JCAHO takes aim at reducing communication errors

To meet its goal of reducing errors in communication, the Joint Commission on Accreditation of Healthcare Organizations now requires each health-care facility to ban the use of certain abbreviations in written documentation and to follow specific guidelines when receiving verbal orders and reports. While the rules apply primarily to hospitals, it's common sense to implement them in office settings, as well.

As of April 2004, health-care organizations must develop and adhere to a "Do Not Use" list of abbreviations, acronyms, and symbols. According to Nursing 2004 (3/04), the list must include those banned by the Joint Commission, as well as three additional abbreviations, acronyms, or symbols added by the facility.

Among the abbreviations that have been banned by the Joint Commission in all clinical documentation are U, IU, q.d., and q.o.d.; instead, the terms unit, international unit, daily, and every other day, respectively, must be written out. The use of trailing zeros (such as 9.0 mg) and the absence of leading zeros (such as .9 mg) are also prohibited.

Moreover, the Joint Commission requires staff who receive orders or test results verbally to first write them down or enter them into the computer, and then read it back. The "read-back" rule applies to all spoken orders, not just medication orders. So be prepared to have a nurse or other staff member read your orders back to you, after they have written them down.