Concord Ambulatory Surgery Center

1. Concord Ambulatory Surgery Center Official “Do Not Use” List

2. Purpose and Goals • To prevent medication errors through misinterpretation of orders. • To standardize documentation and improve clarity of medical records. • Used in conjunction with a list of approved abbreviations.

3. Today’s Situation • Many using same abbreviations with different meanings. • Physician orders could be misread leading to medication errors. • Medical records were inconsistent.

4. How Did We Get Here? • The Institute for Safe Medication Practice formulated a “Do Not Use” list and recommended it be used to help prevent medication errors and to clarify medication orders • The 2006 National Patient Safety Goal (2B) is for facilities to standardize a list of abbreviations, acronyms and symbols that are not to be used within the organization.

5. What are we doing? • A copy of our list is in each of our patient’s charts in the order entry section. • This is a patient safety initiative. • To help prevent medication orders • To help prevent misinterpretation of documentation

6. How are we doing it? • We strongly encourage physician buy-in based on patient safety. • Nursing staff must have orders clarified by physician if “DNU” abbreviation used. • Included in our monthly chart review.

7. Follow-up • Non compliant physicians receive: • Verbal notification • Written notification • If problem persists, it is brought up at our management committee meetings where the provider can have the opportunity to explain why he continues to use items from the “DNU” list.

8. Outcomes • During first year of implementation, we had 92% compliance. • In the last 8 months we have had 100% compliance. • We will continue to monitor this as new physicians enter our practice