By: Kathy Smith, RN, Senior Risk Manager
Alex: The answer is, “Abbr”
Teacher contestant: “What is the abbreviation for abracadabra?”
Alex: Sorry, that is incorrect.
Doctor/Provider contestant: “What is the Abbreviation for the word “Abbreviation”?
Alex: You are correct for One Million Dollars!
One million dollars just may be the verdict for a malpractice claim that resulted in patient harm due to the use of an unapproved abbreviation. Using unapproved abbreviations can lead to confusion and/or misinterpretation resulting in medical errors that can be detrimental and have devastating outcomes to both inpatients and outpatients.
Recently a prescription was written for QD and transcribed as QID. An astute staff member caught the error before it reached the patient. QD is an UNAPPROVED abbreviation as are many other frequently used abbreviations.
Some abbreviations have ambiguous meaning such as OD (could be daily or right eye). It is easy to get caught up in an abbreviated world during the business of the day, but the extra few seconds that it takes to use an approved abbreviation or to write out the word “daily”, “milligram”, or “unit” could be worth it’s weigh in gold to prevent an error.
Here is a written example of the “QD” unapproved abbreviation:
Is that Tequin 400mg po qd times 3 days or qid times 3 days? The correct answer is qd times 3 days, however, it was interpreted and given as qid times 3 days. Patient harm resulted from this use of an unapproved abbreviation.
The following is an example of another unapproved abbreviation (source - ©2004 Institute for Safe Medication Practices, Medication Safety Alert, October 21, 2004, Volume 9 Issue 21):
“A recent error occurred when a nurse who was taking a patient’s history recorded his insulin dose using the letter “u” instead of the word “unit” (see Figure 1). The physician misread the “u” as a “4” and wrote orders dramatically different from what the patient had been taking (see Figure 2).”
Figure 1 – nurse’s note
Figure 2 – physician’s order
In conclusion, physicians/providers can make a difference in error reduction by using approved abbreviations and/or by simply writing out the word. A list of approved abbreviations can be found on the LGH intranet under Reference Room.