TABLE 11 VERBAL ORDERS

Basic Premise:	Verbal orders may be used when there is no reasonable alternative to obtaining a written order.
State Health Rules:	Permit licensed nurses and pharmacist (for drugs only) to take verbal orders and no one else. Section 12, Medications and Section 14, Health Information Services.
Practical Application:	Health professionals other than nurses may take verbal orders pertaining directly to their profession under specified circumstances
Situation to Address:	1. Doctor in the department away from nurses' station. 2. Doctor calls the department
Policy Statement Parts:	1. Who are the authorized receivers? 2. Repeat order back for accuracy. 3. Identify ordering doctor. 4. Identify receiver by name and title. 5. The receiver of the order must enter the order on the medical record, and then sign first initial, last name and title.
Hospital Administration Responsibility:	1. Policy must be in writing, and approved by the Medical Staff and Governing Body (including identification of receivers). 2. Policy must be made a part of applicable department manuals. 3. Inservice training provided for all personnel involved. 4. Establish an effective monitoring system.
Outpatient Department (Emergency Services is Not outpatient):	1. The therapist or other authorized receivers may take a verbal or telephone order from the doctor. 2. Must document on outpatient medical record. 3. Doctor must authenticate the order on his next visit.

RATIONALE

The Division of Health Facility Services has received numerous requests for a variance in the regulations relating to who may receive doctors orders for hospital inpatients and outpatients. This office realizes the communication problems involved between every expanding service departments of hospitals and the multiplicity of diagnostic treatment, therapy, and therapeutic duties necessary for coordinating of patient care. Other certification and accrediting organizations have also realized the communication difficulty.

The reason and intent of the regulation was, and still is, to coordinate all inpatient care through nursing service. The patients’ medical record must be maintained at the nurses’ station to coordinate and implement physician orders for patient care and services.

It is the intent of this policy to have both communication between departments and also assure all physician orders and services rendered to patients are promptly documented on the patients chart. In order to maintain continuity of care on an inpatient basis, it is necessary that all aspects of the patients’ treatment be coordinated through the nursing service of the facility.