1. Copyright © 2015 Cengage Learning® Chapter 5 Abbreviations and Systems of Measurement

2. Copyright © 2015 Cengage Learning® Abbreviations First responsibility when preparing medication for administration –Interpretation of the medication order Knowledge of medical abbreviations and symbols –Essential for accurate interpretation of the physician’s order Orders may vary in the use of capital versus lowercase letters 2

3. Copyright © 2015 Cengage Learning® Abbreviations (cont’d.) Institute for Safe Medication Practice (ISMP) –Monitors for and categorizes medication errors –Identifies practices that have contributed to medication errors –Has published a list of problematic abbreviations (ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations) 3

4. Copyright © 2015 Cengage Learning® Abbreviations (cont’d.) The Joint Commission –Approved a minimum list of “dangerous” abbreviations that have been prohibited effective January 1, 2004 –Items required to be on an organization’s DO NOT USE list are highlighted with a double asterisk (**) in the ISMP List 4

5. Copyright © 2015 Cengage Learning® Abbreviations (cont’d.) Medication orders contain six parts –Date –Patient’s name –Medication name –Dosage or amount of medication –Route or manner of administration (e.g., oral, subcutaneous, etc.) –Time to be administered, or frequency 5

6. Copyright © 2015 Cengage Learning® Abbreviations (cont’d.) Medication orders must always be written and signed by a physician –In an emergency the physician may give a verbal order (VO) Health care practitioner must read back the order before administration, and write down medication, amount, and time of administration as soon as it is given 6

7. Copyright © 2015 Cengage Learning® Abbreviations (cont’d.) Telephone orders –Always determine the policy of the agency before taking a telephone order (TO) –Some agencies require a registered nurse –Always obtain the name of the person and write it down, as well as the time –Repeat all of the details regarding the medication, dosage, frequency, etc. –Physician must sign all verbal and telephone orders within 24 hours in most cases 7

8. Copyright © 2015 Cengage Learning® Abbreviations (cont’d.) Medication orders –Can be written on the patient’s record in the physician’s office, clinic, or institution, or on a prescription blank –The health care practitioner is responsible for checking for completeness Date, patient name, medication name, dosage, route, and frequency Question any discrepancy, omission, or unusual order 8

9. Copyright © 2015 Cengage Learning® Abbreviations (cont’d.) The prescription blank contains two additional items –Physician’s Drug Enforcement Administration registration number if the medication is a controlled substance –The number of times that a prescription can be refilled If there are to be no refills, write the word “NO,” “NONE,” or “0/” after Refill 9

10. Copyright © 2015 Cengage Learning® 10

11. Copyright © 2015 Cengage Learning® Systems of Measurement Apothecary system –Original system Obsolete Metric system –Preferred system of measurement Used at the present time 11

12. Copyright © 2015 Cengage Learning® Systems of Measurement (cont’d.) Household system –Least accurate More familiar to the layperson and used in prescribing medications for the patient at home 12

13. Copyright © 2015 Cengage Learning® Metric System International standard for weights and measures –Based on three basic units: liter (L) for volume, meter (m) for length, and gram (g) for weight Prefix representing a "power of ten" can be placed before each of these units to change its value Example: "milli" means "one thousandth" and therefore a milligram (mg) would be one thousandth of a gram (i.e., 1000 milligrams would equal 1 gram) 13

14. Copyright © 2015 Cengage Learning® Household System Conversion from metric system to household system may be necessary –Especially in the home care setting Memorize the most commonly used basic equivalents –See Table 5-3 –Equipment commonly used for measuring includes the medicine cup and various syringes calibrated in milliliters 14

15. Copyright © 2015 Cengage Learning® Common Medical Conversion Almost all countries use the metric system as their official measurement system –United States still uses the English system of measurement Ounces, pounds, feet, miles, yards etc. Often a conversion of units is needed –Example: patient weighs 150 pounds but drug is ordered on a per kilogram dose Conversion factor: 1 pound = 2.2 kilograms, therefore 150/2.2 = 68.18 kilograms 15