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Children's Hospital and Regional Medical Center (Clinical Policy/Procedure: D ) Dangerous Abbreviations and Decimal Use POLICY: The specified abbreviations are not allowed in the medical record. PURPOSE: Abbrevations are not safe to use. The following abbreviations related to medications have a high chance of harming our patients. These abbreviations are prohibited in the entire medical record, including orders, prescriptions, progress notes, flow-sheets, communications and other documentation. PROCEDURE: I. Children’s Hospital prohibits use of the following abbreviations: Figure 1 Unacceptable Abbreviations Acceptable Use Rationale μg Can look like milligrams. MS, MSO4, MgSO4 Spell out micrograms, or use mcg Spell out morphine or magnesium sulfate QD or QOD Spell out once daily or every other day Mistaken for each other. The period after the Q can be mistaken for an I and the O can be mistaken for I. u for units IU for International Units Naked Decimal Write out the word unit or units or international units The handwritten U or u can look like a zero or a six, leading to an overdose error. Add zero before leading decimal Can be mistaken for a whole number. .5mL Trailing Zero 0.5mL Avoid zero after decimal when writing whole numbers 2 Potential for 10 fold error. 2.0 Morphine sulfate can be mistaken for magnesium sulfate or magnesium sulfate can be mistaken for morphine sulfate. Exception: If a key or legend is provided on the same page, an otherwise unacceptable abbreviation may be used on a typed Children’s document (e.g. clinical path or roadmap) but such use is discouraged. c:\documents and settings\twatso\desktop\unaccepted_abbreviations.doc (sh:t)© 2006 Children’s Hospital and Regional Medical CenterAll Rights Reserved Page 2: Clinical Policy/Procedure: Dangerous Abbreviations and Decimal Use II. III. If the pharmacist encounters any other drug abbrevation which raises a concern for a potential medication mix-up, they will call the prescriber to obtain clarification prior to processing the order. Appropriate Placement of Decimal: A. Trailing zeros may be used in non-medication related documentation when there is a clear need to demonstrate level of precision, such as: 1. Laboratory values 2. Imaging study measurement of lesion sizes 3. Catheter and therapeutic tube sizes See also: Clincal P&P Medication Ordering and Transcription Submitted by: Helen Kurre, PharmD, MBA, Medication Safety Manager Reviewed by: Medical Records-Medical Informatics Committee (Mark DelBeccaro, MD, Chair) Quality Improvement Steering Committee (Pat Hagan, COO, Chair) Pharmacy & Therapeutics Committee, May 2005 (Eric Harvey, PharmD and Janet Englund,MD, Co-Chairs) Revised by: Patient Safety Communications Committee (Jill Langle, Chair) Approved by Medical Executive Committee: 6/03, 12/03, 5/05 APPROVED BY: Richard Molteni, MD Vice President & Medical Director ORIGINATED: REVIEWED: REVISED: Susan Heath, RN, MN Nurse Executive 4/03 12/03, 5/05, 4/06 Additional Key Words: Dangerous Abbreviations, Abbreviations, Trailing Zero, Naked Decimal, JCAHO Sentinel Event Alert, Patient Safety, Unacceptable Abbreviations c:\documents and settings\twatso\desktop\unaccepted_abbreviations.doc (sh:t)© 2006 Children’s Hospital and Regional Medical CenterAll Rights Reserved