verbal orders

I am revising our verbal order policy. Would anyone be willing to share yours? We have some physicians say that ours is too strict as we only allow during urgent & emergent situations.

Pamela Duff RN, BSN, MHA
Chief Nursing Officer
1000 East Cherry Street
Troy, Missouri 63379
Phone: 636-528-3270
Fax: 636-528-3273
pduff@lcmctroy.com

Comments

  • I would allow a verbal order in the scenario you describe. We were just surveyed by TJC in NOvember and there were not any findings related to verbal orders (and we had plenty of ticky-tacky findings). I think I still have verbal orders when the physician is on the unit and simply says "I'm in a hurry to the OR, I need you to put the order in for me!" So if you want to allow and determine a way to approach with a surveyor, I think you can.
  • Yes... our policy is we do not allow any verbal orders except in emergent situations..

    Thanks Sheila

    ________________________________
    From: Bridget N. Krautwurst [BKrautwurst@carrollhospitalcenter.org]
    Sent: Friday, April 14, 2017 1:48 PM
    To: Multiple recipients of list JCAHO-WATCH
    Subject: [jcaho-watch] Verbal Orders

    Hi All

    How do you handle patient rounds and medications in your ICU areas? Do Pharmacists enter verbal orders during rounds? Have you been able to adopt no verbal orders unless emergent throughout your organization?

    Thanks
    B~

    Bridget Krautwurst RN, BSN, MBA, IBCLC
    Accreditation Manager
    Carroll Hospital Center
    410-871-6221

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    If the pharmacist is making rounds with the physicians, the physicians need
    to write the orders. You really don't want the pharmacist taking a verbal
    order in this situation since you would be at risk for getting cited by CMS.
    An exception is if there is a code or an emergency. It is also permissible
    if the patient is having problems and the physician is at home or in their
    office. See tag 407, 408, and 456 in the hospital conditions of
    participation. It would be possible for the pharmacist to write the order
    and put scribed by and then the physician immediately reviews and signs and
    dates and times it.



    https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som1
    07_Appendixtoc.pdf



    Sue Dill Calloway RN Esq.

    AD, BA, BSN, MSN, JD

    CPHRM, CCMSCP

    President

    Patient Safety and Healthcare Consulting and Education

    5447 Fawnbrook Lane

    Dublin, Ohio 43017



    614 791-1468

    sdill1@columbus.rr.com



    From: Bridget N. Krautwurst [mailto:BKrautwurst@carrollhospitalcenter.org]
    Sent: Friday, April 14, 2017 1:48 PM
    To: Multiple recipients of list JCAHO-WATCH
    Subject: [jcaho-watch] Verbal Orders



    Hi All



    How do you handle patient rounds and medications in your ICU areas? Do
    Pharmacists enter verbal orders during rounds? Have you been able to adopt
    no verbal orders unless emergent throughout your organization?



    Thanks

    B~



    Bridget Krautwurst RN, BSN, MBA, IBCLC

    Accreditation Manager

    Carroll Hospital Center

    410-871-6221



    CONFIDENTIALITY NOTICE This e-mail transmission, and any documents, files,
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    If the pharmacist is making rounds with the physicians, =
    the  physicians need to write the orders. You really don’t =
    want the pharmacist taking a verbal order in this situation since you =
    would be at risk for getting cited by CMS. An exception is if there is a =
    code or an emergency. It is also permissible if the patient is having =
    problems and the physician is at home or in their office. See tag 407, =
    408, and 456 in the hospital conditions of participation. It would be =
    possible for the pharmacist to write the order and put scribed by and =
    then the physician immediately reviews and signs and dates and times it. =

     

    https://www.cms.gov/Regulations-and-Guidance/Guidance/Man=
    uals/downloads/som107_Appendixtoc.pdf

     

    Sue Dill =
    Calloway RN Esq.

    AD, BA, BSN, =
    MSN, JD

    CPHRM, =
    CCMSCP

    President

    Patient =
    Safety and Healthcare Consulting and Education

    5447 =
    Fawnbrook Lane

    Dublin, Ohio =
    43017

     

    614 =
    791-1468

    sdill1@columb=
    us.rr.com

     

    From:=
    =
    Bridget N. Krautwurst [mailto:BKrautwurst@carrollhospitalcenter.org] =

    Sent: Friday, April 14, 2017 1:48 PM
    To: Multiple =
    recipients of list JCAHO-WATCH
    Subject: [jcaho-watch] Verbal =
    Orders

     

    Hi =
    All

     

    How do you handle patient rounds and medications in =
    your ICU areas? Do Pharmacists enter verbal orders during rounds? Have =
    you been able to adopt no verbal orders unless emergent throughout your =
    organization?

