Nursing Communication Orders
Used inappropriately can cause safety/quality issues
* Missed orders* Delays in care* Medication errors
Medica
tion orders
Cathete
r ord
ers
Lab te
st
Diet ord
er
Activit
y ord
er
Device
order
Vital si
gn ord
er
Discharg
e ord
er
Wound ca
re ord
er
IV/fluid ord
er
Oxyge
n order
Diagnosti
c test
Fall p
recau
tions
Blood tran
sfusio
n order
I/O ord
er
Radiology
test
Sedati
on wea
ning ord
er0
10
20
30
40
50
60
70
80
90
Nursing Communication Orders by Category
221 “physician order” types out of 400 randomized nursing communication orders (approximating a 5-hour period in Jan-mid Feb 2013)
Solutions
• Investigate why physicians use nursing communication order rather than established pathways
• Create order sets if needed or missing• Educate physicians about existing order sets• Monitor inappropriate use of nursing
communication orders• Eliminate nursing communication orders
pathway