The joint commissions status update on how registered nurses, LPN, LVN, and other nursing fields should avoid the words listed in the article below, it outlines the “Do not Use” list for nursing and medical staff on charting. These abbreviations have been shown to be misread multiple times. Computerized charting has helped alleviate some errors from these written orders, however, not all facilities are computerized…yet.
Facts about the Official “Do Not Use” List
In 2001, The Joint Commission issued a Sentinel Event Alert on the subject of medical abbreviations, and just one year later, its Board of Commissioners approved a National Patient Safety Goal requiring accredited organizations to develop and implement a list of abbreviations not to use. In 2004, The Joint Commission created its “do not use” list of abbreviations (see below) as part of the requirements for meeting that goal. In 2010, NPSG.02.02.01 was integrated into the Information Management standards as elements of performance 2 and 3 under IM.02.02.01. Currently, this requirement does not apply to preprogrammed health information technology systems (for example, electronic medical records or CPOE systems), but this application remains under consideration for the future. Organizations contemplating introduction or upgrade of such systems should strive to eliminate the use of dangerous abbreviations, acronyms, symbols, and dose designations from the software.
|Do Not Use||Potential Problem||Use Instead
|U, u (unit)||Mistaken for “0” Mistaken for “0” (zero), the|
number “4” (four) or “cc”
|IU (International Unit)||Mistaken for IV (intravenous)|
or the number 10 (ten)
|Write "International Unit"
|Q.D., QD, q.d., qd (daily)|
Q.O.D., QOD, q.o.d, qod
(every other day)
|Mistaken for each other|
Period after the Q mistaken for
"I" and the "O" mistaken for "I
Write "every other day"
|Trailing zero (X.0 mg)*|
Lack of leading zero (.X mg)
|Decimal point is missed||Write X mg
Write 0.X mg
MSO4 and MgSO
|Can mean morphine sulfate or|
Confused for one another
|Write "morphine sulfate"
Write "magnesium sulfate"
1 Applies to all orders and all medication-related documentation that is handwritten (including free-text computer entry) or on pre-printed forms.
*Exception: A “trailing zero” may be used only where required to demonstrate the level of precision of the value being reported, such as for laboratory results, imaging studies that report size of lesions, or catheter/tube sizes. It may not be used in medication orders or other medication-related documentation.
While most acute care facilities must have computerized charting in place within the next couple of years, not all medical or skilled nursing facilities may have this done so soon. It is the hope that this list will help in the meantime to alleviate the use of dangerous acronyms.