Verifying medications

It depends on the system. When using CPOE, the system that I use has a screen with new CPOE orders which is just an FYI since there's nothing to "check-off" with CPOE. Once we've seen the order, we click it off and in that case you are just saying you saw the order.

I'm not sure I understand how your system works. Does a Nurse take an order such as a verbal or telephone order and then enter into the computer without writing it down?

Our system does not allow you to give a drug that that has not been reviewed either, but it does still come up in the EMR so that you know there is a drug due but it needs to be reviewed. The system you describe sounds problematic.

Yes, the nurse just enters the order from a verbal or telephone order. Nothing is written down.

So what is the Nurse who took the order checking it against, other than their memory?

That's correct. The nurse has nothing to check the order against. So our manager wrote her up for not verifying a med that the other shift took an order for. She told her she should have verified it. We have no doctors in our hospital at night, just an NP or PA.

Putting the orders in the CPOE has fallen on the nurse. I feel

uncomfortable verifying an order that I did not personally take.

I'm a bit confused here. Let's say a nurse, at the end of his/her shift, takes a phone order for a medicine (let's say a PRN blood pressure med). Where I worked, the order was faxed to the pharmacy and the put it on the MAR. As the next nurse, would you not verify that order? Why not? Not trying to sound accusatory...just trying to determine the process and your thinking on the matter. Would you not give the first dose of a medicine that was ordered via a phone order taken by another nurse if the doctor had not yet signed the phone order?

In our computer system, we are just verifying that we saw the new order. After it is verfied by the floor nurse, the order goes into the appropriate ques. If it's for a med, the pharmacy must review and release it.

if it's a telephone order, you write it down and then you can check it against the order you wrote against what pharmacy sends to you before verifying it. If the physician wrote it, you check the original order against what pharmacy enters on the e-mar. If everything is correct, you verify it. If something does not match up (wrong time, wrong route, wrong drug, etc, you do not verify it, but clarify it.

Yes, the nurse just enters the order from a verbal or telephone order. Nothing is written down.

this seems odd. Where does a doctor write his order?

I feel

uncomfortable verifying an order that I did not personally take.

Generally speaking I feel the same. However, I work with a few nurses who I trust completely.

Some places still use paper......

ps. (I mean that tongue in cheek;))

As hard as it is to believe, yes.