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Do Not Use Abbreviations The Institute for Safe Medication Practice (ISMP) and the Joint Commission (JACHO) have each developed a list of dangerous abbreviations. The list includes abbreviations considered to be dangerous because of the potential for misinterpretation. PPIC recommends that insureds follow the guidelines. “An abbreviation on the 'do not use' list should not be used in any of its forms, upper or lower case, with or without periods. For example, if Q.D. is on your list, you can't use QD or qd. Any of those variations are confusing and can be misinterpreted.” (JACHO) PPIC recommends that facilities using abbreviations for documentation purposes keep lists of approved and unapproved abbreviations at each documentation area. This compilation of “do not use” abbreviations, as defined by ISMP and JACHO, is current as of July 2004. PPIC encourages you to frequently check ISMP and JACHO websites for updates to the list (http://www.ismp.org and http://www.jcaho.org). Abbreviation or Symbol Intended Meaning Potential Problem Preferred Term or Misinterpretation or Correction U Unit Mistaken as zero, four, or cc Write "unit" IU International unit Mistaken as IV (intravenous) or 10 (ten) Write "international unit" Decimal point is missed Never write a zero by itself after a decimal point (X mg), and always use a zero before a decimal point (0.X mg) Trailing zero (X.0 mg), Lack of leading zero (.X mg) µg H.S. S.C. or S.Q. D/C Microgram Mistaken for mg Write "mcg" (milligrams) resulting in one thousand-fold dosing overdose Half-strength or Latin abbreviation for bedtime Mistaken for either Write out "halfhalf-strength or hour strength" or "at of sleep (at bedtime). bedtime" q.H.S. Mistaken for every hour. Subcutaneous Mistaken as SL for Write "Sub-Q," sublingual, or 5 every "subQ," or "subcutaneously" Discharge Interpreted as discontinue or whatever medications follow (typically discharge meds) Write "discharge" or “discontinue” IJ Injection Mistaken as IV or intrajugular Write “injection” IN Intranasal Mistaken as IM or IV Write “intranasal” or “NAS” OJ Orange juice Mistaken as OD or O Write out “orange juice” By mouth, orally Mistaken for left eye Use “PO” or “by mouth” or “orally” One daily Mistaken as tid Use “1 daily” Cubic centimeter Mistaken for U (units) Write "ml" for when poorly written milliliters Per os t/d c.c. or cc A.S., A.D., A.U. Latin abbreviation Mistaken for OS, OD, Write "left ear," for left, right, or both OU, etc. "right ear," or ears "both ears" Ounce Dram Minim 3, m, ml, and others Use the metric system mg Microgram Mistaken for mg when handwritten Use “mcg” o.d. or OD Once daily Use “daily” Misinterpreted as “right eye” (OD— oculus dexter) and administration of oral medications in the eye TIW or tiw Three times a week Mistaken as three times a day q.d. or QD Every day Apothecary symbols such as: ƺƷm Don’t use this abbreviation, write out “three times a week” Mistaken as q.i.d., Use “daily” or especially if the “every day” period after the “q” or the tail of the “q” is mistaken for an “i” qn Nightly or at bedtime Misinterpreted as qh (every hour) Use “nightly” qhs Nightly at bedtime Misread as every hour Use “nightly” q6PM, etc. Every evening at 6 PM Misread as every six hours Use 6 PM “nightly” q.o.d. or QOD Every other day Misinterpreted as q.d. (daily) or q.i.d. (four times daily) if the “o” is poorly written Use “every other day” x3d For three days Mistaken for three doses Use “for three days” BT Bedtime Mistaken as BID (twice daily) Write it out ss Sliding scale (insulin) or ½ (apothecary) Mistaken for 55 Spell out “sliding scale.” Use “onehalf” or use “½” SSRI Sliding scale regular insulin Mistaken as selective-serotonin reuptake inhibitor. Sliding scale insulin Mistaken as strong solution of iodine (Lugol’s) Spell out “sliding scale insulin” > and < Greater than and less than Mistakenly used opposite of intended Use “greater than” or “less than” / (Slash mark) Separates two doses or indicates “per” Misunderstood as the number 1 (“25 unit/10 units” read as “110” units Do not use a slash mark to separate doses Use “per” SSI @ At Mistaken as 2 Use “at” & And Mistaken as 2 Use “and” + Plus or and Mistaken as 4 Use “and” o Hour Mistaken as zero Use “hour, h, or hr” Intended Meaning Misinterpretation Correction ARAºA Vidarabine CytarabineARAºC Use complete drug name AZT Zidovudine (retrovir) Azathioprine Use complete drug name CPZ Compazine (prochlorperazine) Chlorpromazine Use complete drug name DPT DemerolPhenerganThorazine Diphtheria-pertussis- Use complete tetanus (vaccine) drug name HCl Hydrochloric acid Potassium chloride (The “H” is misinterpreted as “K”) Use complete drug name HCT Hydrocortisone Hydrochlorothiazide Use complete drug name Drug names HCTZ MgSO4 MSO4 or MS MTX Hydrochlorothiazide Hydrocortisone (seen Use complete as HCT250 mg) drug name Magnesium sulfate Morphine sulfate Use complete drug name Morphine sulfate Magnesium sulfate Use complete drug name Methotrexate Mitoxantrone Use complete drug name TAC Triamcinolone Tetracaine, Use complete ADRENALIN,cocaine drug name ZnSO4 Zinc sulfate Morphine sulfate “Nitro” drip Nitroglycerin infusion Sodium nitroprusside Use complete infusion drug name “Norflox” Norfloxacin NORFLEX Use complete drug name IV Vanc Intravenous vancomycin Mistaken as Invanz Use complete drug name DTO Diluted tincture of opium, or deodorized tincture of opium (Paregoric) Mistaken as tincture of opium Use complete drug name PCA Procainamide Mistaken for patient controlled analgesia Use complete drug name PTU Propylthiouracil Mistaken for meracptopurine Use complete drug name Tylenol with codeine #3 Mistaken for liothyronine Use complete drug name TNKase Mistaken for TPA Use complete drug name T3 TNK Use complete drug name