Health professionals and their support personnel frequently produce handwritten copies of information they see in print; therefore, such information is subjected to even greater possibilities for error or misinterpretation on the part of others. Thus, particular care must be given to how drug names and strengths are expressed when creating written healthcare documents.
The following are a few examples of safe writing rules suggested by the Institute for Safe Medication Practices, Inc.*
1. There should be a space between a number and its units as it is easier to read. There should be no
periods after the abbreviations mg or mL.
10 mg 10mg
100 mg 100mg
2. Never place a decimal and a zero after a whole number (2 mg is correct and 2.0 mg is incorrect). If the decimal point is not seen because it falls on a line or because individuals are working from copies where the decimal point is not seen, this causes a tenfold overdose.
3. Just the opposite is true for numbers less than one. Always place a zero before a naked decimal (0.5 mL is correct, .5 mL is incorrect).
4. Never abbreviate the word unit. The handwritten U or u looks like a 0 (zero), and may cause a tenfold overdose error to be made.
5. IU is not a safe abbreviation for international units. The handwritten IU looks like IV. Write out international units or use int. units.
6. Q.D. is not a safe abbreviation for once daily, as when the Q is followed by a sloppy dot, it looks like QID which means four times daily.
7. O.D. is not a safe abbreviation for once daily, as it is properly interpreted as meaning ‘‘right eye’’ and has caused liquid medications such as saturated solution of potassium iodide and Lugol’s solution to be administered incorrectly. There is no safe abbreviation for once daily. It must be written out in full.
8. Do not use chemical names such as 6-mercaptopurine or 6-thioguanine, as sixfold overdoses have been given when these were not recognized as chemical names. The proper names of these drugs are mercaptopurine or thioguanine.
9. Do not abbreviate drug names (5FC, 6MP, 5-ASA, MTX, HCTZ, CPZ, PBZ, etc) as they are misinterpreted and cause error.
10. Do not use the apothecary system or symbols.
11. Do not abbreviate microgram as mic g instead use mg as there is less likelihood of misinterpretation.
12. When writing an outpatient prescription, write a complete prescription. A complete prescription can prevent the prescriber, the pharmacist, and/or the patient from making a mistake and can eliminate the need for further clarification.
The legible prescriptions should contain:
a. patient’s full name
b. for pediatric or geriatric patients: their age (or weight where applicable)
c. drug name, dosage form, and strength; if a drug is new or rarely prescribed, print this information
d. number or amount to be dispensed
e. complete instructions for the patient, including the purpose of the medication
f. when there are recognized contraindications for a prescribed drug, indicate to the pharmacist that
you are aware of this fact (eg, when prescribing a potassium salt for a patient receiving an ACE inhibitor, write ‘‘K serum level being monitored’’)
*From ‘‘Safe Writing’’ by Davis NM, PharmD and Cohen MR, MS, Lecturers and Consultants for Safe Medication Practices, 1143 Wright Drive, Huntington Valley, PA 19006. Phone: (215) 947-7566.