Abbreviations and Acronyms in the Healthcare Industry Introduction The use of abbreviations and acronyms in healthcare has become an international patient safety issue. Common problems include ambiguous, unfamiliar, and look-alike abbreviations and acronyms leading to misinterpretation and medical errors. The patient’s safety is a common goal in every healthcare institution. One of the major issues in a patient safety is an error that can be caused by an abbreviation. The most common is medication errors. One of the most common but preventable causes of medication errors is the use of ambiguous medical notations.
Some abbreviations, symbols, and dose designations are frequently misinterpreted and lead to mistakes that result in patient harm. They can also delay the start of therapy and waste time spent in clarification. Body Q1 Patient safety and promotion of zero medication error are common goals in every healthcare institution, thus eliminating abbreviations can reduce life-threatening medical errors, and medication errors is the most frequent problem. A nurse administering the wrong dosage to a patient if the physician’s handwritten abbreviations are not clear can be lethal.
As well, when a patient is transferred from one care provider to another, if the medical records are written with abbreviations this could lead to tragic results. Thus providing clear, communication, unabbreviated prescribed prescriptions, reports, and records would greatly reduce medical errors. However eliminating all medical abbreviations would reduce errors but if abbreviations were eliminated it would make it very difficult on medical professionals who would have to write out very lengthy medical terms.
According to Dr. Darryl S. Rich, “to minimize the potential for error and to maximize patient safety, prescribers need to avoid such specifically dangerous abbreviations and phrases. ” (www. jointcommission. org/SentinelEvents/SentinelEventAlert/sea_23. htm) A reality of healthcare today is the specialized nature of individual services and disciplines. A study in the United Kingdom examined physicians’ understanding of Ear, Nose, and Throat (ENT) surgical abbreviations (Das-Purkayastha, McLeod, ; Canter, 2004).
Physicians-in-training who rotated among specialties, but were not familiar with otolaryngology, completed a questionnaire to determine knowledge of their specialized abbreviations. Six of the 13 commonly used abbreviations were unclear to 90% of these doctors in other specialties. This has similar implications for nurses floating from one unit to another. What is obvious to one specialty may be obscure to another. House staff travel also among various institutions in the same city or region and may leave a legacy of new and unfamiliar abbreviations for the next generation to decipher (Calfee, 1997).
They also may be interpreted based on knowledge gained in another specialty, therefore qualifying them as ambiguous. Using a global example, many abbreviations used in the United Kingdom routinely, for example CP for Crystalline Penicillin, would take on other meanings in the United States. Cheng (1999) suggests that the use of acronyms has become such a competitive game that the clinical trial may be named to match a clever acronym already created. Q2 The JCAHO (Joint Commission on Accreditation of Healthcare Organizations) has recently mandated the accredited organizations to develop and enforce a sure list.
Many organizations are developing written policies stating which abbreviations should not be used and medical professionals are trained to write legible when using other abbreviations. The Joint Commission has come up with a do not use list. (www. jointcommission. org/PatientSafety/DoNotUseList) JCAHO provides institutions with a list of dangerous abbreviations that should be avoided in clinical documentation. Moreover, the Institute for Safe Medication Practice also promotes the consistent application of not using specified abbreviations to prevent errors.
The policy recommends not using abbreviations, symbols and acronyms in medical communication. The use of the said policy is of great advantage to the healthcare system. First and foremost, it ensures patient safety because of the prevention of errors. Secondly, it promotes safe and efficient communication between the health care team. Studies have shown that the use of abbreviations/ acronyms or symbols in medical communication had been one of the reasons of medication errors. Commonly, abbreviations are misinterpreted that leads to unsafe health practice.
Aside from the available policy from the JCAHO, an extensive written policy regarding the said issue should be researched and accomplished. Corresponding sanctions should also be created if the policy is not followed. An extensive policy will result to better outcomes. Q3 According to the ISMP (Institute For Safe Medication Practices), abbreviations should never be used in “external communication, telephone/verbal prescriptions, computer generated labels, labels for drug storage bins, medication administration records, as well as pharmacy and prescriber computer order entries.
However, abbreviations are acceptable on internal communication and documentation. I think as long as 1) most people would know what you meant by an abbreviation and 2) if you write it sloppily it won’t be mistaken for something else (O for 0, or QID for QD) you can use an abbreviation. It saves time for many people. Abbreviations are acceptable when you’re writing or speaking informally. But when you are trying to be clear when speaking, or when you are writing formally, it is better to not use abbreviations. Try to confirm if others correctly understand the abbreviation written. (www. boston. om/jobs/healthcare/oncall/articles/2008/04/10/in_other_words) Q4 Furthermore, the “do not use abbreviation “policy is not enough to prevent medication errors. Along with the use of the policy, proper information dissemination and adequate education of the health care members should be enhanced. I strongly believe that posting the list of the said abbreviations in nursing units, bulletin boards and the internet is not enough to fully stop errors. Provision of teachings and ensuring that all medical staff are fully oriented and are following the policy are ways to prevent errors due to usage of abbreviations.
