Mollie Cole is Director of Health System Improvement at the Health Quality Council of Alberta, and a registered nurse of many years.
As a registered nurse, I have encountered my fair share of abbreviations, symbols, and dose designations over the years. I’ve seen these used in treatment orders, prescriptions, medication administration records, care plans, clinical notes, and instructions to patients. I’m sure I was responsible for a few of these too. After all, some habits are hard to break without an occasional reminder.
That’s why, on behalf of the Health Quality Council of Alberta, I am pleased to share with you a few helpful tips and important reminders about the hazards of abbreviations, symbols, and dose designations in medical communications – and why it’s best to avoid them.
While it’s difficult to estimate the impact of this problem across Alberta, it’s not hard to find alarming studies that point to the danger of abbreviations, symbols, and dose designations in healthcare settings across the world.
One U.S. study of 30,000 medication errors, some fatal, showed five per cent were linked to abbreviations in notes.1
As many of you in the healthcare sector already know communication shorthand commonly cause medication errors and adverse events. They can lead to the misinterpretation of instructions, especially if the language has multiple meanings or is not understood by all members of a healthcare team. And while the advent of electronic medical records and order sets have likely helped to mitigate abbreviation, symbols. and dose designations use in recent years, we know from audits that abbreviations in SMS texting are increasingly being found.
The Health Quality Council of Alberta has a mandate to promote and improve patient safety, person-centred care, and health service quality, and we’ve taken a keen interest in medication safety issues over the years such as the appropriate use of abbreviations, symbols, and dose designations.
This month, we launched a new page on our website, The Hazards of Abbreviations, Symbols, and Dose Designations, that highlights efforts healthcare providers and organizations can take to reduce the temptation to use shorthand in medical communications. This page replaces our abbreviations.hqca.ca site with a concise, updated look at this important topic.
One of the valuable resources you’ll find on our new webpage is a link to the Institute for Safe Medication Practices Canada (ISMP Canada) Do Not Use List – which is a regularly updated list of abbreviations and symbols that frequently create problems in medical communication and should never be used.
“The list is based on reports of medication errors to ISMP Canada,” said Carolyn Hoffman, CEO, ISMP Canada. “Through practitioner and consumer-lived experiences, we learn and share so that all of us can act to reduce the risk of this type of preventable harm.”
To learn more about this important topic, check out the new Hazards of Abbreviations, Symbols, and Dose Designations page.
HQCA Matters is published intermittently and presents HQCA representative perspectives on topics or issues relevant to healthcare in Alberta.