Inappropriate Medical Abbreviations

The use of medical abbreviations in medicine is not new. Since the development of mainstream medicine nearly 200 years ago, abbreviations have been used. While initially, the abbreviations were limited to the writing of prescriptions, today, abbreviations have become very common in all aspects of medical documentation. Medical abbreviations are used in all medical and surgical departments, during surgery, in the emergency room, and at discharge. One area where medical abbreviations are used most often and are a cause for concern is when writing drug orders. Until recently, the use of abbreviations has never been regulated, and there is no universal rule as to which abbreviations can be used and which ones cannot. In fact, over the past three decades, some healthcare workers have been making up abbreviations. The long-standing practice of writing medical abbreviations has become so entrenched in healthcare that even the most junior medical and nursing school graduates are accustomed to writing them. In fact, many healthcare institutions have specialized lists of abbreviations that can be used. The use of medical abbreviations is not only an American phenomenon but a global problem. For the past three decades, healthcare leaders have been encouraging less use or even eliminating medical abbreviations in medicine. The US Institute of Safe Medication Practices (ISMP) has regularly received a continual stream of reported errors, some of which have resulted in adverse events due to misinterpretation of some dangerous medical abbreviations. The Joint Commission has regularly issued updates and regulations on the safe use of medical abbreviations and, in fact, has also published a short list of dangerous medical abbreviations and dose expressions that should never be used. However, despite many key organizations condemning the use of medical abbreviations, they continue to be used at an alarming rate. Medical abbreviations are almost routine in any medical chart or drug prescription. This can often place junior healthcare staff who are supposed to decipher the drug orders at significant risk because often the healthcare provider who writes the medical abbreviations may not be around, and the junior staff or nurse may use their limited knowledge to determine what the abbreviations exactly mean. The other alternative is to refuse to carry out any order where the abbreviations do not make sense, but this refusal can also jeopardize a patient's healthcare. Now, with a more formalized practice of medicine, there is a concern that the rampant use of medical abbreviations may pose a danger to the patient. While there are anecdotal examples of medical abbreviations that have caused harm to a few patients, good clinical evidence to support the belief that medical abbreviation use is dangerous or is causing problems in the delivery of standard of care is lacking. In any case, the potential for harm to the patient from improper communication due to medical abbreviations cannot be understated.