended Meaning: Greater than and less than Misinterpretation: Mistakenly used opposite of intended. Correction: Use “greater than” or “less than.” 10
  11. 11. Potential Problem: Confused for one another. Can mean morphine sulfate or magnesium sulfate. Preferred Transcription: Write “morphine sulfate” or “magnesium sulfate” 11
  12. 12. 12
  13. 13. (for three times a week) 13 Potential Problem: Mistaken for 3 times a day or twice weekly, resulting in an overdose. Preferred Transcription: Write “3 times weekly” or “three times weekly”
  14. 14. μg (for microgram) 14 Mistaken for mg (milligrams), resulting in one thousand-fold dosing overdose. Write “mcg”
  15. 15. (for discharge) Potential Problem: Interpreted as discontinue whatever medications follow Preferred Transcription: Write “discharge” 15
  16. 16. Intended Meaning: Separates two doses or indicates “per” Misinterpretation: Misunderstood as the number “1” (Example: “25 units /10 units” read as 110 units) Correction: Do not use a slash mark to separate doses. Use “per.” 16
  17. 17. (Latin abbreviation for left, right, and both ears) Potential Problem: Mistaken for OS, OD, and OU. Preferred Transcription: Write “left ear,” “right ear,” or “both ears” 17
  18. 18. (for cubic centimeter; pertains to liquid measurements only, not mass) Potential Problem: Mistaken for U (units) when poorly written. Preferred Term: Write “mL” for milliliters 18
  19. 19. Of Note 19 AHDI Book of Style (3rd ed.) Page 210: “The rule for changing cc to mL only pertains to liquid volume. MTs should continue to transcribe cubic centimeter references to mass as cc, as are encountered in measuring organs, tissues, and specimens of solid volume. In addition, when cc is used to describe other non-liquid volumes, such as gas, this should be retained and not changed to mL. “
  20. 20. x3d INTENDED MEANING: for three days MISINTERPRETATION: Mistaken for “three doses.” CORRECTION: Use “for three days.” 20
  21. 21. Use the complete spelling for ALL drug names 21
  22. 22. per os INTENDED MEANING: orally MISINTERPRETATION: The “os” can be mistaken for “left eye.” CORRECTION: Use “p.o.,” “by mouth,” or “orally.” 22
  23. 23. Abbreviation Intended Meaning Possible Error Correction qn Nightly or at bedtime Misinterpreted as “qh” (every hour) . Use “nightly” qhs Nightly at bedtime Misread as every hour Use “nightly” q6PM, etc. Every evening at 6 PM Misread as every 6 hours Use 6 PM “nightly.” 23
  24. 24. Intended Meaning: Sliding scale (insulin) or ½ (apothecary) Misinterpretation: Mistaken for “55.” Correction: Spell out “sliding scale.” Use “one- half” or use “½.” 24
  25. 25. BT 25 Intended meaning: Bedtime Misinterpretation: Mistaken as “BID” (twice daily) Use “at bedtime”
  26. 26. 26 1. Sims, Lea M. The Book of Style for Medical Transcription, third edition. Association for Healthcare Documentation Integrity, 2008. For more information on AHDI, visit: www.ahdionline.org