Telephone orders...read back and verified... - page 3

We were just told today in our staff meeting that we are suppose to read back telephone orders to the doctors and then sign it "read back and verified." I always read my orders back to the... Read More

  1. by   MarcusKspn
    At the hospital where I do my clinicals Telephone orders are written like this:

    TO: "order"/Name MD, Name Nurse, c RB

    c RB stands for with Read Bach
  2. by   Dr. Kate
    While there is little that you can do to stop physician denying having given a particular order, reading back orders and documenting that you did it is little enough to do to make sure you as the nurse have done all you can to verify the order you took was the one given.
    I was taught to always read back the orders I took over the phone. I've done it when the doc didn't want to hear the orders again, when I was "too" busy to waste the time reading the orders back, and on rare occasion had a doctor change an order on read back.
    It's an unfortunate commentary that in my facility we have had errors because a nurse was obviously unclear on what was being said or heard and didn't ask for clarification or spelling. Does it irritate a doc to have to spell something, usually. Does it protect the patient and the nurse, yes.

    Also, despite evidence to the contrary, docs are made aware of these sorts of rule changes. And, in well run hospitals, they are held to following the JCAHO rules that have made their way into the medical staff bylaws.

    As much as a lot of what JCAHO requires seems silly or irrelevant, most of the requirements are ther result of a number of adverse events that have in some way put patients at jeopardy.
  3. by   deespoohbear
    Originally posted by Dr. Kate
    I was taught to always read back the orders I took over the phone. I've done it when the doc didn't want to hear the orders again, when I was "too" busy to waste the time reading the orders back, and on rare occasion had a doctor change an order on read back.

    Also, despite evidence to the contrary, docs are made aware of these sorts of rule changes. And, in well run hospitals, they are held to following the JCAHO rules that have made their way into the medical staff bylaws.

    As much as a lot of what JCAHO requires seems silly or irrelevant, most of the requirements are ther result of a number of adverse events that have in some way put patients at jeopardy.
    I am not c/o about having to read them back because I do read back my orders....I am just c/o about the extra documentation. Yeah, I know it is a little bit of writing but we take lots of phone orders being a small facility with no house doc except for ER's. And he is only available for near codes/codes when the primary MD is not around....

    Just wait. JCAHO will eventually ban telephone orders...they are already working toward that goal....and I do believe it will happen at some point in time....
  4. by   ocicat
    We have a box on the doctors order that we check that says "read back"
  5. by   ocicat
    http://bertrogers.com/olc/healthcare...ter/verbal.htm
    This is an excellent website that talks about why verbal orders/telephone orders can lead to problems. And ways to prevent it. Ever play that game telephone as a child? Where you tell someone something and they pass it on? By the time it reaches the end.....it sounds nothing like it started out as?????
  6. by   kyti
    We also use T.O. RBV Dr Nasty/ Nurse Sweetness RN. I am wondering about the facilities that said they are droping JACHO. We have always been threatened that if we are not JACHO cert. we will lose all our medicare/medicade (which is 90% of our clients) and will have to close down. Are they just trying to scare us?
  7. by   RN-PA
    Since the time I first posted on this thread a year ago, my hospital has instituted the use of pre-printed stickers for verbal orders. There's a line for date and for time at the top. Then 4 lines below it are for writing out the order. Below that is a place for RN's signature with the words, "Order received By:", then "Order Given By:" where we write the Dr.'s name below, then under that "Read Back and Verified" where there's a space for your initials. The last two lines are for the Dr.'s signature and another for date and time whenever they get in to sign. Works pretty well except the labels are often too small for all the verbal orders we sometimes receive. (Approximately 3-1/4 inches high and 5 inches wide.)
  8. by   Katnip
    We just had our JCHAO visit. And they said, T.O. is fine. What they want to see is people actually doing it, not just writing about it.
  9. by   Ortho_RN
    We just put VRB Dr. Jones/B.Boop RN

    but as you say it all comes down to your word vs the doc if something isn't right..
  10. by   Teacher Sue
    When I worked in acute care,we did RBV too. And we did have one doc who would deny that he gave orders. We would just have another RN on the line, and both signed the verbal order.
  11. by   purplemania
    We write V.O.R. (verbal order readback) or T.O.R. (telephone order readback). Really not that hard.
  12. by   NannaNurse
    We have been doing this for about 6-8 months now. They put big signs up...
    "RTO=Read back tele. order"
    "RVO=Read back verbal order" and some of the dingy nurse still write what they want......'this tele. order was read back and verified'....etc. Much easier to write RTO/RVO.
    I agree, if something comes up, we 'little nurses' are the ones going to the chopping block.
    Nanna :hatparty:

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