Hazards of Abbreviations and Symbols

The use of abbreviations and symbols in communication about medications is a common cause of medication error and adverse events.

The use of abbreviations and symbols is a common practice in healthcare that is recognized as a risk to patient safety. They can lead to misinterpretation of instructions if they have multiple meanings or if not understood by all healthcare providers.

U, u, IUMisread as IV {intravenous}; 0 (zero) or 4
Qd; od, QD, ODMisread as q.i.d. or right eye
Daily, every day
Examples of error-prone abbreviations and symbols

What we know

Audits of medical communications find that abbreviations and symbols are still used in medical treatment orders, prescriptions, medication administration records, care plans, clinical notes, and instructions to patients. Texting with abbreviations is increasingly found in audits of health records.

What we can do

Improving patient safety by eliminating abbreviations and symbols from medical communications will take the combined efforts of healthcare providers and organizations.


  • Technology holds great promise for limiting the use of abbreviations and symbols. Studies show electronic medical records, forced functions, and standard electronic order sets significantly reduce the use of abbreviations and symbols.


  • Policies, ongoing education, and reminders for health care providers about the harms associated with abbreviations and symbols can also support reductions in their use.


  • The Institute for Safe Medication Practices Canada produces a “Do not use” list containing commonly used, problematic abbreviations and symbols for which there is consensus they should not be used. Healthcare providers should familiarize themselves with the list and consider all the ways abbreviations and symbols could be eliminated from their practice, including texting, notes in patient records, preprinted order sets and standing orders, and teaching materials.

Additional Information

Institute for Safe Medication Practices Do Not Use List