Poll: "Do Not Use List" of abbreviations

[soontobe_RN]

what do you think about the "do not use list" of abbreviations implemented by the joint commision in 2004?

information can be found at the address below.

http://jcsearch.jcaho.org/cgi-bin/msmfind.exe?query_encoding=utf-8&cfgname=mssfind.cfg&query=do+not+use+list&and_on=y&no_dl=x

once you get to this page click on:

2006 npsgs - goal 2 faqs

thank you for voting :)

[GrnHonu99, RN]

I am a student and we were told not to use these abbr's either...I know a nurse that misread an order that said 13U as 130...I guess she should have recognized the error but luckily someone caught her in time...if units had been written out maybe it would have helped...ive also been told that most hospitals are trying to move away from using cc and using ml...is this becuase cc can look like two zeros when written?

[soontobe_RN]

I want to thank everyone again for your imput and votes. I was curious to see what other nurses think about the "do not use list". I learned about the list from work.The nurses who work at the facility have posted the prohibited abbreviations on the wall around the medication dispensing area. Considering that I am currently taking medical terminology, I figured that my instructor would have said something about it. When I noticed that she was still teaching us these abbreviations, I decided to do my term paper for the class on the "do not use list". I mentioned my topic to her and she seemed very interested.

Overall, I have gatherd that most people in the medical field agree with JACHO decision on the list. From what I have read and heard, medication errors are one of the biggest problems in hospitals and facilities. If this list cuts down on how many errors occur, then it is definitly worth it. I also agree, though, that "you can't teach an old dog new tricks". Many of these doctors and nurses have been using these abbreviations for years and years. For them to stop suddenly is nearly impossible. It is unfortuante that JACHO needs to make a list of what most of us feel would fall under common sense, however, common sense is less common then what we all think .

[grannynurse FNP student]

I initially thought it was dumb but then our pharmacist showed me studies where med errors went down drastically . . .so, I'm all for it.

steph

I would be interested in viewing these studies. Are they peer reviewed and what journals were they published in?

Grannynurse :balloons:

[UnewmeB4]

I was at a seminar several years ago when the head of the IMSP gave a seminar on drug errors. It was quite impressive. They are the ones who let drug companies know if they are coming out with a new drug that their is already a similar sounding name, and it would be best if they gave it a different name. They also send out bullitens to inform hospitals of recent errors found in administering medications. They work with drug companies to change packaging, to prevent errors. Our pharmacy will not fill any orders with unapproved abbreviations. We have bright orange stickers on the front to remind the Docs. They are learning!

[milestogo/homenurse]

it was hard to embrace the do not use list, but now that i've broken my old habits, i realize that i am a better nurse to my patients. it has helped me to keep my patient discharge instructions in the patient's language, and not my medical abbreviation language. i am much more aware as i enter medication orders/ a true benefit for my agency that has computerized documentation is that our medication teaching tools now print out in the correct format for the patient.

[VivaLasViejas, ASN, RN]

I still don't get why we have to use ml's instead of cc's, and I HATE writing everything out, but I can understand the reasons for most of the now-banned abbreviations.

Now, if we can just get the MDs to follow suit.......I really don't appreciate our hospital's policy of calling them for clarification orders on every little violation of the new rules "you did mean Morphine Sulfate, didn't you?" when I've got five gazillion other things to do. :stone

[GLORIAmunchkin72]

We are NOT supposed to accept anything we can't read. At least that's what we were taught in class.

I'm for it.

Now, if we could just have the docs write their names legible...we'd really be in business.

Hate finding a chart with orders and no one knows who wrote them and no one can decipher the signature or the writing as belonging to what doc.

[tntrn, ASN, RN]

"We are NOT supposed to accept anything we can't read. "

True: However, when you've worked with the same docs, in the same place, for anything over 5 years (and for some of us make that 20 years), you CAN read what they write. In the beginning, 2 decades ago, you clarified what each little squiggle of theirs meant, and from then on, you could read it.

For new people coming out of school, of course, it's no problem. They're learning abbreviations for the first time, and not ever using the old ones, (the ones that have been in use for 50 years or more. If anything, I think there's more poor attitudes now about clarifying now for use of an "illegal" abbrevation because it comes across as a scolding. In the past, we just called and asked them what they heck they meant, gave them some little chiding about rotten handwriting and went on with our jobs.

As pointed out by another poster, everybody now is supposed to be policing everybody else. Our JACHO visit is looming ahead and now we're all supposed to be policing everybody else's charting. Give me a break. Like we don't have enough to do on our own, doing our own work on our own shift. And what if we find something that was omitted? Maybe that person won't be at work again for a couple of days. That chart will be long gone. I personally refuse to chart someone else's omission; that would be falsification of a permanent record. I will call that nurse and bring it to their attention, but at that point, it's our of my hands.

I can see both sides to this Do Not Use thing, but I still believe it's not all it's cracked up to be, like much of the what JACHO spews.

[GLORIAmunchkin72]

Where I work there are always new faces, like agency nurses. We cannot assume that the same nurses are going to be working with the same doctors forever.

"We are NOT supposed to accept anything we can't read. "

True: However, when you've worked with the same docs, in the same place, for anything over 5 years (and for some of us make that 20 years), you CAN read what they write. In the beginning, 2 decades ago, you clarified what each little squiggle of theirs meant, and from then on, you could read it.

