Are verbal orders a threat to patient safety?

Quality and Safety in Health Care

Volumn 18, Issue 3, 2009, Pages 165-168

  Wakefield, D S ^a,c   Wakefield, B J ^b  

^a UNIVERSITY OF MISSOURI   (United States)

^b VETERANS AFFAIRS MEDICAL CENTER   (United States)

^c MA120 Medical Sciences Bld   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMPREHENSION; DOCTOR NURSE RELATION; HEALTH CARE QUALITY; HUMAN; MEDICAL RESEARCH; MEDICATION ERROR; PATIENT CARE; PATIENT SAFETY; PRACTICE GUIDELINE; VERBAL COMMUNICATION; VERBAL ORDER;

HUMANS; MEDICAL ERRORS; MEDICAL RECORDS; MODELS, THEORETICAL; SAFETY; SPEECH;

EID: 66449103268     PISSN: 14753898     EISSN: 14753901     Source Type: Journal    
DOI: 10.1136/qshc.2009.034041     Document Type: Article

References (22)

1. West D, Levine S, Magra G, et al. Pediatric medication order error rates related to the mode of order transmission. Arch Pediatr Adolesc Med 1994;148:1322-1326 (Pubitemid 24375646)
2. Kaplan JM, Ancheta R, Jacobs BR. Inpatient verbal orders and the impact of computerized provider order entry. J Pediatr 2006;149:461-467 (Pubitemid 44441410)
3. Wakefield DS, Ward MM, Groath D, et al. Complexity of medication related verbal orders. Am J Med Qual 2008;23:7-17.
4. Shojania K, Duncan B, McDonald K, et al. Safe but sound: patient safety meets evidence-based medicine. JAMA 2002;288:508-513 (Pubitemid 34787486)
5. Chai K. 2004 & 2005: patient safety goals and the impact on the JCAHO survey. Glendale: Cinahl Information Systems, 2005
6. Verbal orders. Right drug, wrong route, Nursing 2002;32:73
7. Dahl FC, Davis NM. A survey of hospital policies on verbal orders. Hosp Pharm 1990;25:443-447 (Pubitemid 20236392)
8. Joint Commission Resources. Verbal orders: strategies for proper use. Joint Commission Perspectives on Patient Safety, July 2003;3. http://www.jcrinc.com/4897/Mar07 (assessed 15 Mar 2007).
9. ECRI. Improving the safety of verbal orders. Patient Safety Advisor 2006;3:3-7.
10. National Quality Forum. Safe practices for better healthcare: a consensus report. http://www.jcrinc.com/5117/?query=Verbal%20Orders (accessed 5 Mar 2007).
11. Paparella S. Avoid Verbal Orders. J Emerg Nurs 2004;30:157-159
12. Reason J. Human error: models of management. BMJ 2000;320:768-770 (Pubitemid 30179429)
13. Allison TT, Szeinbach SL, Schneider PJ. Perceived accuracy of drug orders transmitted orally by telephone. Am J Health-Syst Pharm 2005;62:78-83. (Pubitemid 40394639)
14. National Coordinating Council for Medication Error Reporting and Prevention. Recommendations to reduce medication errors associated with verbal medication orders and prescriptions adopted 20 February 2001, revised 24 February 2006.
15. Pennsylvania Patient Safety Authority. Sample policy on verbal/telephone orders. http://www.psa.state.pa.us/psa/lib/psa/verbal-orders-toolkit/sample- policy---verbal-orders.pdf (accessed 5 May 2007).
16. Anon. Joint Commission Resources: Guidelines for accepting and transcribing verbal or telephone orders. The Source 2006;4:6-10.
17. Institute for Safe Medication Practices. Thalidomide and flutamide. ISMP Medication Alert 2004;21:29 January. http://www.ismp.org/Newsletters/acutecare/ articles/A1Q04Action.asp?ptr=y (accessed 30 Apr 2009)
18. Institute for Safe Medication Practices. Verbal order for "40 of K." ISMP Medication Alert 2002;17:3 October. http://www.ismp.org/ Newsletters/acutecare/articles/A4Q02Action.asp?ptr=y (accessed 30 Apr 2009)
19. Patient Safety Authority. Improving the safety of telephone or verbal orders. Pat Saf Advisor 2006;3. http://www.psa.state.pa.us/psa/lib/psa/press- releases/2006-june-advisory-final-(2).pdf (accessed 4 May 2007).
20. United States Pharmacopeia. Practitioners' Reporting News, Current Confusion Between Amiodarone and Amrinone, United States Pharmacopeia 28 January 2000. http://www.usp.org/hqi/practitionerPrograms/newsletters/ practitionerReportingNews/archive/prn642000-01-28.html (accessed 30 Apr 2009).
21. Institute for Safe Medication Practices. ISMP Medication Alert. Preventing magnesium toxicity in obstetrics. http://www.ismp.org/Newsletters/ acutecare/articles/20051020.asp?ptr=y (accessed 30 Apr 2009).
22. Agency for Healthcare Research and Quality. Getting to the Root of the Matter, AHRQ Web M&M Case & Commentary, June, 2005. http://www.webmm. ahrq.gov/case.aspx?caseID=98&searchStr=%22verbal+order%22 (accessed 30 Apr 2009).