Old abbreviations now passe?

Specialties Med-Surg

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I just heard from a friend that, in nursing school nowadays, nurses are no longer taught things like "b.i.d." "q.i.d" "q6h" "h.s" and things like that--that, in fact, it is now required that, in nursing notes and even on the part of the physicians writing orders, that the actual phrase be written out--"twice a day" "evey 6 hours" or "at hour of sleep, before bedtime, or at 10 p.m." (choose the most appropriate)

Have those of you who work med-surg noted this to be true on your post-op patients? If so, when did it all start, and do you know if it was a JCAHO patient safety decision?

I am curious as to whether it affected other commonly used abbreviations, as well. For example, do the dosc now write "anti-embolic stockings" instead of simply "TEDS" and instead of writing "SCDs" do they actually write out "sequential compression devices?" Do they write out "arterial blood gases" instead of "ABGs?" "Complete blood count" instead of CBC? Just curious as to the exact rules, if any, involving this "no abbreviations" trend, and if it has changed your OWN charting practices.

I was reviewing a chart the other day in which "PAS" was written on a line in which another order was crossed out. At first I thought it was the initials of the person who crossed out the order, but on closer inspection I saw that HIS initials were "PAC."

Since it was critical I know for sure what this meant, yet never having seen the term "PAS" I called a nurse friend in the state in which the chart originated. She knew right away--it stood for "Pneumatic antiembolic stockings." "Whoda thunk it"--certainly not anybody in MY neck of the woods. We call them SCDs or ICDs (intermittent compression devices) or simply "compression pumps" out here.

Anybody else know them as "PAS?"

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Specializes in LTC, assisted living, med-surg, psych.

JCAHO has indeed determined that such abbreviations as "MS04" or "MS" (for morphine sulfate) and "u" for units should not be used. Too many errors have been made due to incorrect interpretation of certain abbreviations.......some of the others are "QOD/QID/QD" etc. and "HS". We have had to start writing these out, and the word on the street is there may be more coming down the pike soon.

Personally, I think patients would be better served if the dang MDs were forced either to write legibly or do all their orders on the computer.....but I'm a nurse, what the hell do I know? :uhoh3:

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We have stickers on the inside of all the charts reminding us to write discharge or discontinue rather than "d/c", and morphine instead of "ms", among a few others. I see PAS on many charts, but it means something was signed by a PA student. And the stockings, we call 'em SCD's or sequentials. I agree that some abbreviations can be dangerous, but when you have to write so much when you're pressed for time, it's hard not to do it. This will be a hard habit to break.

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Just something else a nurse will have to learn once they get out of school. I really don't think the abbreviations used by Dr.'s will go away any time soon. There are way to many who have used them their entire career to stop now. I even run into a few that still use the apothecary system occasionally.

bob

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Specializes in Nursing Education.

The physicians are going to have to comply with this initiaitive just like everyone else in the health care field. If the physicians do not comply, Joint Commission will make life and fines on the hospital so significant that the hospitals will force physician compliance.

Besides, with all the studies and research that proves these abbreviations are a patient safety issue, I can't imagine anyone who would purposefully or willfully want to do something that might even suggest a probelm for patient safety, even if they are stubborn to change.

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They're still teaching those abbreviations at my school, although I have seen the notices not to use them at hospitals.

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

Patrick, I totally agree that this is needed desperately.What kind of pressure on the physicians? Can JCAHO fine them? The hospitals aren't going to stand up to the very doctors who bring them money are they?

Admittedly it's been awhile for me, but last I heard nurses were still trying to translate chicken scratch orders, find out WHO wrote them and then discover a beeper or callback number to clarify what was written.

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certain abbreviations have been tied to patient injury and death. MDs and others no longer have the excuse of "I've always done it this way" since federal guidelines prohibit certain abbreviations. How can they stand up in court and say"I know it was not allowed but did it anyway and I am sorry Ms. Jones died as a result"? Will just have to be a few well-publicized lawsuits to make it stick I guess.

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Specializes in Neurology, Neurosurgerical & Trauma ICU.

According to our policy, we have to use:

"morphine" instead of MSO4

"magnesium" instead of Mg

"Units" instead of U

Also, I just saw where we're supposed to start using "every day" or "every other day" instead of "QD" because it gets confused with QOD. The docs don't follow this one yet though.

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Specializes in OR Hearts 10.

personally, i think patients would be better served if the dang mds were forced either to write legibly or do all their orders on the computer.....but i'm a nurse, what the hell do i know? :uhoh3:

i've got to agree with you on that one

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Specializes in Psych, Psych and more Psych.

Does JCAHCO really assess fines? I thought they were an accrediting body, not a regulatory body. I would think they could pull certification, but monetary fines? Just curious, as I don't know much about "Jay-co".

Thanks,

Mary

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Specializes in Med Surg/Tele/ER.
I just heard from a friend that, in nursing school nowadays, nurses are no longer taught things like "b.i.d." "q.i.d" "q6h" "h.s" and things like that--that, in fact, it is now required that, in nursing notes and even on the part of the physicians writing orders, that the actual phrase be written out--"twice a day" "evey 6 hours" or "at hour of sleep, before bedtime, or at 10 p.m." (choose the most appropriate)

Have those of you who work med-surg noted this to be true on your post-op patients? If so, when did it all start, and do you know if it was a JCAHO patient safety decision?

I am curious as to whether it affected other commonly used abbreviations, as well. For example, do the dosc now write "anti-embolic stockings" instead of simply "TEDS" and instead of writing "SCDs" do they actually write out "sequential compression devices?" Do they write out "arterial blood gases" instead of "ABGs?" "Complete blood count" instead of CBC? Just curious as to the exact rules, if any, involving this "no abbreviations" trend, and if it has changed your OWN charting practices.

I was reviewing a chart the other day in which "PAS" was written on a line in which another order was crossed out. At first I thought it was the initials of the person who crossed out the order, but on closer inspection I saw that HIS initials were "PAC."

Since it was critical I know for sure what this meant, yet never having seen the term "PAS" I called a nurse friend in the state in which the chart originated. She knew right away--it stood for "Pneumatic antiembolic stockings." "Whoda thunk it"--certainly not anybody in MY neck of the woods. We call them SCDs or ICDs (intermittent compression devices) or simply "compression pumps" out here.

Anybody else know them as "PAS?"

I am in my first semester of nursing and we are taught abbreviations. We are also being taught if you cannot read a doctors orders or do not understand what is written CALL the doctor. Do not guess and if the doctor gets upset too bad, he should make things clear as someones life could depend on it.CRB613

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