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PubMed2005

Medication safety issue brief. Eliminating dangerous abbreviations, acronyms and symbols.

The use of abbreviations, acronyms and symbols in prescribing and transcribing medication orders too often results in the misinterpretation of the order's intent. Busy health care practitioners often use these shortcuts to indicate drug names, dosages, the patient's condition and route of administration. The result can be omission errors, extra or improper doses, administering the wrong drug, or giving a drug in the wrong manner. Stopping the use of unapproved abbreviations, acronyms and symbols can go a long way toward preventing these errors, but that's proven difficult to accomplish. This briefing examines ways that hospitals can put an end to the practice.

Abbreviations as Topic↗
PubMed1981

[Sense and nonsense of abbreviations in medical linguistic usage].

Abbreviations usually being a useful and precious help for understanding achieve yet the reverse as increasing misuse takes place, especially in medical journals. Often understood only by experts in a special field they promote neither the communications between the disciplines nor the cooperation between clinic and practice. Editors of (medical) journals, therefore, are advised to start each contribution with a tabulated glossary and an explanation of the applied abbreviations.

Abbreviations as Topic↗
PubMed1977

Application of the Faschingbauer Abbreviated MMPI with alcoholic patients.

There is a need to examine the usefulness of an abbreviated form of the MMPI with alcoholic patients. The Faschingbauer Abbreviated MMPI (FAM) was administered to 225 male alcoholics. The correlations between the T-scores for the FAM and their full MMPI counterparts ranged from .761 to .919. Examination of the high-point code for each FAM-MMPI pair yielded 52.89% with identical high-point codes. A comparison between the MMPI and the FAM pairs showed that 78% of the profiles had the same number of scales with T-score above 70 plus or minus one scale. The authors suggest that when a full MMPI administration is not feasible, the FAM is a valid substitute for alcoholic populations.

Adult↗
PubMed1979

Comparison of the utility of two abbreviated forms of the MMPI for psychiatric screening of the elderly.

Assessed the utility of the Faschingbauer Abbreviated MMPI (FAM) and MMPI-168 for use with the elderly. FAM and MMPI-168 items were extracted from the MMPIs of 24 older male veteran medical or alcoholic patients. The results indicate that both abbreviated forms are highly correlated with and yield similar diagnostic inferences to the standard MMPI. For this sample population, the FAM was significantly (p less than .001) more in accordance with the standard MMPI than the MMPI-168.

Aged↗
PubMed1995

Support for abbreviation of the Wide Range Achievement Test-Revised spelling subtest in neuropsychological assessments.

The Wide Range Achievement Test-Revised (Level 2) provides valuable data in neuropsychological assessments, but its inclusion is costly in time. Although the Reading and Arithmetic subtests are inappropriate for abbreviation, the Spelling subtest is unnecessarily lengthy for most clinical needs. In a retrospective study of the reliability of data obtained from split-half and split-third tabulations with mixed psychiatric and forensic subjects, strong correlations were obtained between the split-halves and between split-half and full administration scores. A Spearman-Brown correction of the relationship between the split-halves yielded a correlation of .97, higher than that reported for any WAIS-R subtest (Wechsler, 1981). Standard scores generated by split-half tabulations were within 10 points of those generated from the complete raw data in 94.6% of cases. These findings suggest that the Spelling subtest could be abbreviated in clinical settings with minimal loss of reliability.

Female↗
PubMed1985

Increased efficiency of transfusion practice in routine surgery using pre-operative antibody screening and selective ordering with an abbreviated crossmatch.

In an effort to meet the increasing demands for blood to cover routine surgery and in order to reduce the amount of time-expired blood, we have adopted a system of grouping and screening patients' blood preoperatively but not crossmatching blood unless there is more than a 30 per cent chance that it will be used. This approach is based on schemes developed in the USA over the past three decades. If there is unexpected haemorrhage at operation and the patient's serum is known to be free of irregular antibodies, blood of the same ABO group is provided, with only an abbreviated crossmatch to check ABO compatibility. During the first 6 months in which the new scheme was in operation it is estimated that the laboratory crossmatched at least 3000 units of blood (44 per cent) less than it would otherwise have done. 336 units were transfused after an abbreviated crossmatch and, as expected, there were no haemolytic transfusion reactions.

ABO Blood-Group System↗
PubMed2000

Immunisation of lambs with drug-abbreviated Haemonchus contortus infections: protection against homologous and heterologous challenge.

