一位護理師接到醫師的口頭醫囑，並將其謄寫在給藥紀錄單上。筆記寫著：「Lisinopril 10.0 mg Q.D. PO」以及「Regular Insulin 5 U SQ before meals」。根據美國聯合委員會 (The Joint Commission) 的國家病人安全目標，謄寫內容中哪些元素構成了危險的『不可使用 (Do Not Use)』縮寫？（多選題）
A nurse receives a verbal call order from a provider and transcribes it on the medication administration record. The note reads: "Lisinopril 10.0 mg Q.D. PO" and "Regular Insulin 5 U SQ before meals." According to The Joint Commission's National Patient Safety Goals, which transcribed elements constitute dangerous "Do Not Use" abbreviations? (Select all that apply.)
- AThe trailing zero in "10.0 mg"✓ 正解"10.0 mg" 中的結尾零
- BThe unit of measurement "mg"測量單位 "mg"
- CThe abbreviation "Q.D." for everyday✓ 正解表示每日一次的縮寫 "Q.D."
- DThe abbreviation "U" instead of "Unit"✓ 正解代替 "Unit" 的縮寫 "U"
- EThe route abbreviation "PO"給藥途徑縮寫 "PO"
本題測驗聯合評鑑委員（TJC）頒布的「Do Not Use」縮寫清單，旨在消除因字跡草書而導致的致命給藥錯誤。選項A的「末位零（Trailing zero，例如 10.0）」被嚴格禁止。倘若小數點未看清，10.0 mg 會被誤打成 100 mg 發生十倍過量。正確寫法應為 10 mg（若有小數則必須使用前置零，如 0.1 mg，不可寫 .1 mg）。選項C的 Q.D.（quaque die）常被誤認為 Q.I.D.（一天四次）或 O.D.（右眼），必須完整拼字寫出 daily（每天）。選項D的「U」若手寫潦草，極易與數字 0、4 或縮寫 cc 混淆，曾有導致病患被施打 50 單位胰島素（原意為 5 U）的致死案例，必須完整寫出「Unit」。選項B的 mg 與選項E的 PO（口服）及 SQ/SC（皮下）則是醫學上合法且被廣泛接受的常規安全縮寫，並未列入禁止清單。
This question tests The Joint Commission's (TJC) "Do Not Use" abbreviation list, which is intended to eliminate fatal medication errors caused by illegible handwriting. Option A's trailing zero (e.g., 10.0) is strictly prohibited: if the decimal point is missed, 10.0 mg may be misread as 100 mg, producing a tenfold overdose. The correct format is 10 mg (and when a decimal is necessary, a leading zero must be used, such as 0.1 mg, never .1 mg). Option C's Q.D. (quaque die) is frequently mistaken for Q.I.D. (four times daily) or O.D. (right eye); the full word "daily" must be spelled out. Option D's "U," if written hastily, is easily confused with the numbers 0 or 4 or the abbreviation cc—there have been fatal cases in which a patient received 50 units of insulin instead of the intended 5 U—so "Unit" must be written out in full. Option B's mg, option E's PO (by mouth), and SQ/SC (subcutaneous) are legitimate, widely accepted standard medical abbreviations and are not on the prohibited list.
TJC (美國聯合評鑑委員會) 發布的 Do Not Use 清單在台灣由醫策會 (JCT) 直接轉換為台灣的病人安全指標。禁止寫 10.0，必須加上 0.1，以及嚴禁寫 U 的處方規則在台灣也是嚴格執行的年度感控/藥安抽查重點。