We asked accredited organizations how they have implemented the prohibited abbreviations requirement for National Patient Safety Goal 2b. We received more than 100 responses, including lots of good ways to share the list of prohibited abbreviations and to achieve consistent compliance. Here's how some organizations are effectively communicating their prohibited abbreviations list to staff:
- Print list on brightly colored paper/post-it notes/posters/stickers/magnets and place in medical records/patient charts, place at/on/near computers, and post in patient care areas.
- Provide pocket-sized cards with the list to staff.
- Print the list in the margin or bottom of the physician order sheets and/or progress notes.
- Attach laminated copies of the list to the back of the physician order divider in the patient chart.
- Delete prohibited abbreviations from preprinted order sheets and other forms.
- Create clipboard cover that provides the list.
- Provide the list on the front page of the intranet.
- Provide a card with the list that can be attached to the back of the identification badge.
- Place tent cards with the list where physicians write orders and dictate.
- Have the list printed on pens.
- Send monthly reminders of the list to staff via computer.
- Educate and monitor staff who document in the medical record.
- Create an educational display for use during Patient Safety Awareness Week.
- Educate affiliated health care professional education programs about the list.
- Place articles in employee and physician newsletters.
- Provide mouse pads with the list.
- Convene regional/community meeting to develop consistent list for physicians who maintain privileges at two or more facilities.
- Direct pharmacy not to accept any of the prohibited abbreviations. Orders with dangerous abbreviations or illegible handwriting must be corrected before being dispensed.
- Conduct a mock survey and question staff to test their knowledge.
- Work with software vendor to ensure changes are made to be consistent with the list.
- At every medical staff meeting, give patient safety updates, including information about the prohibited abbreviations.
- Identify and promote "Physician Champions" who support accreditation-related activities and advocate for full compliance with the NPSGs.
- Ask every staff person to sign a statement that he/she has received the list and agrees not to use the abbreviations.
- Create a catchy name or theme: Do the "Write" Thing; Dirty Dozen; Outlaw Abbreviations—Join the Patient Safety Posse; "Operation BANEM" (Banned Items); Uncle Sam-style poster saying "You can prevent a fatal error;" P.S. It's all about Patient Safety.
- Promote a "Do not use abbreviation of the month" campaign.
- Create a song incorporating the "do not use" list.
- Create a slide show/presentation illustrating poor handwriting and dangerous abbreviations. Include actual examples from your organization.
- Please feel free to use any of these practices that you feel may be helpful for your staff.