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Six ways to tackle unapproved abbreviations: tips to success

Nurse Leader Weekly, September 2, 2005

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One-quarter of U.S. hospitals received requirements for improvement for unapproved abbreviations in 2004, according to JCAHO data. But six steps helped one New Jersey hospital ace the abbreviation portion of its July survey.

JCAHO surveyors did not find any instances of unapproved abbreviations while inspecting Meadowlands Hospital Medical Center in Secaucus, NJ, says Wren Lester, the hospital's corporate director of performance improvement.

"It's about application," Lester says. "It's about diligence. You've just got to hammer it down."

The following six tips may help your hospital come survey time:
1. Check the JCAHO Web site to find out about the latest unapproved abbreviations. The JCAHO recently eliminated a requirement that hospitals choose three additional abbreviations along with the nine already required, and the accreditor is considering adding other abbreviations, acronyms, or symbols in the future.

2. Use the absolute bare minimum abbreviations necessary to comply with the JCAHO. Lester says her hospital started out with nearly 18 unapproved abbreviations a year ago, but leaders soon realized the daunting task required to gain compliance with every single one.

3. Get the hospital's medical director to embrace the concept of unapproved abbreviations. Present the topic during the medical executive committee meetings and grand rounds, Lester says. Make the topic a standing agenda item on meeting minutes.

4. Create posters with the hospital's unapproved abbreviation list. Hang them in the nursing lounges, operating rooms, and physician lounges. Also laminate cards with the abbreviations and put them in patient charts, and print the abbreviations on every order sheet so physicians can see them when ordering, Lester says.

5. Have nursing staff reject orders with unapproved abbreviations. Tell them to call a physician to seek clarification if an order has an unapproved abbreviation, Lester says. If nurses fail to catch this, pharmacists should call to clarify the order.

6. Create a list of unapproved abbreviations used by each physician. Assign a code or number for each physician so their names remain anonymous, but publish the physicians' codes and the abbreviations used during the medical executive committee meeting, Lester says.

Source: Adapted from Briefings on JCAHO (September 2005), published by HCPro, Inc.

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