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MOHAMMED E. ABUSHAIQA, PHARM.D., is Assistant Director, Medication Department, Medical Supply, General Administration of Medical Services Ministry of Interior, Riyadh, Saudi Arabia; when this study was conducted he was Pharmacy Practice Management Resident, Detroit Receiving Hospital (DRH)/University Health Center (UHC), Detroit, MI. FRANK K. ZARAN, B.S.PHARM., is Clinical Pharmacist Specialist, Drug Information Services, Department of Pharmacy Services, DRH/UHC. DAVID S. BACH, PHARM.D., M.P.H., FASHP, is Executive Director, Pharmacy Services, Detroit Medical Center (DMC), and Director, Pharmacy Services, DRH/UHC. RICHARD T. SMOLAREK, M.S., is Director of Pharmacy, Department of Pharmacy Services, Children’s Hospital of Michigan, Detroit. MARGO S. FARBER, PHARM. D., is Manager, Drug Information/Drug Use Policy, DMC.

Address correspondence to Dr. Abushaiqa at the Medication Department, Medical Supply, General Administration of Medical Services Ministry of Interior, Riyadh 11492, Saudi Arabia (alsharif3{at}yahoo.com).

Purpose. Educational interventions to reduce the use of abbreviations and dosage designations that were deemed unsafe at a level 1 trauma center are described. Summary. Strategies to reduce the use of unsafe abbreviations at Detroit Receiving Hospital were studied. Six abbreviations and dosage designations were deemed as unsafe by the site’s medication-use and patient medical safety committees: (1) U for units, (2) µg for microgram, (3) TIW for three times a week, (4) the degree symbol for hour, (5) trailing zeros after a decimal point, and (6) the lack of leading zeros before a decimal point. Data on abbreviation use was collected starting in September 2003 by examining copies of patients’ order sheets, which are sent from nursing units to the pharmacy for processing. Data were collected during three 24-hour periods each month, with 7–10 days between each period. A data collection sheet was developed to assist in documenting the number of opportunities for each unsafe abbreviation and the actual incidence of each. Educational strategies were developed and implemented starting in October 2003 to decrease the use of the unsafe abbreviations. These strategies included inservice education programs for the medical, pharmacy, and nursing staffs; laminated pocket cards; patient chart dividers; stickers; and interventions by pharmacists and nurses during medication prescribing. During the eight-month evaluation period, 20,160 orders were reviewed, representing 27,663 opportunities to use a designated unsafe abbreviation. Educational interventions successfully reduced the overall incidence of unsafe abbreviations from 19.69% to 3.31%. Conclusion. Educational interventions markedly reduced the use of unsafe abbreviations in medication orders over an eight-month evaluation period. Index terms: Abbreviations; Dosage; Education; Errors, medication; Health professions; Hospitals

 

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