Impact of 'Never Use' Abbreviations (Error-Prone Abbreviations-EPA's) List on the Incidence of EPAs in Inpatient Medical Prescriptions in Apex Tertiary Care Public Hospital in India.

Abstract

The aim of the study was to assess the impact of never-use list and standardized abbreviations on error prone abbreviations. Abbreviations are commonly used in medical records to save time and space but use in prescriptions, which can lead to communication failures and preventable harm. Prescriptions need to be clear for correct interpretation. Hospitals should implement uniform use of approved abbreviations, such as an approved list or never-use list of abbreviations and symbols. In the hospital under study, there was no system of avoiding error prone abbreviations while prescribing any medication. Hence, an interventional study was performed to quantify and reduce the incidence of error prone abbreviations. The main objectives were to determine the incidence of error prone abbreviations, development and implementation of 'Never-use' list and standardized abbreviations and finally determine its effectiveness in reducing the error prone abbreviations in the prescriptions. The study design was pre-post interventional / quasi-experimental design. The settings were inpatient wards of broad specialties of a tertiary care hospital. 'Never-use' list and standardized abbreviations were developed by review of relevant literature, existing lists by Institute for Safe Medication Practices and Australian Commission on Safety and Quality in Health Care compared against findings of the pilot study of prescriptions for error prone abbreviations and experts' input. Poster copies of the lists were affixed in inpatient wards, doctors were educated, and poster pamphlets were distributed. Pre-intervention data was collected by a retrospective closed in-patient medical record review. Post-interventional incidence of error prone abbreviations was determined, and the effectiveness of the same was assessed by using statistical analysis. The incidence of error abbreviations in inpatient prescriptions was 47.5%, and the 'Never Use' list of abbreviations led to a statistically significant reduction of error prone abbreviations by 8.2% from 47.5% to 43.6% (P\0.006). 'Never Use' lists are effective in reducing the incidence of common error-prone abbreviations, and discipline-wise variation is observed.