TPA or r-TPA tissue plasminogen activator, alteplase MgSO4 magnesium sulfate KCl potassium chloride MTX methotrexate 6-MP mercaptopurine AZA azathioprine NaCl, saline, NS sodium chloride, sodium chloride 0.9% ½ NS sodium chloride 0.45% NaHCO3 sodium bicarbonate G5W 5% glucose in water ISMN isosorbide mononitrate Do not include the salt of the chemical unless it is clinically significant. For example, ‘mycophenolate mofetil’ or ‘mycophenolate sodium’ are examples of that are clinically significant. Where a salt is part of the name, it should follow the medicine name and not precede it. Use National Tall Man Lettering[13] for ‘look-alike, sound-alike’ medicines. This should be done for medicines known to cause confusion for medicine orders that are digitally generated and printed. Dose Use words or Hindu-arabic numbers. Use 1, 2, 3 etc., preferably followed by the unit of measure, i.e. ‘1 tab/tablet’, ‘2 puffs’, ‘3 caps/capsules’. Do not use Roman numerals. Do not use ‘ii’ to mean two, ‘iii’ for three, ‘v’ for five etc. Use metric units. Use metric units such as ‘gram’ or ‘mL’ rather than Imperial or other measurements. Clearly separate different elements of the medicine order. Ensure letters do not appear to flow into the numbers that follow. Use a leading zero in front of a decimal point for a dose less than 1. Do not use a ‘naked’ decimal point without a leading zero; for example, use ‘0.5’ not ‘.5’. Do not use trailing zeros. For example, use ‘5’ not ‘5.0’ for doses of medicines expressed in whole numbers Exception: While the recording of pathology or laboratory results is out of the scope of this document, it is acknowledged that a ‘trailing zero’ may be used to express the level of precision of the reported value (e.g. where blood levels are reported on the chart). Do not follow abbreviations such as ‘mg’ or ‘mL’ with a decimal point or full stop (‘mg.’ or ‘mL.’). This can be mistaken as the number 1 if written poorly.
For oral liquid preparations, express dose in weight as well as volume. For example, in the case of morphine oral solution (5 mg/mL), prescribe the dose in mg and confirm the volume in brackets, e.g. ‘10 mg (2 mL)’. Express dosage frequency unambiguously. For example, use ‘three times a week’ not ‘three times weekly’, as the latter could be confused as ‘every three weeks’. Use 24-hour time for administration. Midnight medicine administration should be avoided where possible. Avoid fractions. For example: ‘1/7’ could be interpreted as ‘for one day’, ‘once daily’, ‘for one week’ or ‘once weekly’ ‘1/2’ could be interpreted as ‘half’ or as ‘one to two’. Do not use symbols. Avoid, for example, ‘°2’ to mean ‘every two hours’. Avoid acronyms or abbreviations for medical terms and procedure names on orders or prescriptions. For example, avoid using ‘EBM’ to mean ‘expressed breast milk’. Use words to express numbers of 1,000 or more. For example, say ‘one thousand’ instead of ‘1,000’, and ‘one million’ instead of ‘1,000,000’ or ‘1m’. Otherwise use commas for dosing units at or above 1,000.
Australian Commission for Safety and Quality in Health Care. Recommendations for Terminology, Abbreviations and Symbols used in the Prescribing and Administration of Medicines. Sydney; 2011 Australian Commission on Safety and Quality in Health Care. National Guidelines for On-screen Display of Clinical Medicines Information. Sydney: ACSQHC, 2016. Accessed October 2016 Joint Commission on Accreditation of Healthcare Organizations. (JCAHO) Sentinel Event Alert- Medication errors related to potentially dangerous abbreviations: Joint Commission on Accreditation of Healthcare Organisations. Illinois, USA; 2001 Dooley MJ, Wiseman M, Gu G. Prevalence of error-prone abbreviations used in medication prescribing for hospitalised patients: multi-hospital evaluation. Sydney: Internal Medicine Journal; 2012 Mar; 42(3):e19–22 Dunn E, J. Let Go of Latin! Little Rock, USA: Vet Human Toxicol 2001; 43:235–236 Institute for Safe Medication Practices. (ISMP) List of Error-Prone Abbreviations, Symbols, and Dose Designations. Horsham, USA; 2015. Accessed October 2016 Australian Digital Health Agency. Australian Medicines Terminology (online). Sydney; 2016. Accessed October 2016 Australian Commission on Safety and Quality in Health Care and NSW Therapeutic Advisory Group Inc. National Quality Use of Medicines Indicators for Australian Hospitals. Sydney; 2014. Accessed October 2016 Australian Commission on Safety and Quality in Health Care. National Inpatient Medication Audit. Accessed September 2016. Clinical Oncological Society of Australia (COSA). Guidelines for the Safe Prescribing, Supply and Administration of Cancer Chemotherapy 2008. Accessed October 2016 National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). Recommendations to Enhance Accuracy of Prescription/ Medication Order Writing. NCC MERP. USA; October 2014. Accessed October 2016 Clinical Oncological Society of Australia. Guidelines for the Safe Prescribing, Supply and Administration of Cancer Chemotherapy. Sydney; 2008. Accessed October 2016 Australian Commission on Safety and Quality in Health Care. National Tall Man Lettering. Accessed August 2016.