May 2006

Study shows how to avoid verbal-order inaccuracies

Verbal orders don’t go wrong as often in a chiropractic clinic as they do in hospitals, but to avoid miscommunication between you and your chiropractic assistants, you might want to consider what researchers at the Cincinnati Children’s Hospital Medical Center have learned.

The researchers found that by having orders read back before they were entered into the computer, medical errors were reduced to zero, according to Michael Vossmeyer, MD, a pediatrician at Cincinnati Children’s and the study’s main author.

At Cincinnati Children's, rounds are conducted inside patients' rooms to make care more family-centered, and orders are entered into the computer system right at the bedside. The attending physician or chief resident verbally communicates the order and a resident physician enters it into the system.

For the study, the team on rounds took 70 consecutive orders. After rounds, they examined the orders for errors. They discovered errors in 9.1 percent of all orders. Most of the errors were in dosages that would not have affected safety. In two instances, however, the intern wrote down the wrong drug.

Vossmeyer and his research colleagues instituted a process of order read back: Before leaving a patient's room, the resident reads back the order entered to verify its accuracy. After instituting this process, the researchers examined 75 orders for errors and found none.

Source: Cincinnati Children's Hospital Medical Center, www.cincinnatichildrens.org.

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