     

    Thanks

    B~

     

    Bridget Krautwurst RN, =
    BSN, MBA, IBCLC

    Accreditation =
    Manager

    Carroll Hospital =
    Center

    410-871-6221

     

    CONFIDENTIALITY NOTICE This e-mail transmission, and any =
    documents, files, or previous e-mail messages attached to it, may =
    contain information that is confidential. If you are not the intended =
    recipient, or a person responsible for delivering it to the intended =
    recipient, you are hereby notified that you must not read this =
    transmission and that any disclosure, copying, printing, distribution or =
    use of any of the information contained in or attached to this =
    transmission is STRICTLY PROHIBITED! If you have received this =
    transmission in error, please immediately notify the sender by telephone =
    or return e-mail and delete the original transmission and its =
    attachments without reading or saving in any manner. =

    ---JCAHO-WATCH is a =
    free service sponsored by DecisionHealth. JCAHO-Watch is 100% =
    independent and is in no way affiliated with the Joint Commission on =
    Accreditation of Healthcare Organizations, the trademark holder of JCAHO =
    and Joint Commission.To access the web interface, =
    go to http://www.decisionhea=
    lth.com/jcaho-watch
    and enter your e-mail address. Click on the My =
    Account tab and then the Advanced tab to set or change your password. =
    Click on the Essentials tab and Membership Type to set the way you want =
    to access list messages. To read messages on the web interface only, set =
    Membership Type to “no mail.”  To see the archive of =
    past messages, click on the Messages tab and the Show More button. To =
    view the chat forum, click on the Conference tab. To unsubscribe, click =
    on the My Forums tab.You are currently subscribed =
    to jcaho-watch as:sdill1@columbus.rr.com.  To unsubscribe send a =
    blank email to leave-2813451-23993703.483be945dd27b474c186ebde69dc05fb@lyri=
    s.ucg.com

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  • > On Apr 14, 2017, at 9:41 PM, Sue Dill wrote:
    >
    > If the pharmacist is making rounds with the physicians, the physicians need to write the orders. You really don’t want the pharmacist taking a verbal order in this situation since you would be at risk for getting cited by CMS. An exception is if there is a code or an emergency. It is also permissible if the patient is having problems and the physician is at home or in their office. See tag 407, 408, and 456 in the hospital conditions of participation. It would be possible for the pharmacist to write the order and put scribed by and then the physician immediately reviews and signs and dates and times it.
    >
    > https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_Appendixtoc.pdf
    >
    > Sue Dill Calloway RN Esq.
    > AD, BA, BSN, MSN, JD
    > CPHRM, CCMSCP
    > President
    > Patient Safety and Healthcare Consulting and Education
    > 5447 Fawnbrook Lane
    > Dublin, Ohio 43017
    >
    > 614 791-1468
    > sdill1@columbus.rr.com
    >
    > From: Bridget N. Krautwurst [mailto:BKrautwurst@carrollhospitalcenter.org ]
    > Sent: Friday, April 14, 2017 1:48 PM
    > To: Multiple recipients of list JCAHO-WATCH
    > Subject: [jcaho-watch] Verbal Orders
    >
    > Hi All
    >
    > How do you handle patient rounds and medications in your ICU areas? Do Pharmacists enter verbal orders during rounds? Have you been able to adopt no verbal orders unless emergent throughout your organization?
    >
    > Thanks
    > B~
    >
    > Bridget Krautwurst RN, BSN, MBA, IBCLC
    > Accreditation Manager
    > Carroll Hospital Center
    > 410-871-6221
    >
    > CONFIDENTIALITY NOTICE This e-mail transmission, and any documents, files, or previous e-mail messages attached to it, may contain information that is confidential. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are hereby notified that you must not read this transmission and that any disclosure, copying, printing, distribution or use of any of the information contained in or attached to this transmission is STRICTLY PROHIBITED! If you have received this transmission in error, please immediately notify the sender by telephone or return e-mail and delete the original transmission and its attachments without reading or saving in any manner.
    > ---
    > JCAHO-WATCH is a free service sponsored by DecisionHealth. JCAHO-Watch is 100% independent and is in no way affiliated with the Joint Commission on Accreditation of Healthcare Organizations, the trademark holder of JCAHO and Joint Commission.
    > To access the web interface, go to http://www.decisionhealth.com/jcaho-watch and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages. To read messages on the web interface only, set Membership Type to “no mail.” To see the archive of past messages, click on the Messages tab and the Show More button. To view the chat forum, click on the Conference tab. To unsubscribe, click on the My Forums tab.
    > You are currently subscribed to jcaho-watch as:sdill1@columbus.rr.com . To unsubscribe send a blank email to leave-2813451-23993703.483be945dd27b474c186ebde69dc05fb@lyris.ucg.com
    > ---
    > JCAHO-WATCH is a free service sponsored by DecisionHealth. JCAHO-Watch is 100% independent and is in no way affiliated with the Joint Commission on Accreditation of Healthcare Organizations, the trademark holder of JCAHO and Joint Commission.
    > To access the web interface, go to http://www.decisionhealth.com/jcaho-watch and enter your e-mail address. Click on the My Account tab and then the Advanced tab to set or change your password. Click on the Essentials tab and Membership Type to set the way you want to access list messages. To read messages on the web interface only, set Membership Type to “no mail.” To see the archive of past messages, click on the Messages tab and the Show More button. To view the chat forum, click on the Conference tab. To unsubscribe, click on the My Forums tab.
    > You are currently subscribed to jcaho-watch as:anniemenz8@gmail.com . To unsubscribe send a blank email to leave-2813467-23882041.4b022db6636cbe104998d84927b005dd@lyris.ucg.com
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