Also, regular evaluation of the adherence to the policy should also be done. Memos should be given to medical members not following the policy. Strict application of the policy should be implemented so as to prevent lapses in the adherence to the policy. The JCAHO and the ISMP have taken the big step to reduce errors caused by the use of abbreviations, symbols and acronyms. However, it is important that proper education be given to the health care members and frequent evaluation be done. Additionally, it is also a responsibility of the health team to strictly adhere to the policy.
Since the policy was started, it is also recommended that a more extensive and an updated additional written policy be carried out. Only the facilities that have JCAHO accreditation are going to the “do not use” list. Small hospitals and clinics that are not accredited do not have anyone to prevent them from using dangerous abbreviations. We should have national standards that all medical personnel must follow when documenting and using abbreviations. There should be sanctions placed against those who do not follow the standards. ————————————————-
Various methods are being used in order to improve the reduction of medical errors, one way is Using a Bar-Coded Medication Administration System(Julie Sakowski PhD, http://ww w. medscape. com/viewarticle/519719_2), the computer prescription the MD can send the script via computer to the pharmacy. Also computer orders are being done in most hospitals so nurses can read the orders without trying to decipher. Also pharmacy has look alike sound alike alerts so when a nurse takes out a medication they go through a variety of safety steps making sure the correct med is being given.
Further steps need to be done by reducing the nurse patient ratio so the nurse can have more time to give meds safely with instruction on use and side effects. More education is needed for patients to take medications safely at home. ————————————————- Conclusion ————————————————- I believe eliminating abbreviations can in-fact reduce errors, but it could also increase confusion. Since many of the words used in the medical field are Latin derivatives, spelling the words correctly could become an issue.
The doctors and medical professionals should be well versed in the medical translation, but for the average person it is a little more complicated. Abbreviations, if used, should be chosen carefully since we now live in a world full of abbreviations and acronyms. ————————————————- When a report is written or notes made in medical file abbreviations should not be used. Also if a patient should receive information regarding a medication or diagnosis they should be given both the full spelling and pronunciation of the words along with the popular abbreviation.
Any and all policies within the medical field should be universal, standards should remain high for medical personnel, and they hold a lot of the public’s trust and should be accountable for the diagnosis and action relating to any patients needs. ————————————————- References 1. Acronyms and initialism. (2006). http://en. wikipedia. org/wiki/Acronym 2. American Psychological Association. (2002). Publication manual of the American Psychological Association (5th ed. ). Washington, DC: Author. 3. Calfee, B. (1997). Abbreviations that cause injury, complicate communication and may kill!
The Director, 5(4), 128. 4. Cheng, T. (1999). Acronyms of clinical trials in cardiology-1998. American Heart Journal, 137, 726-765. 5. Das-Purkayastha, P. , McLeod, K. , & Canter, R. (2004). Specialist medical abbreviations as a foreign language. Journal of the Royal Society of Medicine, 97, 456-457. 6. Fred, H. , & Cheng, T. (2003). Acronymesis: The exploding misuse of acronyms. Texas Heart Institute Journal, 30(4), 255-257. 7. Institute for Safe Medication Practices. (2001). Please don’t sleep through this wake-up call. ISMP Medication Safety Alert; http://www. smp. org/ Newsletters/acutecare/articles/ 20010502. asp 8. Institute for Safe Medication Practices. (2002). Eliminating dangerous abbreviations and dose expressions in the print and electronic world. http://ismp. org/ Newsletters/acutecare/articles/ 20020220. asp 9. Institute for Safe Medication Practices. (2004). Hospital and medical staff leadership is key to compliance with JCAHO dangerous abbreviation standard. http://www. ismp. org/Newsletters/acutecare/articles/20040812_2. asp? ptr=y 10. Institute for Safe Medication Practices. (2005). ISMP’s list of rror-prone abbreviations, symbols, and dose designations from www. ismp. org/PDF/ErrorProne. pdf 11. Joint Commission International Center for Patient Safety. (2006). Implementation tips for eliminating dangerous abbreviations; http://www. jcipatientsafety. org/show. asp? durki=9733&site=164&return=9335 12. Julie Sakowski PhD, http://ww w. medscape. com/viewarticle/519719_2), 13. Madison Patient Safety Collaborative. (2006). Eliminating the use of dangerous abbreviations. http://www. madisonpatientsafety. org/projects/abbreviations. htm 14. Scribal abbreviations. (2006, February 22). ttp://en. wickepedia. org/wicki/ Scribal_abbreviation 15. The American Heritage Dictionary of the English Language (4th ed. ). (2000). Boston: Houghton Mifflin. 16. The Joint Commission on Accreditation of Healthcare Organizations. (2006). Facts about the official “do not use” list; http/www. jcaho. org/PatientSafety/DoNotUseList/facts_dnu. htm 17. The Journal of the American Medical Association. (2007, August 3, 2007). Instructions for authors. http://jama. ama-assn. org/misc/ifora. dtl ————————————————- ————————————————-