The results of a Joint Commission study that highlights the detrimental impact of the use of abbreviations on patient safety were lauded by hospital industry representatives, despite the study's reliance on a small sample size.
Handwritten prescriptions with abbreviated orders are quick, "but may not be the safest" method, said Nancy Foster, vice president of quality and patient-safety policy at the American Hospital Association.
The "Impact of Abbreviations on Patient Safety" report stated about 5% of all errors named in the national medication error-reporting program Medmarx between 2004 and 2006 were attributed to abbreviations. Over that same time, hospital compliance with the commission's "do not use" list of abbreviations fell to 64% from 75%.
"Armed with the understanding that communication is the leading cause of sentinel events and that abbreviation use hinders communication, limiting abbreviation use improves patient safety and patient care, the commission said in its report, published in the September issue of the Joint Commission Journal on Quality and Patient Safety.
Researchers studied 643,151 total medical errors reported through Medmarx. Of those, 29,974 errors, or 4.7% were made because of abbreviation use; however, the commission analyzed only 18,153 of those errors because of missing information from reporting organizations for 11,821 of the errors. Using only the smaller sample size shows that 2.8% of errors reported were attributed to abbreviation use.
Regardless, this is the first report that has shown the effect of abbreviation use and it reinforces to clinicians that poor communication risks patient safety, Foster said.
The abbreviation most frequently associated with errors was "QD," substituted for "once daily"one of the shortcuts on the "do not use" list, according to the report. The second in the ranking is "U," often used in place of unit, which also appears on the list.
People need to see the results of their behavior changes in order to see the value of that change, Foster said. If people dont see the impact "they'll go back to their old habits; it's kind of human nature."
The report notes that "Although the use of abbreviations may be more time-efficient, error-prone abbreviations are preventable and therefore are a logical area for improvement."
Electronic health records and electronic medication orders can help in that regard, Foster said. Hospitals are aspiring to implement electronic data and eliminate handwriting altogether. "Simple human error can be avoided" that way, she said.
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