Dangerous Abbreviations at Women’s College Hospital

By Gabriela Krnac and Stephanie Vidotto

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Dangerous abbreviations are abbreviations (shortened words, symbols and dose designations) that have been identified by the Institute for Safe Medication Practices (ISMP) Canada as easily misinterpreted or involved in medication incidents leading to harm and should be avoided in medication-related documentation. The “Do Not Use” ISMP list of dangerous abbreviations is posted on the Pharmacy Services intranet page available here. Examples from the list include: U or IU (for unit), D/C (for discharge), cc (for mL) and trailing or lack of leading zeros. 

All clinicians need to be familiar with these abbreviations to ensure that they are not used in any form of written or electronic documentation including medication orders, general documentation (clinic notes, letters, etc.) for medication related communications, pre-printed forms, electronic order sets and pharmacy generated labels and forms. Due to the potential for harm with use of these abbreviations, the “Do Not Use” list of abbreviations is a Required Organizational Practice of Accreditation Canada. Click here for the QTip.

As part of the WCH Dangerous Abbreviations Documentation policy document, the use of dangerous abbreviations and policy compliance is audited by Pharmacy Services and Professional Practice staff. The Professional Practice staff audit abbreviation use in general documentation for a subset of patient charts biannually. The annual audit completed by Pharmacy Services staff analyzes the frequency of dangerous abbreviations used in medication orders entered in Epic. The frequency of dangerous abbreviations used in medication orders has declined with the shift to computerized provider order entry (CPOE), however there is still potential for entry of abbreviations in select fields that allow free text entry. Based on the frequency of dangerous abbreviations identified through the audit, more frequent audits may be performed along with changes to practice in accordance with protocols established by WCH Pharmacy and Therapeutics committee.

The only approved abbreviations for medications at WCH are: ECASA for enteric-coated acetylsalicylic acid and ASA for acetylsalicylic acid. WCH staff are provided with education about the Do Not Use list during orientation and when changes are made. 

To find the approved abbreviations list for WCH, click here.

To access the WCH Dangerous Abbreviations Policy, click here.

To learn more about Accreditation, visit the Accreditation Intranet Hub.