Haemonchus contortus is known as a prolific parasite, producing high numbers of eggs. It could therefore be used as a cheap source of larvae for immunisation of lambs. The value of immunisation would be improved if the immunity produced gave protection against not only homologous but also heterologous infections. Because antibody cross-reactivity between Haemonchus and Ostertagia has been well established, we wanted to know whether drug-abbreviated infections of H. contortus would stimulate production of antibodies that would cross-react with Trichostrongylus colubriformis. The results obtained from these trials indicated that H. contortus drug-abbreviated infections produced significant immunity against not only Haemonchus but also O. circumcincta. Immunisation increased the level of immunoglobulin E (IgE) and IgE-specific antibodies against T. colubriformis, but the differences between experimental and control animals were not statistically significant. Significantly higher levels of IgG-specific antibodies against T. colubriformis were observed.

Animals↗
PubMed1999

Cyclosporine A monitoring in children: abbreviated area under curve formulas and C2 level.

Cyclosporine A (CsA) is the most commonly used drug in organ transplantation. To evaluate exposure the gold standard is area under curve (AUC), but this is expensive and requires many blood samples. For this reason, abbreviated formulae have been developed in adults. Data in children are scanty. Formulae cannot be applied in patients taking CsA every 8 h. We tested the abbreviated AUC formula published for adults in renal transplant children on twice daily therapy and we propose a method, requiring three blood samples, for those taking CsA every 8 h. A very good correlation was obtained for both groups. Furthermore, we studied the correlation between CsA concentration 2 h after administration and AUC. A good correlation was found supporting the possible use of this parameter for monitoring CsA therapy.

Adolescent↗
PubMed1999

Abbreviated cyclosporine AUCs on Neoral--the search continues!

Cyclosporine is a powerful immunosuppressant with a narrow therapeutic window and considerable inter- and intrapatient variability. The pre-dose trough concentration (C(min)) is commonly used for therapeutic drug monitoring. With the new microemulsion (Neoral), intrapatient variability was reduced. However, the usefulness of Neoral C(min) was questioned. Firstly, because of the improved and more-rapid absorption, accidental intake before blood sampling has a greater impact on C(min) than with classic cyclosporine. Secondly, C(min) may be low despite high drug exposure, due to rapid clearance in children. A full pharmacokinetic (PK) profile with determination of the area under the curve (AUC) is expensive and cumbersome, and therefore a search for an abbreviated AUC began. Here, we present a retrospective analysis of 84 PK profiles from 78 pediatric renal transplant recipients. By analysis of rejection episodes and toxicity, we estimated a target AUC above 5,000 ng x h/ml in the early post-transplant period and 3,900 ng x h/ml beyond 100 days. The abbreviated AUC using the 2- and 6-h concentrations (C2 and C6) and a simple estimate derived from the 3-h concentration (C3) were equally well correlated with the AUC. From our data, we recommend a target C3 at approximately 800 ng/ml early after transplantation and 450-550 ng/ml beyond 100 days.

Adolescent↗
PubMed1986

Abbreviation of the period of sexual behavior in female guinea pigs by the progesterone antagonist RU 486.

In previous studies we have tested the hypothesis that the termination of the period of sexual behavior in female guinea pigs results from the loss of progestin receptors from hypothalamic cell nuclei. We have shown that hormonal manipulations that delay heat termination also delay loss of hypothalamic nuclear progestin receptors. In order to determine if accelerated nuclear receptor loss results in abbreviation of the period of sexual behavior, we tested the effect of 17 beta-hydroxy-11 beta-(4-dimethylaminophenyl)-17 alpha-(1-propyl)-estra-4,9-diene-3-one (RU 486), a progesterone antagonist, on heat termination. Ovariectomized guinea pigs were treated with estradiol benzoate. Forty hours later, they received progesterone followed 4 h later by injection of RU 486 or vehicle. RU 486 injected 4 h after progesterone caused heat abbreviation. We have found that RU 486 administration to estradiol-treated guinea pigs causes accumulation of progestin receptors in cell nuclear extract. Because this accumulation can be detected only when assay conditions are used that promote exchange of RU 486 progestin receptor complexes (15 degrees C incubation rather than 0 degree C); our routine assay conditions (at 0 degree C) can be used to measure primarily receptors that are occupied by progesterone. In order to confirm that RU 486 decreased progesterone-occupied nuclear progestin receptor levels when injected 4 h after progesterone, animals treated as in the behavioral experiment were killed 6 or 10 h after progesterone injection (2 or 6 h after RU 486), and nuclear progestin receptor levels were measured. RU 486 treatment resulted in lowered nuclear concentrations of hypothalamic progestin receptors at both times. These results support our hypothesis that the termination of the period of sexual receptivity in female guinea pigs is the result of loss of progestin receptors from hypothalamic cell nuclei.

Animals↗
PubMed2006

Assessing worry in older and younger adults: Psychometric properties of an abbreviated Penn State Worry Questionnaire (PSWQ-A).

