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The Joint Commission Do Not Use list of abbreviations

Updated October 3, 2026 by Kamal Nasir

The Joint Commission's Do Not Use list names abbreviations and dose expressions that are easily misread and can cause medication errors: U, IU, Q.D., Q.O.D., trailing zeros, missing leading zeros, MS, MSO4 and MgSO4. For each one it says what to write instead, such as "unit" for U and "daily" for Q.D. In January 2026 the Joint Commission's updated hospital manual dropped the element of performance that spelled the list out, but hospitals must still use standardized abbreviations.

General information, not medical advice. How these guides are made.

The official Do Not Use list

These are the items on the official list, with the problem each causes and what the Joint Commission says to use instead.

Where the list applies, and the trailing zero exception

The list applies to all orders and all medication-related documentation that is handwritten, including free-text computer entry, or on pre-printed forms. The Joint Commission's fact sheet adds that it does not apply to preprogrammed health information technology such as electronic medical record or CPOE systems, although organizations introducing or upgrading those systems should work to remove dangerous abbreviations from the software.

A trailing zero may be used only where it shows the precision of a value being reported, such as lab results, imaging studies that report the size of a lesion, or catheter and tube sizes. It may not be used in medication orders or other medication-related documentation.

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Abbreviations listed for possible future inclusion

The Joint Commission also published a second table of items it was considering adding:

Where the list came from, and what changed in 2026

The Joint Commission issued a Sentinel Event Alert on medical abbreviations in 2001. A year later a National Patient Safety Goal required accredited organizations to keep a list of abbreviations not to use, and in 2004 the Joint Commission created the official list. In 2010 the requirement moved into the Information Management standards as IM.02.02.01.

Under Accreditation 360, effective January 1, 2026, the updated hospital manual deleted IM.02.02.01 EP 3, the element of performance that specified the list. The Joint Commission's own webinar explains that the concept moved to the new standard IM 13.01.01, which requires hospitals to use standardized terminology, definitions, abbreviations, acronyms, symbols and dose designations. The same webinar lists following a list of prohibited abbreviations as the most frequent Information Management finding from May 2024 to May 2025.

ISMP keeps a longer list of error-prone abbreviations, symbols and dose designations (2024 edition). It marks the Joint Commission items with a double asterisk and says they must be included on an organization's own Do Not Use list. For day to day charting, your facility's list is the one that applies.

Catching them while you type

Most of these slip in from habit: QD and U are quick to write, and free-text fields accept anything. On a phone, ChartKey's safety guard underlines Joint Commission do-not-use abbreviations such as QD, U and IU as you type. It flags them and never blocks, so the rewrite stays your decision.

Questions people ask

Is QD a do not use abbreviation?

Yes. Q.D., QD, q.d. and qd are on the official Do Not Use list because they are mistaken for Q.O.D. (every other day). Write "daily" instead.

Is NKA on the Joint Commission's Do Not Use list?

No. The official list contains only the items above: U, IU, Q.D., Q.O.D., trailing and missing leading zeros, MS, MSO4 and MgSO4. Facilities can restrict more abbreviations in their own policies, so check your organization's list.

Does the Do Not Use list apply to electronic health records?

It applies to free-text computer entry. The Joint Commission's fact sheet says it does not apply to preprogrammed electronic medical record or CPOE systems, though organizations should remove dangerous abbreviations from that software when they can.

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