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Use of medical abbreviations in medicine is not new. Since the development of mainstream medicine nearly 200 years ago, abbreviations have been used. While initially, the abbreviations were limited to the writing of prescriptions, today, abbreviations have become very common in all aspects of medical documentation. Medical abbreviations are used in all medical and surgical departments, during surgery, the emergency room, and at discharge. One area where medical abbreviations are used most often and are a cause for concern is when writing drug orders. Until recently, the use of abbreviations has never been regulated, and there is no universal rule as to which abbreviations can be used and which ones cannot. In fact, over the past 3 decades, some healthcare workers have been making up abbreviations. The long-standing practice of writing medical abbreviation has become so entrenched in healthcare that even the most junior medical and nursing school graduates are very accustomed to writing them. In fact, many healthcare institutions have specialized lists of abbreviations that can be used. Now, with a more formalized practice of medicine, there is a concern that rampant use of medical abbreviations may pose a danger to the patient. While there are anecdotal examples of medical abbreviations that have caused harm to a few patients, good clinical evidence to support the belief that medical abbreviation use is dangerous or is causing problems in the delivery of standard of care is lacking. In any case, the potential for harm to the patient from improper communication as a result of medical abbreviations cannot be understated. This activity reviews the inappropriate use of medical abbreviations and discusses the role of the interprofessional team in avoiding acting on orders that are unclear due to the use of an abbreviation. Objectives: Describe the errors reported by the ISMP and Joint Commission related to inappropriate medical abbreviations. Outline methods to avoid acting on inappropriate and unclear medical abbreviations. Identify examples of potential harm that can result from inappropriate medical abbreviations. Summarize the inappropriate use of medical abbreviations and highlight the role of the interprofessional team in avoiding acting on orders that are unclear due to the use of an abbreviation. Access free multiple choice questions on this topic.

The use of medical abbreviations in medicine is not new. Since the development of mainstream medicine nearly 200 years ago, abbreviations have been used. While initially, the abbreviations were limited to the writing of prescriptions, today, abbreviations have become very common in all aspects of medical documentation. Medical abbreviations are used in all medical and surgical departments, during surgery, in the emergency room, and at discharge. One area where medical abbreviations are used most often and are a cause for concern is when writing drug orders. Until recently, the use of abbreviations has never been regulated, and there is no universal rule as to which abbreviations can be used and which ones cannot. In fact, over the past three decades, some healthcare workers have been making up abbreviations. The long-standing practice of writing medical abbreviations has become so entrenched in healthcare that even the most junior medical and nursing school graduates are accustomed to writing them. In fact, many healthcare institutions have specialized lists of abbreviations that can be used. The use of medical abbreviations is not only an American phenomenon but a global problem.

The use of medical abbreviations in medicine is not new. Since the development of mainstream medicine nearly 200 years ago, abbreviations have been used. While initially, the abbreviations were limited to the writing of prescriptions, today, abbreviations have become very common in all aspects of medical documentation. Medical abbreviations are used in all medical and surgical departments, during surgery, in the emergency room, and at discharge. One area where medical abbreviations are used most often and are a cause for concern is when writing drug orders. Until recently, the use of abbreviations has never been regulated, and there is no universal rule as to which abbreviations can be used and which ones cannot. In fact, over the past three decades, some healthcare workers have been making up abbreviations. The long-standing practice of writing medical abbreviations has become so entrenched in healthcare that even the most junior medical and nursing school graduates are accustomed to writing them. In fact, many healthcare institutions have specialized lists of abbreviations that can be used. The use of medical abbreviations is not only an American phenomenon but a global problem. For the past three decades, healthcare leaders have been encouraging less use or even eliminating medical abbreviations in medicine. The US Institute of Safe Medication Practices (ISMP) has regularly received a continual stream of reported errors, some of which have resulted in adverse events due to misinterpretation of some dangerous medical abbreviations. The Joint Commission has regularly issued updates and regulations on the safe use of medical abbreviations and, in fact, has also published a short list of dangerous medical abbreviations and dose expressions that should never be used. However, despite many key organizations condemning the use of medical abbreviations, they continue to be used at an alarming rate. Medical abbreviations are almost routine in any medical chart or drug prescription. This can often place junior healthcare staff who are supposed to decipher the drug orders at significant risk because often the healthcare provider who writes the medical abbreviations may not be around, and the junior staff or nurse may use their limited knowledge to determine what the abbreviations exactly mean. The other alternative is to refuse to carry out any order where the abbreviations do not make sense, but this refusal can also jeopardize a patient's healthcare.

For the past three decades, healthcare leaders have been encouraging less use or even eliminating medical abbreviations in medicine. The US Institute of Safe Medication Practices (ISMP) has regularly received a continual stream of reported errors, some of which have resulted in adverse events due to misinterpretation of some dangerous medical abbreviations. The Joint Commission has regularly issued updates and regulations on the safe use of medical abbreviations and, in fact, has also published a short list of dangerous medical abbreviations and dose expressions that should never be used. However, despite many key organizations condemning the use of medical abbreviations, they continue to be used at an alarming rate. Medical abbreviations are almost routine in any medical chart or drug prescription. This can often place junior healthcare staff who are supposed to decipher the drug orders at significant risk because often the healthcare provider who writes the medical abbreviations may not be around, and the junior staff or nurse may use their limited knowledge to determine what the abbreviations exactly mean. The other alternative is to refuse to carry out any order where the abbreviations do not make sense, but this refusal can also jeopardize a patient's healthcare. Now, with a more formalized practice of medicine, there is a concern that the rampant use of medical abbreviations may pose a danger to the patient. While there are anecdotal examples of medical abbreviations that have caused harm to a few patients, good clinical evidence to support the belief that medical abbreviation use is dangerous or is causing problems in the delivery of standard of care is lacking. In any case, the potential for harm to the patient from improper communication due to medical abbreviations cannot be understated.[1][2]

The Joint Commission The Joint Commission strongly believes that completely removing dangerous medical abbreviations is a far better option than healthcare institutions undertaking secondary measures like quality control or restricting the use of only certain abbreviations. In many hospitals, many prescriptions written by clinicians have to be clarified and/or corrected by pharmacists to prevent errors. To avoid this type of recurrence, the rule should be that no prescription should have any medical abbreviations. Nurses should ask healthcare workers to rewrite orders that contain abbreviations. All interprofessional healthcare team members should be on the same page regarding the non-use of medical abbreviations. Other remedies to counter medical abbreviation usage include education, a reward for non-usage, accountability for habitual offenders, and education. The healthcare staff who continue to use medical abbreviations need to be identified and cautioned. This applies to all clinical staff, including physicians, pharmacists, and nursing. Furthermore, the use of stickers and posters on the dangers of medical abbreviations should be posted on the chart and the nursing floors. Sometimes education may not be adequate to change the writing habits of certain healthcare professionals. In such cases, these individuals may have to be reprimanded, or their ordering privileges be suspended.