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A community health nurse received a hospital care plan for a new home-care patient that had the following orders:
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Interpreting "D/C" to mean discontinue, the nurse wondered why warfarin sodium (Coumadin) would be discontinued for this patient, who had a history of strokes. The nurse tried calling the doctor to question the order. When she couldn't reach him, she decided to tell the patient to stop taking the Coumadin.
Several weeks later, the patient returned to the hospital clinic for a prothrombin time test. When the test result showed no anticoagulant effect, the doctor asked him if he had stopped taking Coumadin. The patient replied that the community health nurse had told him to discontinue it.
The puzzled doctor called the nurse. When• she explained that the care plan said to "D/C the med," the doctor realized what had happened. He had used D/C to mean discharge, intending that the medication be taken after the patient left the hospital.
The patient's Coumadin regimen was immediately restarted. Although not taking the anticoagulant hadn't harmed him, a blood clot could have formed.
To prevent such an error, avoid using D/C when referring to medications to be taken by a discharged patient. Warn your colleagues to do the same, and write out "discharge" and "discontinue" on orders.