Introduction Verbal ordering of medications has been a joint development between medical, nursing and pharmacy staff. There has been a need for verbal orders especially when a doctor is not available on the inpatient unit e.g. in the out of hours setting.

The overwhelming benefit of verbal orders is avoiding delays to medication administration and omitted doses by:-

1. Providing the re-prescription of medications that the patient is already on e.g. Controlled drugs and syringe pumps

2. Providing for a dose of anemergency medication to be given immediately whilst the doctor is travelling to the hospice e.g. Naloxone

3. Providing for prescription of the starting dose of a new medication which otherwise would have to wait until the next working day oruntil the doctor has arrived at the unit e.g. Antibiotics

Aim

• To establish a Standard Operating Procedure for managing verbal orders

• To evaluate the process that will inform key indicators of quality and safety

Process A Multidisciplinary team was established in order to develop a clinical procedure for managing verbal orders on the inpatient unit.

The procedure outlines how verbal orders are given, received, managed and monitored on the inpatient unit.

Staff were deemed competent to undertake this procedure provided they attended a training workshop and successfully completed the training competency.

Outcomes and actions Trinity Hospice has approved this procedure

• In order to quality-assure the scheme, procedure compliance will be audited by pharmacy each time a verbal is given. The clinical risk group will monitor the outcomes of these audits

• This will provide on-going risk management as verbal orders are a high risk process and will need to be monitored closely

• Staff eligible to undertake the role have been accredited to do so. This is now a mandatory requirement for all medical and nursing staff.