Patient Safety Rules

Patient safety rules were made for a reason. Patient safety is one of the primary issues facing the health care industry today. It is also one of the most studied areas. According to the Institute of Medicine, approximately 98,000 Americans die each year from avoidable medical errors. In an absurd comparison, a patient in a hospital is 40 percent more likely to be injured because of negligence than an airline passenger is to have his luggage lost.

One of the most prevalent reasons for medical errors results from the lack of adequate information. The inability to access information is the largest challenge. Doctors and nurses don't set out to make mistakes, but if they don't have the patient's medical history at their fingertips, errors can easily be made.

The credit cards in your wallet contain vital information about your identity that can be accessed just by passing its magnetic strip through a reader. But your medical records are still maintained in large paper files held in hospital vaults and M.D. offices. In the event of an emergency, chances of accessing that information in a timely manner are very slim to none.

The technology exists to solve this dilemma, but there needs to be an organization to oversee dissemination of information. Privacy laws recently enacted have both helped and hindered this process. One thing is for sure, these errors add to the high cost of medical care.

Errors in health care stem from several actions. These actions can be errors of execution such as doing something incorrectly. They can be errors of omission such as not doing something that needs to be done. And they can be errors of commission as in doing the wrong thing.

Several nonprofit organizations have formed and stepped in to study the problem, and to establish goals and interventions to help reduce and prevent medical errors. Accreditation agencies such as JCAHO have taken the issue seriously and have established standards that include patient safety goals. For additional information, see the JCAHO site at

JCAHO has also implemented mandatory safety standards throughout the industry for accredited facilities. One of these is a “Do Not Use List” for abbreviations. This list is a minimum standard. Facilities are required to add their own items to the list. Items on the official list include:

  • U that can be mistaken for a 0 (zero), or cc. Instead write out the word “unit.”

  • IU that could be mistaken for IV, or the number 10. Instead write out “International Unit.”

  • QD and QOD that can be mistakenly interchanged or mistaken for QID. Instead you must write out “daily,” “every day,” or “every other day.”

  • Trailing and leading zero (.x mg, or x.0 mg) in which case the decimal point can be missed. Instead write out “0.x mg” or “Xmg.”

  • MS, MSO4, and MgSO4 can be mistaken for each other. Instead write out “morphine sulfate” or “magnesium sulfate.”

  • The only exceptions to these rules are for the trailing zero in laboratory results, imaging studies, or other reports where a precise value may be needed. The trailing zero must not be used in conjunction with a medication under any circumstances.

    Following patient safety goals and rules will help to reduce the occurrence of medical errors. Staying informed about advances in medical treatments and procedures will help as well. And encouraging your facility and coworkers to become comfortable with technological advances will help health care move more quickly into a realm where medical information is stored electronically and immediately accessible.

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