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

[seks]

"BM +++" or ++ or whatever

???

[canesdukegirl, BSN, 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.

That was my first thought as well. We use what looks like a lower case t with a dot on top to abbreviate 1, 2 and 3. It is beyond me why anyone would use +++ to abbreviate 3, but I have seen it.

[mpccrn, BSN, RN]

Who knows? I've never seen it on any acceptable abbreviations list.

[GHGoonette, BSN, RN]

It's actually a hangover from the "dinosaur days" when the + signs were used to indicate quantity; for example, bleeding + meant that bleeding was visible but minimum. ++ was still within accepted levels, but +++ was potentially dangerous, active bleeding. There was no 4 plus or above, because by then your patient was bleeding to death.

And no, it's not accepted practice, although you may find it (illicitly) used.