SWEDISH MEDICAL CENTER

During 2004 the Medication Variance Oversight Team and Pharmacy & Therapeutics Commit-tee reviewed a list of dangerous abbreviations, acronyms, and symbols. The Medical Executive Committee subsequently approved the list. JCAHO has changed the required “Do Not Use” list, and the upper table is SMC’s Official “Do Not Use” list*. The lower table lists recommended Do Not Use abbreviations, Acronyms and Symbols.

The following are Abbreviations, Acronyms, and Symbols are not to be used.

Do Not Use / Potential Problem / Use Instead
IU (for international unit)
U (for unit) / Mistaken as IV (intravenous) or 10 (ten) / Write “international unit”
Mistaken as zero, four, or cc / Write “unit”
QD
QOD
(Latin abbreviations for once daily & every other day) / Mistaken for QD. The period after the Q can be mistaken for an “I” and the “O” can be mistaken for an “I” / Write “daily“ or “every day” and “every other day”
Trailing zero (2.0 mg)
Lack of leading zero (.2 mg) / Decimal point is missed / Never write a zero by itself after a decimal point (2 mg), and always use a zero before a decimal point (0.2 mg)
MS
MSO4
MgSO4 / Confused for one another. Can mean morphine sulfate or magnesium sulfate / Write morphine for “morphine sulfate” or magnesium sulfate for “mag sulfate”

*Applies to all orders and all medication-related documentation that is handwritten (including free-text computer entry) or on pre-printed forms.

The following are Additional Abbreviations, Acronyms and Symbols

Discontinuance is recommended in medical records and on pre-printed forms.

Do Not Use / Potential Problem / Use Instead
< (less than) and
> (greater than / Symbol mistakenly used as opposite of intended meaning / Spell out
“less than” and “greater than” or
“above” and “below”
Abbreviations for drug names, such as MTX (Methotrexate) / Misinterpreted due to similar abbreviations for multiple drugs / Write drug names in full
gr. (grain) / Outdated; no drugs use this designation / DO NOT USE
m (Greek letter mu for micro) / Mistaken for milligram / Use “mcg” or “micrograms”

References: JCAHO 2005 National Patient Safety Goal 2b

ISMP – List of Error-Prone Abbreviations, Symbols, and Dose Designations, November 27, 2003

Revised: July 2005 John Zarek, RPh 386-2330