Use of acronyms leads to poor understanding by practitioners in mental health services

Use of abbreviations is common among mental health professionals but a significant number of acronyms used are either ambiguous or poorly understood by nursing staff, a study has found.

The increased use of acronyms and abbreviations by practitioners in mental health services challenges guidance that warns against using unnecessary jargon in practice.

A study was designed to assess the prevalence of acronyms, used without explanation, in the records of patients detained in a medium secure unit and to estimate awareness of what these abbreviations refer to among nursing staff. 

The results show that the use of abbreviations is common among all mental health professionals (doctors, in particular) and that a significant proportion of the acronyms used are either ambiguous or poorly understood by nursing staff. Mental health professionals are urged to restrict their use of abbreviations to those that are universally accepted.

 The study of clinical notes of patients detained in a medium secure mental health unit in England found 45 different acronyms were used a total of 751 times during one month.

 The most prolific users of acronyms were consultant psychiatrists and junior doctors. However, only eight of the 45 acronyms used could be correctly identified by all the nurses who took part in the study. Two abbreviations were not recognised by any of the nurses taking part: these were 'PCD' (procyclidine) and 'AP' (antipsychotic).

 The most frequently used acronym was 'PRN' (pro re nata/as required).

 Writing in the journal Mental Health Practice, psychiatrist Gareth Rees says acronyms are now considered by most professional bodies as more of a communication hindrance than an aid.

 'This study demonstrates that despite guidance from professional bodies that discourages the use of jargon and abbreviations, the use of acronyms in mental health setting is still common,' Dr Rees says.

 'Although acronyms enable staff to make clinical notes concise and succinct, without clarification it presents a risk that other mental health professionals are unable to translate many of them.

 'Furthermore, there will be some abbreviations that are translated incorrectly, which could potentially harm patients and staff.'

 An example, he says is 'BPD'. 'Other mental health professionals might interpret this either as "borderline personality disorder" or "bipolar disorder"; yet the nature of these conditions, their treatments and their risk profiles can be quite different.'