Among older adults, recent work indicated that Penn State Worry Questionnaire (PSWQ) data fit poorly with previously established models, leading to use of model modification procedures to create an abbreviated worry questionnaire (PSWQ-A; Hopko, D. R., Stanley, M. A., Reas, D. L., Wetherell, J. L., Beck, J. G., Novy, D. M., et al. (2003). Assessing worry in older adults: Confirmatory factor analyses of the Penn State Worry Questionnaire and psychometric properties of an abbreviated model. Psychological Assessment, 15, 173-183). Given limitations of this prior study that included the post hoc statistical development of the scale and undefined relevance toward assessing worry in younger cohorts, psychometric properties of the PSWQ-A were explored among independent samples of older (n = 115) and younger adults (n = 183). Exploratory factor analyses supported a unidimensional model (breadth and control of worry) that accounted for substantial variance in older (57%) and younger adult samples (70%) and was associated with high factor loadings (.66-.89). Internal consistency (alpha = .89-.94) and test-retest reliability (r = .87-.95) was strong in both samples. Moderate to strong convergent validity with measures of worry and anxiety was evident (r = .46-.83), as was support for the construct validity of the PSWQ-A via its relation to the PSWQ (r = .65-.83) and similar relations with other anxiety and worry measures. Although further study is required, the PSWQ-A may be a parsimonious method to assess worry in older and younger adults.

Adult↗
PubMed2005

Effectiveness of abbreviated and delayed 7-valent pneumococcal conjugate vaccine dosing regimens.

We estimated the effectiveness of abbreviated regimens of 7-valent pneumococcal conjugate vaccine (PCV7) based on serotyped cases of invasive pneumococcal disease (IPD) in children under 5 reported from 2001 to 2004 to two US surveillance programs. Vaccination regimens included in the analysis were 1 dose < 3 months old, 2 doses < 5 months old, 3 doses < 7 months old, full schedule (3 doses and a booster), 1 dose at 12-23 months, and 2 doses at 12-23 months. Vaccine effectiveness (VE) was calculated as (1-Mantel-Haenszel summary odds ratio in vaccinated children, as compared to unvaccinated children)x100% for each regimen, stratifying by year. Among 400 eligible cases, for vaccine-type IPD, VE was 90.5% for the full schedule, 76.6% for 3 doses < 7 months old, and 70.5% for 2 doses < 5 months old; 1 dose < 3 months provided no significant protection. No regimen provided significant protection against vaccine-related serotypes. Data for regimens begun at 12-23 months were inconclusive. These data support the use of the 2-dose and 3-dose infant PCV7 regimens when the full series cannot be delivered and detail the limitations of abbreviated dosing regimens.

Child, Preschool↗
PubMed1997

Abbreviated educational session improves cranial computed tomography scan interpretations by emergency physicians.

STUDY OBJECTIVE: Previously published research (phase I) demonstrated a concerning misinterpretation rate of cranial computed tomography (CT) scans by emergency physicians. This study (phase II) determined whether an abbreviated educational session would improve emergency physician interpretation skills of cranial CT scans. METHODS: Participants in this prospective, interventional study in a county hospital ED were patients undergoing cranial CT scanning during ED evaluations and attending level emergency physicians. An abbreviated educational session on cranial CT interpretation skills was given to the same attending emergency physicians who participated in phase I. The educational session included basic CT interpretation skills and misinterpreted CT scans from phase I. We determined the postsession accuracy rate of the emergency physicians on 324 ED patient CT scans. The CT interpretation accuracy rates were then compared between phase I and phase II to determine the effectiveness of the educational session. RESULTS: The radiology/ED CT scan concordance rate improved from 61.3% (kappa = .22) to 88.6% (kappa = .70; P < .0001). Potentially clinically significant CT scan misinterpretations decreased from 24.1% to 4.0% (P < .0001). Most importantly, major missed findings on CT scans decreased from 11.4% to 2.8% (P < .0001). Continuous quality improvement monitoring found no instance of clinically significant patient mismanagement. CONCLUSION: Within the limits of this study, we conclude that emergency physicians' interpretation skills of cranial CT scans may be improved using a 1-hour educational session.

Brain Diseases↗
PubMed1996

Immunisation of sheep by drug-abbreviated infections of Ostertagia circumcincta and Trichostrongylus colubriformis against field challenge of gastro-intestinal nematodes.

A very high level of protection was achieved against homologous (up to 97%) and heterologous (up to 87%) infections in 12-month-old Romney sheep immunised with oxfendazole-abbreviated infections of Ostertagia circumcincta and Trichostrongylus colubriformis. No significant protection occurred following ivermectin-abbreviated infections. None of the immunised sheep showed an increase in antibody level against excretory-secretory antigen of T. colubriformis infective larvae. The immunisation procedures did not cause a decrease in wool production, or liveweight gains compared with non-immunised controls.

