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


"BM +++" or ++ or whatever



1,246 Posts

Has 36 years experience.

Possibly 'very large'.


164 Posts

Specializes in LTC, Hospice, corrections, +.

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

6,931 Posts

Specializes in Acute Care, Rehab, Palliative.

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


13 Posts

Interesting... I have never seen that!


734 Posts

Specializes in Home health was tops, 2nd was L&D.

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". :D


337 Posts

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


277 Posts

Specializes in Med-Surg.

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).


12 Posts

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


122 Posts

Specializes in stepdown RN.

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.