For safety's sake, dump abbreviations
June 1, 1997
For safety’s sake, dump abbreviations
And do so ASAP, OK?
There’s nothing wrong with using certain abbreviations in medicine, if you write them clearly. And that may be the biggest problem with abbreviations overall, says Michael Cohen, MS, president of the Institute for Safe Medication Practices in Warminster, PA. Many acceptable abbreviations, written in a pinch, come out looking like something else.
Here’s a list of abbreviations Cohen says hospitals should consider banning from medication orders because they’re often confused with other things:
• U for units
Written carelessly, it can look like a 4, a zero, or even cc.
• ug for micrograms
A sloppy writer makes this look like "milligrams."
• Q.D.
Some prescribers get a bit carried away on that period after Q, so that it looks like an "I." That turns a once a day order into a four-fold overdose.
• Q.O.D.
This, too, can come off looking like QID or QD. Either way, it’s a recipe for an overdose.
• SC or SQ
Not many pharmacists would buy an insulin order for sublingual use, but that’s what these abbreviations are sometimes mistaken for, Cohen says.
• TIW
This abbreviation morphed out of TID. It’s totally unacceptable right up there with BIW, QW, and QIW. Some might even confuse TIW as meaning twice a week instead of its intended meaning of three times weekly.
• D/C
You can’t get a more standard abbreviation than this one. The problem is, it can mean two different things: discharge or discontinue. A "D/C home" order, followed by a list of drugs, could mean discharge the patient on these drugs, or discontinue the drugs now that the patient is going home.
• HS
Most pharmacists recognize this as the abbreviation for "at bedtime." But it’s been mistaken for "half strength." By the way, another confusing pharmaceutical abbreviation for half of something is "ss."
• cc
It’s going to be hard to get rid of this one it flows so much easier from the pen than the more acceptable ml. They both mean the same thing, of course, but cc can come out looking like the abbreviation for units when written carelessly.
• AU, AS, AD
Or is it OU, OS, OD? That’s the problem: A one-letter change could mean the difference between someone getting cortisporin in their eyes or their ears. Instead, practitioners should write out for which eye or ear the medication is intended.
• 16, 60
More of a verbal order problem than a written one, these two numbers sound so much alike that they should be differentiated as follows: Verify 16 as 1,6; 60 as 6,0.
• TCN
Or, would you believe, 4CN? That’s not four molecules of cyanide, it’s tetracycline, folks.
• PMP
You probably have no idea what this stands for and you’d still be confused if the physician wrote out the whole thing: Phenoxymethyl penicillin. That’s plain old penicillin to the rest of us. (By the way, PVK also should be dumped.)
• HCN
No, the physician isn’t trying to kill the patient with an order for hydrocyanide it’s hydrocortisone. Or is it hydrocodone?
• HCTZ
Does the expression "shoveling beach sand against the tide" mean anything to you? Hospitals can only hope to get rid of this designation for hydrochlorothiazide, and it’s probably a waste of energy trying to get doctors to write out the whole clunky word. It’s one of the few bits of pharmaceutical shorthand along with MTX (for methotrexate) and 5-FU (for fluorouracil) that’s likely here to stay.
• CTZ
The abbreviation for chlorothiazide? Sorry, that notation won’t work.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content