An exploratory study measuring verbal order content and context.

BACKGROUND: The use of verbal orders, while essential in some healthcare settings, has been identified as a potential contributor to poor quality and less safe care. Despite the widespread use of verbal orders, little research attention has been paid to understanding and measuring the content of verbal orders or variables related to the context in which verbal orders are made. AIM: This paper first identifies variables related to verbal order content and context, and then provides detailed analyses from two exploratory studies conducted in one community hospital. METHODS: The data presented were collected using both a paper-based manual audit, and an analysis of data generated from a computerised order entry system. DISCUSSION: Selected analyses focus of variations in types and timing of verbal orders hospital-wide as well as for specific inpatient units, changes in verbal order utilisation following implementation of a computerised provider order entry system, and an analysis of the presence of sound-alike and high-alert medications in verbal orders.

Management of acute delirium in hospitalized elderly: a process improvement project.

This article will describe a systematic practical approach that was developed to evaluate and manage one of the most dangerous and costly geriatric emergencies in our nation-delirium in hospitalized frail elders. The article is about nurses and physicians who worked together in a continuous quality improvement process to find a collaborative method to reduce the occurrence, severity, duration, and devastating outcomes of acute delirium.