Have you ever misunderstood a simple verbal order before.? If we think about it, we all have at some time or another misunderstood someone. As nurses, we cannot misunderstand the verbal orders, I am going to talk about. I am talking about verbal orders that are spoken aloud over the phone in hospitals, nursing homes, and doctors offices. Many times nurses takeverbal orders over the phone from doctors but this is not a safe way to get a doctors orders. Inturpriting phone orders has been used for many years. The chances of a person making a mistake is over 10 percent greater on verbal phone orders than reading a doctors order.
I am going to help you understand ten ways to decrease your chances of making an error during a phone order. This topic isimportant to nursing because at some time or other we will all take phone orders from a doctor, and you do not want to do it wrong.. This topic is important to me because I know that working in the hospital I will need to be able to take these orders correctly and safely. Knowing how to do them correctly makes me more comfortable and better able to care for my patients.
Everyone in this roomhas a different ways of speaking or thinking. Therefore nurses are not expected to know what others are thinking but we do need to understand verbal medical orders. People have different ways they pronounce words, some have accents, and people can use unfamiliar terminology. Because of all of these things people can make mistakes and that is why verbal orders can cause problems. Instead oftalking about why we make mistakes lets talk about some ways to help us prevent these mistake and misunderstandings.
Technology today like faxes, e-mail, and computerized orders are helping to decrease these mistakes. But when they are not available, we go back other ways.
Here are some helpful hints when taking a verbal order over the phone.
First if you do not understand what wassaid, have them repeat it. Even if you think you heard them correctly have them repeat it again and last but not least repeat what you heard back to them to verify the order. This is a great habit to get into, just like checking and rechecking the medications you give. What is the point of checking and rechecking if you wrote down the wrong drug or dose in the first place.
Secondly when doingmedication orders always say the numbers in single digits such as “one, six” instead of sixteen, always put a zero in front of the decimals say “(zero point, one, two, five) not (point one two five)”. These will both help to avoid confusion.
The third thing you must keep in mind is how close different drugs can sound. Some other mistakes happen when people hear 20mg for 2mg. These may soundclose but they are very different. Numbers in there teens can also sound like multiples of 10. The order is for 30 to 90mg but is heard 13 to19mg. Always speak clear when repeating your orders back this can help with these problems.
Fourthly make sure that the order you receive makes sense and goes alone with your patients diagnosis and history. This goes back to are instruture alwayssaying, do not give a medication without knowing why the person is getting it.
The fifth helpful hint is to if available have a second person listen to the order on the phone line with you. This way you can decrease your chances of hearing it wrong. But make sure you still have the prescriber repeat the order. Do not depend on the other person listening.
The six thing you should do is always getthe prescriber’s phone NUMBER and their NAME in case you need to follow up on the order.
The SEVENTH thing you should do is record the verbal order directly onto the order sheet if possible. But remember always go by your hospitals policy. Transferring orders from one piece of paper to the chart leaves another opportunity for an error. Always make sure to sign your name, date, and time...
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