Faxed signatures of physician orders

[Mazzi]

If you (LNC) were reviewing a chart and found only faxed signed orders and no originals, would this be questionable?

The organization I work for has started this practice. I really have a hard time throwing away the unsigned original written order. Our new Security Officer says this is accepted practice since the invention of technology, Computers, fax machines and PDA. Any input? Thank you in advance.

[sirI, MSN, APRN, NP]

no, i wouldn't have a problem with it.

but, you say, "i really have a hard time throwing away the unsigned original written order". how can the fax be signed and the original not be signed??

[KLKRN, RN]

I think because they fax the unsigned one to the doc and he/she signs it and sends it back. But I would think there would be at least a TORB notation with the nurse's signature on it and the doctors name.

[sirI, MSN, APRN, NP]

Faxed signed copies are as legitimate as original signed ones. I have no issues with this.

[Mazzi]

Unsigned is the hand written copy of the order that the RN writes per telephone order and then sends this to the Dr. for signature per fax. Then he signs the faxed copy, faxes it back to our office and then the secretary will throw the hand written orginal away and file the faxed signed copy. I'm from the old school where the ink origianal is SACARED. HA!!

[KLKRN, RN]

I know, old habits die hard. But this is really every bit as acceptable as the original.

[wooh, BSN, RN]

1. Does the original (that was handwritten) have anything saying it's a verbal/telephone order?

2. If the MD is taking the time to sign it, and then it's faxed, why doesnt' he take the time to actually write the order before it gets faxed.:)

[lvnnars1]

just for clarification, are faxed orders considered telephone orders? do we fill out the telephone order form for any faxed signed orders?

[tewdles, RN]

The faxed and signed document is perfectly legal. We also keep the original in the chart in addition to the fax "log" showing date and time of the original fax to the provider, probably overkill but we are cautious that way.

Sometimes the orders are written as verbal or telephone orders by the nurse because they are. Sometimes they are standing orders or certificates of terminal illness.