We all know (or should know) the medical abbreviations you're never supposed to use:
-- QD, QOD
-- trailing zero
-- MS, MSO4, or MgSO4
However, there are a few additional abbreviations that we're supposed to avoid because they might be confusing:
-- greater than or less than symbols
I actually was informed by a nurse once that I had to rewrite an order because I wasn't allowed to write "straight cath for volume > 300 ml". Apparently, this could have been mistaken for "straight cath for volume 7300 ml. Because that's a totally reasonable mistake that someone could make. Please straight cath patient if their bladder has 10 times more urine than a normal bladder can hold.
Of course, if your handwriting is crap, it doesn't really matter what abbreviations you use. When I was rotating through the ED, I got yelled at by an attending for writing an order to give a diabetic patient D5 NS. What did I actually write? 0.5L NS.
Trying hard to get @ out of my head whilst @ work ( sorry at ).ReplyDelete
Pharmacy hates calling about that stuff as much as you hate being called about it. I always feel like a douche. Me to nurse: "Can you write warfarin daily instead of warfarin QD." Nurse: "But you know what it means." Me: "Well, yeah, but you're not supposed to use it. It could be misread as QID or something." Nurse: "So you want me to rewrite the order, even though you know it's daily? [do you realize how busy I am, while all you do is sit up there in pharmacy and pick on me, implied]. Me: "It's a regulation, I'm not supposed to input it if . . . " Nurse:"What kind of pharmacist would give warfarin four times a day anyway? If you read it that way, you're the idiot." Me:ReplyDelete
But when I don't call, that's when my warfarin QD ends up in my boss's chart audits. I've yet to see an ambiguous abbreviation that doesn't become clear with the context, but I guess there's a reason for the rule.
I admit, I do like to call about naked decimals, just because I like to say accusingly, "Your decimal is NAKED." When I started, some couldn't remember which is wrong, 0.1 or .1, so when I accuse them of needed to cloth their naked decimal in a 0, they normally remember it, and probably remember that I'm an idiot.
I've had many, many cases where abbreviations were confusing. Example: we write "DAT" for diet as tolerated, but when someone wrote DAT meaning "direct antigen test", the nurses were very confused because they knew it didn't mean Diet as tolerated, fromthe context. And they can't read our minds. (although I'm amazed at how often they CAN). Anyway, I avoid abbreviations as much as possible. Except "mg" and "OD". I am NOT spelling out "milligrams" on every drug I order....ReplyDelete