How to Eliminate “Do Not Use” Abbreviations

Abstract

Our facilities are aware of and have tried to eliminate the use of ambiguous, error-prone abbreviations, symbols, and dose designations identified by The Joint Commission (formerly the Joint Commission for the Accreditation of Healthcare Organizations) and the Institute for Safe Medication Practices (ISMP)1,2 because using them is dangerous. Errors caused by ambiguous abbreviations also were discussed extensively in an Institute of Medicine (IOM) report.3 However, these abbreviations still crop up with alarming frequency. How can we put an end to them? Americans love abbreviations-you'll find them everywhere, from their license plates to their e-mails. In medicine, abbreviations are in part necessary to compensate for heavy workloads, and in part used because of powerful tradition and the unique dialect of medical culture. In fact, some abbreviations are so ingrained that health care professionals use them in notes to themselves, casual correspondence, and personal to-do lists. Much of the medical shorthand used in prescribing dates back to the 1400s, when Latin was used as a universal language. As a dead language (a language with no native speakers), it was exact in its meaning and unlikely to be misinterpreted. Many health care providers, having used these abbreviations for decades, are unwilling or reluctant to change.