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Policy Relationship: Clinical General Patient Care: Standards of Patient Care Effective Date: May 6, 2013 9.0 Section Number: 9.0 Subsection Number: 9.1.19P Policy Number: General Patient Care 9.1 Standards of Patient Care 9.1.19P Dangerous Abbreviations - Do Not Use Error Prone Abbreviations, Symbols and Dose Designations 1.0 Purpose The use of abbreviations and symbols can lead to misinterpretation with risk to patients, health care providers and VIHA. The Institute for Safe Medication Practices (ISMP) Canada has identified specific high risk abbreviations and symbols and these have been incorporated into Accreditation Canada Required Organizational Practices (ROPs). This policy is intended to ensure patient safety and compliance with Accreditation Canada Standards, in medication management through safe and accurate communication of medication orders between all members of the health care team. 2.0 Policy Abbreviations, symbols, and dose designations prohibited for use by Accreditation Canada as dangerous and identified by the Institute for Safe Medication Practices (ISMP) Canada will not be used when communicating medication orders. These prohibited abbreviations, symbols and dose designations and the required alternatives are listed in section 3.0 (Definitions) below. This policy applies to all forms of orders including but not limited to Clinical Order Sets and Power Plans. 3.0 Definitions “Do Not Use” Dangerous Abbreviations, Symbols and Dose Designations Issuing Authority: VIHA Combined Quality Council Date Issued: May 6, 2013 Date(s) Reviewed(r)/Revised(R): Page 1 of 2 Do Not Use Dangerous Abbreviations, Symbols and Dose Designations The abbreviations, symbols, and dose designations found in this table have been reported as being frequently misinterpreted and involved in harmful medication errors. They should NEVER be used when communicating medication information. Abbreviation Intended Meaning U unit IU international unit Abbreviations for drug names QD QOD Every day Every other day OD Every day OS, OD, OU Left eye, right eye, both eyes D/C Discharge cc cubic centimetre ISMP Canada July 2006 µg microgram Symbol Intended Meaning @ at > < Problem Mistaken for “0” (zero), “4” (four), or cc. Mistaken for “IV” (intravenous) or “10” (ten). Misinterpreted because of similar abbreviations for multiple drugs; e.g., MS, MSO4 (morphine sulphate), MgSO4 (magnesium sulphate) may be confused for one another. QD and QOD have been mistaken for each other, or as ‘qid’. The Q has also been misinterpreted as “2” (two). Mistaken for “right eye” (OD = oculus dexter). Correction Use “unit”. Use “unit”. Do not abbreviate drug names. Use “daily” and “every other day”. Use “daily”. May be confused with one another. Use “left eye”, “right eye” or “both eyes”. Interpreted as “discontinue whatever medications follow” (typically discharge medications). Use “discharge”. Mistaken for “u” (units). Use “mL” or “millilitre”. Mistaken for “mg” (milligram) resulting in one thousand-fold overdose. Use “mcg”. Potential Problem Correction Mistaken for “2” (two) or “5” (five). Use “at”. Greater than Less than Mistaken for “7”(seven) or the letter “L” . Confused with each other. Use “greater than”/”more than” or “less than”/”lower than”. Dose Designation Intended Meaning Potential Problem Trailing zero X.0 mg Decimal point is overlooked resulting in 10-fold dose error. Never use a zero by itself after a decimal point. Use “X mg”. Lack of leading zero . X mg Decimal point is overlooked resulting in 10-fold dose error. Always use a zero before a decimal point. Use “0.X mg”. Correction Adapted from ISMP’s List of Error-Prone Abbreviations, Symbols, and Dose Designations 2006 Institute for Safe Medication Practices Canada Institut pour l’utilisation sécuritaire des médicaments du Canada Permission is granted to reproduce material for internal communications with proper attribution. Download from: www.ismp-canada.org/dangerousabbreviations.htm Page 2 of 2