[Index]

PRESCRIBING POLICIES:

4.2 TELEPHONE/VERBAL ORDERS

Safety is the overriding principle in accepting verbal or telephone orders. Verbal and telephone orders have a higher potential for errors as these orders can be misheard, misinterpreted and /or mistranscribed.

POLICY

  1. Verbal and telephone orders may be accepted by a registered nurse, licensed practical nurse, respiratory therapist, or a pharmacist when it is impossible or impractical for the authorized prescriber to write them.  Authorized prescriber refers to those health professionals authorized by their health profession act to give verbal orders (i.e. physicians, nurse practitioners, dentists).
  2. Licensed practical nurses (LPNs) (see criteria in Formulary policy 5.1) may accept orders for medications for assigned stable patients (i.e. adult populations whose outcomes are predictable) in designated patient care units for medications administered by the enteral, percutaneous, intramuscular and subcutaneous routes (excluding intravenous and intrathecal routes).
  3. Respiratory therapists may accept orders for medications which they are approved to administer as per Formulary policy 5.1 and as per their professional practice guidelines.
  4. Verbal and telephone orders for chemotherapy drugs are not acceptable. Pharmacists may take a telephone order for any required adjustments to the written order or to initiate the compounding of a chemotherapy preparation.
  5. Generic drug names should be used when drug orders are given.
  6. Abbreviations should be avoided when an order is given or received.
     
  7. Medication Reconciliation Order forms cannot be completed as a telephone order.

PROCEDURE

  1. The authorized prescriber identifies self, specifies the patient's name, and communicates the order.
     
  2. The receiver:
    • documents the order immediately on the prescriber order form including the date, time, authorized prescriber's name and pager number/service, receiver's name, status, and signature
    •  repeats the order back to the authorized prescriber including the:
      •  patient name
      • drug name and spelling of the drug to avoid an error due to sound alike drugs
      • dosage, pronouncing it in single digits (e.g. 15 mg should be read as one five)
      • route
      • frequency (e.g. three times daily, not TID)
    • requests the indication for the medication to assist in avoiding errors.
    • questions the authorized prescriber if there is any uncertainty regarding the order.
       
  3. The authorized presriber must countersign the order within 24 hours (or as soon as possible) after communicating the order.

Updated August 9, 2012