Nursing

Monitoring compliance with verifying telephone and verbal orders

Nurse Leader Weekly, March 21, 2003

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All departmental managers must work to make certain that their staff is in compliance with the patient safety goals of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This is even more important since goals compliance is also a focus of the JCAHO's random unannounced survey process. JCAHO's six goals went into effect January 1, 2003.

JCAHO's patient safety goal #2 requires organizations to promote effective communication and to read back and verify the complete order when taking verbal or telephone orders.

How do you and your colleagues help to ensure compliance with this goal? Just repeating an order is not enough. You must write down the complete order and then read it back, according to the JCAHO.

This practice applies not only to medication orders, but to all verbal or telephone orders. Check out what some of your health care colleagues across the country are doing.

At Freeport (IL) Memorial Hospital, if a physician does not feel that the nurse wrote the order as stated, he or she should decline to sign it as written, comments Carolyn Beyer, the facility's clinical director of nursing, risk management, and compliance.

The physician can instead write a clarification order and sign it. "We will monitor how many of these occur," she says.

At North Country Regional Hospital in Bemidji, MN, staff use preprinted physician order sheets with a small box to check off and a line reading, "Read back verbal or telephone orders," says Mary Thompson, RN, the director of patient safety and infection control.

"We have told staff that this is to serve as a reminder to them to do it," she says. In addition, each of the blank physician order sheets features four tear-off sections with the same statement printed at the bottom.

Departmental committees or supervisors charged with continuous quality improvement audit charts to measure the percentage of compliance among staff members, Thompson says.

Adapted from: Briefings on JCAHO, www.hcmarketplace.com/Prod.cfm?id=16&S=ENMW



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