To enhance patient safety, which of the following abbreviations should be eliminated when introducing or...

The abbreviation “qd” (intended to mean “every day”) should be eliminated because it is well known to be error-prone and has been repeatedly associated with misinterpretation and serious medication dosing errors. In handwritten or poorly rendered text, “qd” can be mistaken for “q.i.d.” (four times daily), which can lead to a fourfold dosing frequency error —a high-risk patient safety event. Because EHR implementations often standardize order sets, medication dictionaries, and clinical documentation templates, this is a key opportunity to remove unsafe abbreviations and replace them with fully spelled-out, unambiguous instructions (e.g., “daily”).

In contrast, NPO (“nothing by mouth”), PRN (“as needed”), and HS (“at bedtime”) are common clinical abbreviations that are generally understood and are not typically singled out in major “do-not-use” abbreviation lists in the same way “qd” is. Safety-focused informatics practice emphasizes embedding these standards directly into computerized provider order entry (CPOE) and order sentences so clinicians select clear, standardized terms instead of typing free-text abbreviations. Eliminating “qd” supports safer prescribing, reduces ambiguity across care teams, and strengthens medication safety during EHR go-lives and upgrades.