What does "+++" mean in narrative charting?

merlee · Apr 13, 2011

Possibly 'very large'.

Hospice Nurse LPN, BSN, RN · Apr 13, 2011

or "several"

deyo321 · Apr 13, 2011

It could also denote UA dips that are grossly positive for blood, Leuks or bilirubin. That was what came to my mind first.

loriangel14, RN · Apr 13, 2011

It usually means several or lots of what they are referring. As in "pt agitated and calling out ++++ ".

rachmdav · Apr 13, 2011

Interesting... I have never seen that!

BrookeeLou_RN · Apr 13, 2011

When I have seen it.. it meant several. But it is not on any approved list by any place I have ever been and documentation should be such that no one needs to guess what it means. I mean really is it that hard to write "several" or "multiple".

barbyann · Apr 13, 2011

I have only seen it used in reference to edema 1+ 2+ 3+ 4+ / +, ++, +++, ++++

Phoenix Nurse · Apr 13, 2011

Shouldn't be using ++++++

Sarah010101 · Apr 13, 2011

Pitting edema 1+, 2+, 3+...... (i personally dont think its that effective... because how much 2+ is to one person, may differ from another persons perspective).

MoisesRN · Apr 13, 2011

First, it's not part of the conventional med. vocabulary.

However, in general interpretation, it means: a lot, more serious, bigger, ...etc

for example: up with max assist you may see "up with assist ++++..." or confused++++ for a pt highly confused. You can go on and on.

I must say that it's prohibited by JHACO

3dayRN · Apr 13, 2011

Do u mean when someone use dot with T underneath dot? I use this all the time. Each one is how many times. Such as one bm, two bm's etc. Don't know if this is what you mean or not. I use this on Dr orders also.