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Postgraduate Medical Journal 2009;85:460-463; doi:10.1136/qshc.2009.034041
© 2009 BMJ Publishing Group Ltd and The Fellowship of Postgraduate Medicine.

ORIGINAL ARTICLES

Are verbal orders a threat to patient safety?

D S Wakefield1, B J Wakefield2

1 University of Missouri Center for Health Care Quality, Department of Health Management and Informatics, Columbia, Missouri, USA
2 Harry S Truman Memorial Veterans Hospital, University of Missouri Sinclair School of Nursing, Columbia, Missouri, USA

Correspondence to:
Correspondence to Dr D S Wakefield, Center for Health Care Quality (CHCQ), MA120 Medical Sciences Bld., DC375.00, One Hospital Drive, Columbia, MO 65212, USA; wakefielddo{at}health.missouri.edu

Background: The use of verbal orders has been identified as a potential contributor to poor quality and less safe care. As a result, many organisations have encouraged changing the verbal orders process and/or reducing/eliminating verbal orders altogether (Joint Commission (2005), Institute of Medicine (2001), Leapfrog organisation, Institute of Safe Medication Practices). Ironically there is a paucity of research evidence to support the widespread concern over verbal order.

Aims: This paper describes the very limited existing research on verbal orders, presents a model of verbal order use identifying potential error trigger points and suggests a verbal order research agenda in order to better understand the nature and extent of the potential patient care safety threat posed by verbal orders.


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