For new people coming out of school, of course, it's no problem. They're learning abbreviations for the first time, and not ever using the old ones, (the ones that have been in use for 50 years or more. If anything, I think there's more poor attitudes now about clarifying now for use of an "illegal" abbrevation because it comes across as a scolding. In the past, we just called and asked them what they heck they meant, gave them some little chiding about rotten handwriting and went on with our jobs.

As pointed out by another poster, everybody now is supposed to be policing everybody else. Our JACHO visit is looming ahead and now we're all supposed to be policing everybody else's charting. Give me a break. Like we don't have enough to do on our own, doing our own work on our own shift. And what if we find something that was omitted? Maybe that person won't be at work again for a couple of days. That chart will be long gone. I personally refuse to chart someone else's omission; that would be falsification of a permanent record. I will call that nurse and bring it to their attention, but at that point, it's our of my hands.

I can see both sides to this Do Not Use thing, but I still believe it's not all it's cracked up to be, like much of the what JACHO spews.

[tntrn, ASN, RN]

I agree with the agency nurse issue. However, most agency nurses I've worked with know how to roll with the punches and will ask for help when they need it.

This JACHO regulation is yet another example of lowering everybody to the lowest common denominator. Example: We live on a residential air strip. Some of the homeowners here do not own planes and are not pilots. Some are new pilots (200 hours or less.) Others, like my DH, are commericial pilots and have 20,000 hours, more or less, no including many hours in small aircraft. There have been occasions when the new pilots and even the non-pilots have tried to dictate what the seasoned pilots can and can't do, citing "safety." There you go, going to the lowest common denominator. That might be an extreme example, but I think it holds true in health care today, in some instances.

Many of my co-workers, and most of us are in the 45 and older place, are outright offended by all the "service excellence" cheerleading (as if we don't already do our utmost to give good care) and also the assumptions that we are too stupid, too inept and too incapable of making good decisions, which would include clarifying any order we could not read.

We had an interesting conversation just this week: at least 5 of us have various and sundry body ills: joints that don't want to work, bad backs, lifting issues, yada, yada, yada. Who's going to keep that place running when we're no longer able? This could happen sooner than we think. Very few of our staff is under age 30. In fact, I can think of 1 nurse at the present time. The rest of us are, as I mentioned, at least 40 and older. Administrations just assume we'll be there forever. This might seem to be a little off topic, but I don't really think so. All the "old" people have been doing a pretty great job doing what we do (at least I think so). And even though most of us fit into that older category, the newest and latest thinking is that things have to change to make it better, safer, blah, blah, blah. I have my doubts as you can see. Yes, we'll have to comply. That doesn't make it easy, or even a good thing. JACHO has way too much power. Just once I'd like to see a hospital put their administration foot down (like that will happen) and say, "nope, we're not doing that, because it has nothing to do with patient safety or anything else."

I'm going to start carrying my own water bottle in my oversized scrub jacket pocket, just so I can get a drink when I want one, without have to walk 100 yards. They haven't outlawed that yet. I guess when they do, you can blame me :chuckle :chuckle :chuckle :chuckle

[milestogo/homenurse]

jacho and medicare surveys can be incredibly difficult,but i thinks its important to rember that these are meant to improve patient care and safety; i've seen it happen in my job/agency.

the new PPS system that home health has learned to deal with because of medicare has forced agencies to identify their deficiencies and make it better....its out there on the web sites for all to see when you're the agency that is below national averages for wound healing/improved medication proficiency etc.

i am a better nurse for making changes as risky practice is found. i'm not a new nurse....i've been doing this for 20 years. old habits are hard to break, but its important that we do a better job of educationing our patients and keeping them safe, not just getting them well enough to go home.

jacho identifies patient safety needs/goals every year. this is not something that will go away. i can either use my energy to embrace or fight the change.

[soontobe_RN]

I agree with mostly everything everyone is saying. The "Do not use list" will benefit us, doctors and mainly the pts, in the end. I also agree that much of what is on this list is common sense, but as I said in a previous post, "common sense is less common than we all think", and due to that fact, we need to take any and all measures possible to ensure pt safety.

I do understand that it is hard to break the habit of using these abbreviations. Truthfully, I decided to due a paper on this for class b/c my instructor is still teaching these prohibited abbreviations and the class is medical terminology. So, why is she teaching us to use something that is prohibited. I guess it is good to know them all sense many physicians are still using them.

Here's my problem with all of this:

B/c medical facilities, hospitals, and dr. offices are so worried about being sited, they are having nurses take time away from their pts just to double check other nurses MARs. How is that going to benefit the pt??? The whole idea of JACHO enforcing this list, was to try and reduce the amount of med errors that occur for the pt safety. But, instead it is causing the facilites to be more concerned about being sited, rather than their pts. At least this is the way it is at my work and it sounds like some of yours.

I definitly do not agree with signing off or fixing anything on a MAR for someone else. AS another poster pointed out, doing that is false documentation on a permenent and legal document. That could cause someone to lose their license over. I actually had a nurse at my work tell us(Med aids) to do this. Of course, being a nursing student, I immediatly spoke up and said "Heck no!!!" and then explained my reason of why I will not do it. Well, .. they could not argue with me b/c they knew I was right.

Through of this, though, my biggest problem is reading what the doctors write, even if they don't use abbreviations. Most of their hand writing is unreadable. Can't JACHO do something about that, besides making us call and confirm everytime?