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“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Saturday, May 21, 2005
    Patient Safety: Or, the End of an Era

    Recently there's been a big campaign in many hospitals to change the way doctors write orders, the goal being to eliminate medication dosage errors and improve patient safety. At the hospital across the street from my office, every nursing station is plastered with posters showing the wrong and right way to write orders. The traditional, esoteric Latin shorthand is being kicked to the curb; now we have to write everything out longhand in plain English. The mystery is gone. (sigh) In all seriousness, I can't object to anything that reduces iatrogenic errors or that improves patient safety, but I admit to a gentle nostalgia for The Way It Used To Be. It's just so much fun to use a secret code, and it's much faster to use the shorthand when you're writing order after order...

    For example, we can't write "QD" anymore, it has to be "daily". The shorthand for left eye (OS), right eye (OD), or both eyes (OU) is verboten; likewise for ears (AS, AD and AU respectively). QID (four times daily) is too easily confused with QD, so it's out too, though the last time I checked BID and TID (twice or three times daily) were still OK (permitted).

    So where I might once write:

    i-ii gtt OU TID-AC &HS

    I now would write "one to two drops in both eyes three times daily before meals and at bedtime."

    Doesn't it just look better the other way?



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