Impact of ‘never use’ abbreviations (Error Prone Abbreviations-EPA’s) list on incidence of EPAs in inpatient medical prescriptions in apex tertiary care public hospital in India

Abstract

AbstractBackgroundAbbreviations are commonly used in medical records to save time and space but use in prescriptions can be a reason for communication failures and preventable harm during healthcare delivery. Nearly 5% of medication errors can be attributable to abbreviation use. Prescriptions need to be clear so that nurses and pharmacists can correctly interpret intentions of doctors. For patient safety, hospitals should implement a process for uniform use of approved abbreviations, such as through use of an approved list or never-use list of abbreviations and symbols.Local ProblemIn the hospital under study, there was no system of avoiding error prone abbreviations while prescribing to prevent medical errors. Hence, an interventional study was done to quantify and reduce incidence of error prone abbreviations.MethodsThe study design was pre-post interventional / quasi-experimental design to assess the impact of never use list and standardized abbreviations. The study was conducted after ethical approval from Institute Ethics Committee. Pre intervention data was collected by a retrospective closed in-patient medical record review. Post interventional incidence of error prone abbreviations was determined and the effectiveness of the same was assessed by using statistical analysis.InterventionAn approved ‘Never use’ list and standardized abbreviations were developed and poster copies were affixed in inpatient wards, doctors were educated and poster pamphlets were also distributed.ResultsIncidence of error abbreviations in inpatient prescription were 47.5% and ‘Never Use’ list of abbreviation led to a statistically significant reduction of error-prone abbreviation by 8.2% from 47.5% to 43.6% (P\0.006)Conclusion‘Never Use’ lists are effective in reducing incidence of common error-prone abbreviations and discipline wise variation is observed. Adoption of such lists is highly recommended. The lists should be comprehensive, regularly updated and educational interventions should be comprehensive and integration into patient medical charts and pocket friendly flash cards may be provided for better outcomes. Enforcing a policy to prohibit the use of EPAs while prescribing will also be helpful.