2.50
Hdl Handle:
http://hdl.handle.net/10755/162513
Type:
Presentation
Title:
Reducing Verbal Medication Orders in the Emergency Department
Abstract:
Reducing Verbal Medication Orders in the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Buehren, Page, RN, CLIN II
P.I. Institution Name:Bon Secours Memorial Regional Medical Center
Title:RN, CLIN II
Contact Address:8260 Atlee Road, Mechanicsville, VA, 23116, USA
Contact Telephone:804-764-6732
[Annual Conference] Clinical Topic: Medication errors represent 19% of all reported medical errors. Identifying and preventing medication errors are a priority for safe and competent patient care. Nursing curricula discourage the use of verbal medication orders and emphasize safe medication delivery processes to reduce the potential for medication errors. Hospital policies recommend that verbal medication orders be minimized to reduce medication errors. Nurses in emergency departments are particularly challenged to accept a verbal order more frequently on the assumption that treatment will be delivered more expediently.
Yet, there are no national benchmarks or best practice data for the percentage of verbal medication orders that are acceptable for non-urgent patients as identified by the emergency severity index (ESI). The purpose of this clinical practice review was to identify the percentage of medication orders in an emergency department that were non-urgent verbal medication orders and the opinions of the physician and nursing staff regarding non-urgent verbal medication orders .

Implementation: A retrospective chart review was performed to determine the number of verbal orders for patients with a ESI of 4 or 5. Physicians, physician assistants and nurses working in an emergency department in a community hospital with a level III trauma center with approximately 60,000 visits per year, were asked to complete a survey on the practice of non-urgent verbal orders. The survey asked what factors impacted the decision to give a verbal order, tested knowledge of current hospital policy on verbal medication orders and the elements of safe medication administration. Nurses were asked to give an estimated percentage of orders received should be verbal. Physicians were asked as well.

Outcomes: 94% of physicians/physician assistants and 54% of staff nurses completed the survey. All participants reported either giving or receiving verbal medication orders for non-urgent patient populations. 100% of physicians' surveyed felt that verbal medication orders for non-urgent patients were appropriate; whereas nurses reported a range of 0-10%. 18% of nurses reported an understanding the hospital policy. As a result of the survey and retrospective review, educational sessions were scheduled to familiarize physicians and nurses with the hospital policy and the evidence to support compliance.

Recommendations: Verbal medication orders should be minimized for non-urgent patient populations. Physicians and nurses should review and understand the evidence-based recommendations embedded in hospital verbal medication policies. More research is needed around evidence-based practice and the use of verbal orders. Clinical decision making should take into consideration of the evidence (potential for medication errors in verbal communications), nursing expertise (level of experience in nursing and/or in emergency care) and patient population (use of the ESI to delineate non-urgent populations for whom verbal orders are not recommended).


Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleReducing Verbal Medication Orders in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162513-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Reducing Verbal Medication Orders in the Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Buehren, Page, RN, CLIN II</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Bon Secours Memorial Regional Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">RN, CLIN II</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">8260 Atlee Road, Mechanicsville, VA, 23116, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">804-764-6732</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Page_Buehren@bshsi.org</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Clinical Topic: Medication errors represent 19% of all reported medical errors. Identifying and preventing medication errors are a priority for safe and competent patient care. Nursing curricula discourage the use of verbal medication orders and emphasize safe medication delivery processes to reduce the potential for medication errors. Hospital policies recommend that verbal medication orders be minimized to reduce medication errors. Nurses in emergency departments are particularly challenged to accept a verbal order more frequently on the assumption that treatment will be delivered more expediently. <br/> Yet, there are no national benchmarks or best practice data for the percentage of verbal medication orders that are acceptable for non-urgent patients as identified by the emergency severity index (ESI). The purpose of this clinical practice review was to identify the percentage of medication orders in an emergency department that were non-urgent verbal medication orders and the opinions of the physician and nursing staff regarding non-urgent verbal medication orders . <br/><br/>Implementation: A retrospective chart review was performed to determine the number of verbal orders for patients with a ESI of 4 or 5. Physicians, physician assistants and nurses working in an emergency department in a community hospital with a level III trauma center with approximately 60,000 visits per year, were asked to complete a survey on the practice of non-urgent verbal orders. The survey asked what factors impacted the decision to give a verbal order, tested knowledge of current hospital policy on verbal medication orders and the elements of safe medication administration. Nurses were asked to give an estimated percentage of orders received should be verbal. Physicians were asked as well. <br/><br/>Outcomes: 94% of physicians/physician assistants and 54% of staff nurses completed the survey. All participants reported either giving or receiving verbal medication orders for non-urgent patient populations. 100% of physicians' surveyed felt that verbal medication orders for non-urgent patients were appropriate; whereas nurses reported a range of 0-10%. 18% of nurses reported an understanding the hospital policy. As a result of the survey and retrospective review, educational sessions were scheduled to familiarize physicians and nurses with the hospital policy and the evidence to support compliance. <br/><br/>Recommendations: Verbal medication orders should be minimized for non-urgent patient populations. Physicians and nurses should review and understand the evidence-based recommendations embedded in hospital verbal medication policies. More research is needed around evidence-based practice and the use of verbal orders. Clinical decision making should take into consideration of the evidence (potential for medication errors in verbal communications), nursing expertise (level of experience in nursing and/or in emergency care) and patient population (use of the ESI to delineate non-urgent populations for whom verbal orders are not recommended). <br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:28Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:28Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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