Animal Feed↗
PubMed1999

Heligmosomoides polygyrus and Trypanosoma congolense infections in mice: effect of immunisation by abbreviated larval infection.

Concurrent African trypanosome and gastrointestinal helminth infections are prevalent in sub-humid savannah where they are endemic. However, acquired resistance in animals varies with their responder status and exposure. As a guide to study in the definitive hosts, the effects of Trypanosoma congolense infection on the development and maintenance of homologous Heligmosomoides polygyrus resistance were investigated in outbred TO mice. These mice were immunised by abbreviation of larval infection. Immune or naive mice were either infected with 500 infective larvae (L3) of H. polygyrus and/or 10(4) bloodstream forms of T. congolense or were not infected. The outcome of infection was monitored by routine parasitological and immunological techniques for 30 days after the day of the T. congolense infection. Significantly more immune mice concurrently infected with both parasites survived than did immune mice in which H. polygyrus was superimposed on a 10-day-old T. congolense infection. Although all the mice in this latter group died before the end of the experiment, larval immunisation prolonged their survival, relative to similarly treated naive mice. The antibody titres to H. polygyrus in the sera of immune mice challenged with H. polygyrus alone were significantly higher than those of immune mice concurrently infected with both parasites but the levels of protection obtained were comparable. It is concluded that T. congolense may not completely block the strong acquired resistance induced by abbreviated H. polygyrus larval infection in TO mice but is capable of interfering with protective responses, especially if the trypanosome infection occurs prior to H. polygyrus challenge infection.

Administration, Oral↗
PubMed1985

Abbreviated surveillance of nosocomial urinary tract infections: a new approach.

An abbreviated method for the surveillance of nosocomial urinary tract infection is described. Combining desirable features of both active and passive surveillance, this new method involves concurrent review of microbiology reports. Compared to traditional active surveillance methods which require review of individual patient charts, the abbreviated method requires only one-fifth the time commitment while maintaining a 98% sensitivity. Although some degree of overestimation is inherent in this method, the primary goals of surveillance--monitoring infection rates and identifying clusters of infection--should be preserved.

Cross Infection↗
PubMed2001

Abbreviated combined anatomical/electrophysiological approach for catheter ablation of atrioventricular nodal reentrant tachycardia in children.

Atrioventricular nodal reentrant tachycardia was proven during electrophysiologic study in 41 children, aged from 3.7 to 16 years, who were referred for catheter ablation of symptomatic supraventricular tachycardia. Using an abbreviated combined anatomical and electrogram-guided approach for selective ablation of the slow pathway, a steerable ablation catheter was placed at the inferior region of the vestibule of the tricuspid valve close to the orifice of the coronary sinus, with the intention of recording a multicomponent local atrial electrogramm during sinus rhythm. If application of radiofrequency current of 500 kHz at 70 degrees C at this site did not result in a slowly accelerated junctional rhythm, at a rate of less than 120 beats per minute, the catheter was stepwise advanced up to a position midway towards the apex of the triangle of Koch for additional applications of energy. Ablation was achieved in 35 of the patients. In 6 patients, the slow pathway was modulated such that the tachycardia could no longer be induced. The number of applications of energy ranged from 1 to 19, with a median of 6 applications. The mean period of fluoroscopy was reduced to 15.6 (4.3 to 39.8) minutes, while the overall duration of the catheterization procedures ranged from 88 to 280 (mean 173.2) minutes. In none of the patients did we observe permanent high grade atrioventricular block. During follow-up over a mean of 4.1 years, two patients had recurrence of tachycardia, corresponding to a 95% rate of success in the midterm. We conclude that selective radiofrequency ablation of the slow pathway using the abbreviated anatomical and electrophysiological approach is a safe and curative therapeutic approach in children with atrioventricular nodal reentrant tachycardia. Periods required for fluoroscopy can be significantly reduced, and mid-term results are excellent.

Adolescent↗
PubMed2004

Parent-child interaction therapy: one- and two-year follow-up of standard and abbreviated treatments for oppositional preschoolers.

The long-term effect of two parent training programs for conduct problem preschoolers is reported. Families of 54 behaviorally disturbed preschool-aged children were randomly assigned to 1 of 3 treatment conditions: standard Parent-Child Interaction Therapy (STD), an abbreviated form of PCIT (ABB), and a no-treatment waitlist control group (WL). Of the families who completed treatment (STD and ABB), data were collected on 97% and 94% of families at 1- and 2-year follow-up, respectively. Follow-up assessment of parent report and independent observations indicated that treatment gains were largely maintained for both treatment conditions with little difference between the two treatments. The findings suggest that an abbreviated form of PCIT has long-term benefits for families with young children displaying early conduct problems.

Adult↗