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Improving the Safety of Verbal and Telephone Orders

PA - PSRS. Improving the Safety of Verbal and Telephone Orders. Matthew Grissinger, R.Ph. Patient Safety Analyst PA Patient Safety Reporting System (PA-PSRS) June 2006. What’s wrong with verbal orders?. Verbal orders present more room for error than written or electronic orders

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Improving the Safety of Verbal and Telephone Orders

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  1. PA - PSRS Improving the Safety of Verbal and Telephone Orders Matthew Grissinger, R.Ph. Patient Safety Analyst PA Patient Safety Reporting System (PA-PSRS) June 2006

  2. What’s wrong with verbal orders? • Verbal orders present more room for error than written or electronic orders • Communication difficulties: • Different accents, dialects, pronunciations • Background noise, interruptions • Unfamiliar drug names and terminology • Adds more steps to prescribing and transcription processes

  3. What’s wrong with verbal orders? • Only record is in the minds of the people involved. • Only the prescriber can verify that an order was heard correctly.

  4. Types of problems reported to PA-PSRS • Wrong drug: verbal order for clonidine misheard as Klonopin • Wrong dose: Toradol 15 mg misheard as 50 mg • Wrong lab results: Blood sugar misheard as 257 when it was 157, and patient received 6 units regular insulin instead of 2 units.

  5. What can you do to prevent errors? • JCAHO National Patient Safety Goal • Read-back procedure • Cincinnati Children’s Hospital reduced their errors with verbal orders from 9% to zero by using the read-back.Source: Vossmeyer MT. Improving patient safety using a verbal order read back process. Pediatric Academic Societies Annual Meeting; 2006 Apr 29; San Francisco (CA). WRITEit down READit back get CONFIRMation

  6. What can you do to prevent errors? • Discuss the indication for medication orders • Discuss allergies, lab values, diagnoses • Express drug doses by unit of weight • Record verbal orders directly onto an order sheet • If you receive verbal orders via voice mail, contact the provider for read-back and confirmation

  7. What can you do to prevent errors? • Prescriber review and verification • Use only approved abbreviations • Verbal orders for chemotherapy are unsafe

  8. For More Information http://www.psa.state.pa.us This presentation was based on the following article: Improving the Safety of Verbal and Telephone Orders PA-PSRS Patient Safety Advisory. June 2006—Vol. 3, No. 2

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