In May 2005, The Joint Commission affirmed its “do not use” list of abbreviations (see next page). The list was originally created in 2004 by The Joint Commission as part of the requirements for meeting National Patient Safety Goal Requirement 2B (Standardize a list of abbreviations, acronyms and symbols that are not to be used throughout the organization). Participants at the November 2004 National Summit on Medical Abbreviations supported the “do not use” list. Summit conclusions were posted on the Joint Commission website for public comment. During the four-week comment period, the Joint Commission received 5,227 responses, including 15,485 comments. More than 80 percent of the respondents supported the creation and adoption of a “do not use” list. However, the field was less supportive of additions to the list. While no additions will be made to the “do not use” list at this time, the following items will be reviewed annually for possible inclusion as part of the development of future Joint Commission NPSGs:
The symbols “>” and “<”
All abbreviations for drug names
Apothecary units
The symbol “@”
The abbreviation “cc”
The abbreviation “μg”
For accreditation purposes, the official “do not use” list applies, at a minimum, to all orders and all medication-related documentation that is handwritten (including free-text computer entry) or on pre-printed forms. This requirement does not currently apply to preprogrammed health information technology systems (for example, electronic medical records or CPOE systems), but remains under consideration for the future. Organizations contemplating introduction or upgrade of such systems should strive to eliminate the use of dangerous abbreviations, acronyms, symbols, and dose designations from the software.
About the National Summit
This special one-day Summit brought together representatives of more than 70 professional societies and associations and special interest groups to discuss medical errors related to the misuse and misinterpretation of abbreviations, acronyms, and symbols. The objective of the Summit was to reach consensus on the scope and implications of this serious and complex problem and to find reasonable solutions using all of the evidence at hand and in the most dispassionate way possible. The National Summit on Medical Abbreviations was hosted by The Joint Commission with its co-conveners American College of Physicians, American College of Surgeons, American Dental Association, American Hospital Association, American Medical Association, American Society of Health-System Pharmacists, Institute for Safe Medication Practices, and United States Pharmacopeia. Approximately 50 professional societies and associations and selected interest groups participated in the Summit representing every perspective.
Background
In 2001, The Joint Commission issued a Sentinel Event Alert on the subject of medical abbreviations, and just one year later, its Board of Commissioners approved a NPSG requirement to develop and implement a list of abbreviations not to use. Failure to substantially eliminate the use of “do not use” abbreviations in medication orders remains one of the most frequent non-compliance findings during Joint Commission surveys. During 2006 surveys, approximately 22 percent of accredited organizations were found to be out of compliance with the abbreviations requirement.
For more information
Visit http://www.jointcommission.org/PatientSafety/DoNotUseList/, contact the Standards Interpretation Group at (630) 792-5900, or complete the Standards Online Question Submission Form.