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Mistaken as qd (daily) or qid (four times daily), especially if the “o” is poorly written Mistaken as q.i.d., especially if the period after the q or the tail of a handwritten q is misunderstood as the letter i Mistaken as right eye (OD, oculus dexter), leading to oral liquid medications administered in the eye Use HS (all UPPERCASE letters) for bedtime

Use SUBQ (all UPPERCASE letters, without spaces or periods between letters) or subcutaneous(ly)Ībbreviations for Frequency/Instructions for Use The q in sub q has been mistaken as “every” SC and sc mistaken as SL or sl (sublingual) The os was mistaken as left eye (OS, oculus sinister) Mistaken as AD, AS, AU (right ear, left ear, each ear) Mistaken as intratracheal, intratumor, intratympanic, or inhalation therapy Use NAS (all UPPERCASE letters) or intranasal Mistaken as OD, OS, OU (right eye, left eye, each eye) Mistaken as cc, leading to administering volume instead of units (e.g., 4u seen as 4cc)Ībbreviations for Route of Administration Mistaken as zero or the number 4, causing a 10-fold overdose or greater (e.g., 4U seen as 40 or 4u seen as 44) M has been used to abbreviate both million and thousand (M is the Roman numeral for thousand) Use mL (lowercase m, UPPERCASE L) for milliliter Lowercase letter l mistaken as the number 1 (International units can be expressed as units alone) Mistaken as IV (intravenous) or the number 10 ISMP 2021.Įrror-Prone Abbreviations, Symbols, and Dose DesignationsĪbbreviations for Doses/Measurement Units ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations.

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How to cite: Institute for Safe Medication Practices (ISMP). Error-prone abbreviations, symbols, and dose designations that are relevant mostly in handwritten communications of medication information are highlighted with a dagger (†). In the Table, error-prone abbreviations, symbols, and dose designations that are included on The Joint Commission’s “ Do Not Use” list (Information Management standard IM.02.02.01) are identified with a double asterisk (**) and must be included on an organization’s “ Do Not Use” list. These abbreviations, symbols, and dose designations should NEVER be used when communicating medical information verbally, electronically, and/or in handwritten applications. This includes internal communications verbal, handwritten, or electronic prescriptions handwritten and computer-generated medication labels drug storage bin labels medication administration records and screens associated with pharmacy and prescriber computer order entry systems, automated dispensing cabinets, smart infusion pumps, and other medication-related technologies. The ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations contains abbreviations, symbols, and dose designations which have been reported through the ISMP National Medication Errors Reporting Program (ISMP MERP) and have been misinterpreted and involved in harmful or potentially harmful medication errors.

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