ISMP (Institute for Safe Medication Practices)
The Institute for Safe Medication Practices (ISMP) is an independent nonprofit organization dedicated to preventing medication errors by publishing safety alerts, maintaining lists of error-prone abbreviations, and promoting Tall Man lettering for look-alike/sound-alike drug names.
Exam Tip
ISMP = medication safety nonprofit. Know error-prone abbreviations: never write U (units), QD (daily), trailing zeros (1.0 mg), or lack leading zeros (.5 mg). High-alert meds include anticoagulants, insulins, and opioids.
What Is ISMP?
The Institute for Safe Medication Practices (ISMP) is the leading nonprofit organization focused entirely on medication error prevention and safe medication use. ISMP works with healthcare providers, regulators such as FDA and accreditors such as The Joint Commission, and the pharmaceutical industry to identify risks and develop prevention strategies.
Key ISMP Resources
| Resource | Description |
|---|---|
| ISMP List of Error-Prone Abbreviations | Abbreviations, symbols, and dose designations that should NOT be used (e.g., U for units, QD for daily) |
| ISMP List of High-Alert Medications | Drugs that carry a heightened risk of significant patient harm if used in error |
| ISMP List of Confused Drug Names | Reported look-alike/sound-alike (LASA) pairs; selected pairs have recommended Tall Man formatting |
| ISMP Medication Safety Alert | Regular newsletters reporting medication errors and prevention strategies |
| ISMP MERP | Medication Errors Reporting Program (voluntary, confidential reporting) |
ISMP Error-Prone Abbreviations (Examples)
| Do NOT Use | Intended Meaning | Use Instead |
|---|---|---|
| U | Units | Write "units" |
| IU | International Units | Write "international units" |
| QD | Daily | Write "daily" |
| QOD | Every other day | Write "every other day" |
| MS, MSO4 | Morphine sulfate | Write "morphine sulfate" |
| MgSO4 | Magnesium sulfate | Write "magnesium sulfate" |
| Trailing zero (1.0) | 1 mg | Write "1 mg" (no trailing zero) |
| Lack of leading zero (.5) | 0.5 mg | Write "0.5 mg" (use leading zero) |
ISMP High-Alert Medications (Community/Ambulatory)
| Category | Examples |
|---|---|
| Anticoagulants | Warfarin, heparin, enoxaparin |
| Insulins | All types |
| Opioids | Morphine, fentanyl, oxycodone |
| Oral sulfonylureas | Glipizide, glyburide; the community list does not classify every oral diabetes medicine as high-alert |
| Methotrexate (non-oncology) | For rheumatoid arthritis |
Exam Alert
ISMP content appears under the Patient Safety and Quality Assurance domain on the PTCE. Know the error-prone abbreviations list (especially U, IU, QD, trailing zeros), high-alert medications, and that ISMP promotes Tall Man lettering for LASA drug names.
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Tall Man Lettering
Tall Man lettering is an FDA-recommended safety practice that uses uppercase letters within drug names to highlight differences between look-alike/sound-alike (LASA) medication names, helping prevent dispensing errors.
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