A survey of hospital policies on verbal orders

The authors present the results of surveys of directors of nursing and directors of pharmacy on the types and extensiveness of the policies their institutions have implemented to control the use of verbal and telephone orders. One hundred hospitals were selected at random from 874 hospitals meeting the following criteria: 250 beds or larger, general medical surgical, short stay, and nongovernmental. The survey results demonstrated that a significant number of hospitals are attempting to regulate the use of verbal and telephone orders. However, only 35.5% of the hospitals surveyed have any policies that prohibit the use of verbal orders when the physician is physically present on the unit where the order is given, in non-emergency and non-bedside procedure situations. Relative to the above policy, directors of nursing state that this policy is followed 41.1% of the time and directors of pharmacy in the same institutions state that the policy is adhered to 11.1% of the time. In addition to the survey, the authors explain situations that may serve as a source of medication errors when using verbal or telephone orders. They also offer several precautions to take when the use of verbal and telephone orders is absolutely necessary.