The use of abbreviations is a special area of concern because many errors have been attributed to the improper use or understanding of abbreviations. In response, the Joint Commission discourages the use of abbreviations and has

established a list of “Do not use” abbreviations an may be included on the “do not use”have list in established lists of approved abbreviations, but the reality is that most lists are

quite long and contain many abbreviations that are not commonly used. A better approach is to use the current list without definitions as a test to determine which terms are most useful and understandable. All staff members or a selected number from different departments can be asked to define the terms on the approved list, and then a new and more usable list can be created from those with the highest recognition factor. Problems are often encountered with use of periods, as some people write them carelessly as slash marks when writing quickly, and these can be misinterpreted as letters or numbers.

Problems can arise if prescribing physicians refuse to comply with the do-not-use restrictions. The nurse is not responsible for monitoring the behavior of prescribers or for correcting them, but nurses should report failure to comply to nursing administration, which in turn can take the issue to medical staff leadership because compliance is part of Joint Commission accreditation. It helps if an institution has do-not-use guidelines prominently posted at nursing stations and other areas of the facility: