Becker's Clinical Quality & Infection Control

15 QUALITY IMPROVEMENT & MEASUREMENT ISMP updates list of error-prone medical abbreviations By Paige Twenter O n April 17, the Institute for Safe Medication Practices added more recommendations to its list of medical abbreviations that should never be used. e organization's List of Error-Prone Abbreviations, Symbols and Dose Designations contains examples of misinterpretations that have or could have caused a medication error. e update includes these five additions: • When a dose is being measured in nanograms, do not use "nanog" as an abbreviation. • For intranasal medications, do not use "NAS" as an abbreviation. • When a medication is intended to be used nightly at bedtime, do not use "nightly" or "HS" to mean at bedtime. Use QHS or qhs instead. • When indicating a half tablet, do not use reduced font-size fractions. Use text instead and avoid using fractions or decimals. • If a slash mark is needed to separate doses, do not use "per." Use "and" instead. "ese abbreviations, symbols and dose designations should NEVER be used when communicating medical information verbally, electronically, and/or in handwritten applications," the ISMP said in an emailed news release. n 5 most challenging requirements in 2023: Joint Commission By Mackenzie Bean M aintaining infection prevention and control during disinfection and sterilization activities was the most challenging compliance standard for hospitals in 2023, according to e Joint Commission. e organization identified the top five requirements for which hospitals were most frequently out of compliance, based on surveys and reviews from Jan. 1 through Dec. 31. e top five most challenging requirements for hospitals in 2023: 1. e hospital implements infection prevention and control activities when doing the following: Performing intermediate and high-level disinfection and sterilization of medical equipment, devices, and supplies. 2. e hospital ensures medications are safely administered. 3. e hospital assesses physical environments to look for objects that could be used during suicide attempts and follows written policies to identify at-risk patients. 4. e hospital has appropriate ventilation systems to ensure airborne contaminants are properly controlled in critical areas. 5. e hospital's interior spaces meet the needs of the patient population and are safe and suitable to the care, treatment and services provided. ese five requirements were also most challenging for hospitals to follow in 2022, though medication safety and airborne contaminant practices both jumped one spot on the list. n The condition EDs often miss in children By Erica Carbajal S eizures are telltale signs of epilepsy, but a subtle type of seizure in children is less likely to be noticed by emergency department physicians, which may lead to delays in diagnosis and treatment, according to new research. Findings from researchers at NYU Langone Health in New York City show that ED physicians correctly spot first- time nonmotor seizures only about 33% of the time. Such seizures are more subtle and can cause children to zone out or stare into space, while motor seizures cause muscles to move abruptly and are more recognizable. The latter types of seizures were correctly identified 81% of the time. Additionally, while nearly 40% of teens in the study had a history of nonmotor seizures, none were asked about them during their hospital visit. The findings underscore the need for improved recognition of nonmotor seizures, which can easily be confused with anxiety or panic attacks. "Encouraging healthcare workers to routinely ask patients about signs of nonmotor seizures may offer a simple way to spot epilepsy before it worsens," Jacqueline French, MD, a senior author of the study and a neurologist, said in a news release. The research involved an analysis of 83 preteens and teens who had started treatment for epilepsy within four months of the study. Nearly 60 had visited a pediatric or general emergency department before they were diagnosed. n

• Cover