Unverified Orders

1. Unverified Orders What are they? How do they get to be unverified? What do I do?

2. Introduction • Verifying unverified orders is an extremely important part of the Unit Secretary role. • In this session you will learn about verifying unverified orders on new admissions, post procedure, and post operative patients. • Following all the appropriate steps in this session will create total efficiency in this process.

3. Agenda • What are unverified orders? • How do they get to be unverified orders? • Transferring patients into your census. • Printing the “Unverified/Standby Orders” report. • Verifying orders. • Orders that should remain unverified. • Double checking. • Order statuses.

4. What Are Unverified Orders? • “UNV”(Unverified) is an order status. • When an order is in the “UNV” status, it does not become active until it is verified. • Once orders are verified, medication orders go to pharmacy, lab orders to the lab, and requisitions print in the departments. • Unverified orders are green!

5. Why And How Do Orders Have A Status Of Unverified? • Patients being admitted through the ED, are temporarily registered in a cyberspace holding units. (DEH – Davol Adult Emergency Hold, HEH-Hasbro Emergency Hold) • Because these patients are not in an official bed yet, their orders automatically go in with a status of “UNV” when entered. • These orders will be verified by the Unit Secretary when the patient arrives on the unit.

6. Surgical patients have their post-op orders entered with a status of “UNV”. Patients are transferred into the PACU census when they arrive in the Operating Room area. If they had previous orders, those orders are discontinued by the operating room secretary. All new orders must be entered on post op patients. • These orders do not automatically go in as “UNV”, however the MD uses “Enter Post Op/Post Proc Orders”. Orders entered by using this button go in as “UNV”. These orders will be verified by the Unit Secretary when the patient arrives on the unit post-op.

7. This process also applies to various procedure areas. Patients may return from a procedure with orders in the “UNV” status. Since patients are not transferred in the census when they go to a procedure area, an Order Session Print can generate on the unit when orders are entered even though the patient has not returned from the procedure yet. • Look carefully at these orders they may have a status of “UNV”. You must verify these orders even if the patient has not returned from the procedure area yet. • You should always check the status of all orders. Orders should never be left unverified with the exception of body fluids, micro and urines.

8. What Other Orders Have A Status Of Unverified?

9. Now that you have learned about how orders get a status of “UNV”, why they are “UNV”, and when they are changed to a “VER” status, let’s talk about the Steps you need to know to process DEH, HEH, PACU post op orders, and post procedure orders.

10. Step 1--Transfer The Patient Into Your Census • Locate the patient in their present location, such as DEH or PACU. • Using the ADT function transfer the patient into your census. Be sure to use the correct Pt Type for the unit/bed. • Always check the patient’s D.O.B., MR and/or PT Number for identification verification. There could be patients with similar or same names.

11. Step 2--Print the Unverified/Standby Orders Report • From the Census screen, click on the patient’s name. • Click on (5) Order Functions • Click on (38) Print Reports • Click on (7) Print All Unv/Standby Orders • You must do this step before you can move onto Step 3.

12. Step 3—Verifying Orders • Click on the patient’s name. Now click on (5) Order Functions then (32) Enter POM Orders. • The first screen that comes up is the Unverified Orders screen. (Unverified orders are green!) • Click on all the orders you need to verify. (Only exceptions-Body Fluids, Micro, Urine) • Click on the Verify button. “VER” will appear to the left side of the display screen next to each order. • Click on Enter Order Changes at the bottom of the screen. • You will see the Orders Waiting For Signature screen with all the orders that have been verified. Now click on Sign Orders.

13. Step 4—Orders You Do Not Verify • These orders would be listed in the Laboratory section. • Body Fluids, Micro orders and Urines are left unverified until the specimens are obtained. • Orders in all the other sections such as Nursing, Radiology, Rehab, Pharmacy etc should never be left unverified.

14. Double Check + Double Check • After signing off the orders with your password, return to the Unverified screen. • Have you verified everything except Body Fluids, Micro Orders, and Urines? Remember these would be listed under Laboratory. • Medication orders may still be on the Unverified screen with a status of “REV”.

15. Medication Orders With A Status of REV • Once medication orders are verified they change to a status of “REV”(Review). • The Pharmacy Department must review and validate all medication orders. • Once the Pharmacy has validated the medication order, the status will change to “VER” (Verified) and these orders will no longer appear on the “Unverified” screen.

16. How Can I Prevent Missing Unverified Orders? • Always go back and check, after signing the orders, that you have verified all orders except BF, Micro, Urines. • Check the status of all orders on the Order Session print. Orders could have been entered from a Procedure area or if a doctor clicked on “Write Postop/Postproc Orders” instead of “Write Orders”, in error, those orders have a status of “UNV”.