The use of abbreviations, symbols, and dose designations 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.
| DO NOT USE | INTERPRETATIONS | USE INSTEAD |
| U, u, IU | Misread as IV {intravenous}; 0 (zero) or 4 | Unit |
| Qd; od, QD, OD | Misread as q.i.d. or right eye | Daily, every day |
What we know
Audits of medical communications find that abbreviations, symbols, and dose designations are still used in medical treatment orders, prescriptions, medication administration records, care plans, clinical notes, and instructions to patients. Texting with shorthand is increasingly found in audits of health records.
What we can do
Improving patient safety by eliminating abbreviations, symbols, and dose designations from medical communications will take the combined efforts of healthcare providers and organizations.
Technology
- Technology holds great promise for limiting the use of shorthand. Studies show electronic medical records, forced functions, and standard electronic order sets significantly reduce the use of abbreviations, symbols, and dose designations.
Education
- Policies, ongoing education, and reminders for health care providers about the harms associated with abbreviations, symbols, and dose designations can also support reductions in their use.
Resources
- The Institute for Safe Medication Practices Canada produces a “Do not use” list containing commonly used, problematic abbreviations, symbols, and dose designations for which there is consensus they should not be used. Adhering to this “Do not use” list is a required organizational practice, according to Accreditation Canada. Healthcare providers should familiarize themselves with the list, communicate it, and consider all the ways shorthand could be eliminated from their practice, including texting, notes in patient records, preprinted order sets and standing orders, and teaching materials.