What are Verbal Orders?

Verbal orders are prescriptions and directions for the administration of medication delivered verbally by a care provider. Pharmacies, hospitals, clinics, and other facilities that provide care to patients usually have specific protocols in place for how to handle these orders. These protocols are designed to keep patients safe and to provide a mechanism for clearly recording verbal orders.
In an example of a verbal order, a physician might call in an order for a prescription to a pharmacy. Likewise, a physician on the floor of a hospital might give an order to a nurse to administer a medication to a patient or to change a patient’s medications. When the order is received, it should be repeated back by the recipient to confirm the patient’s name, the medication, the dosage, and the instructions for use.
One risk with verbal orders is that they may not be recorded properly. Someone can mishear the order or forget the order in the time it takes to record it. Asking people to write down verbal orders as they are given and to repeat them back can address this issue. Likewise, documenting who gave orders and when is important for liability reasons and also for continuity of care. Keeping track of prescriptions ordered for a patient ensures that all members of the patient’s care team know what has been prescribed.
Other issues with verbal orders can include confusions about abbreviations, mistakes with medications that sound alike, or incomplete understanding of an order. When giving these types of orders, care providers are usually required to refrain from using abbreviations and to use clear language such as “one five milligrams” instead of “fifteen milligrams,” which might be misheard as “fifty milligrams.” Spelling out names of medications may also be recommended for safety.
For some types of medications, verbal orders may not be allowed. Sensitive drugs such as chemotherapy medications are a good example. These orders must be written and signed and cannot be accepted in oral form. If there is confusion about the order, the person taking the order should ask clarifying questions to confirm the details. It is also important for concerns about drug interactions to be identified, as a doctor can mistakenly prescribe a conflicting medication without realizing it. If the person accepting a verbal order knows that the patient is on another drug that might conflict, this should be brought up with the prescribing care provider.

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