Unverified Orders

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Unverified Orders

• What are they?
• How do they get to be unverified?
• What do I do?

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Introduction

• Verifying unverified orders is an extremely
  important part of the Unit Secretary role.
• In this session you will learn about verifying
  unverified orders on new admissions, post
  procedure, and post operative patients.
• Following all the appropriate steps in this
  session will create total efficiency in this
  process.

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Agenda

• What are unverified orders?
• How do they get to be unverified orders?
• Transferring patients into your census.
• Printing the Unverified/Standby Orders report.
• Verifying orders.
• Orders that should remain unverified.
• Double checking.
• Order statuses.

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What Are Unverified Orders?

• UNV(Unverified) is an order status.
• When an order is in the UNV status, it does not
  become active until it is verified.
• Once orders are verified, medication orders go to
  pharmacy, lab orders to the lab, and requisitions
  print in the departments.
• Unverified orders are green!

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Why And How Do Orders Have A Status Of Unverified?

• Patients being admitted through the ED, are
  temporarily registered in a cyberspace holding
  units. (DEH Davol Adult Emergency Hold,
  HEH-Hasbro Emergency Hold)
• Because these patients are not in an official bed
  yet, their orders automatically go in with a
  status of UNV when entered.
• These orders will be verified by the Unit
  Secretary when the patient arrives on the unit.

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• Surgical patients have their post-op orders
  entered with a status of UNV. Patients are
  transferred into the PACU census when they arrive
  in the Operating Room area. If they had previous
  orders, those orders are discontinued by the
  operating room secretary. All new orders must be
  entered on post op patients.
• These orders do not automatically go in as UNV,
  however the MD uses Enter Post Op/Post Proc
  Orders. Orders entered by using this button go
  in as UNV. These orders will be verified by
  the Unit Secretary when the patient arrives on
  the unit post-op.

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• This process also applies to various procedure
  areas. Patients may return from a procedure with
  orders in the UNV status. Since patients are
  not transferred in the census when they go to a
  procedure area, an Order Session Print can
  generate on the unit when orders are entered even
  though the patient has not returned from the
  procedure yet.
• Look carefully at these orders they may have a
  status of UNV. You must verify these orders
  even if the patient has not returned from the
  procedure area yet.
• You should always check the status of all
  orders. Orders should never be left unverified
  with the exception of body fluids, micro and
  urines.

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What Other Orders Have A Status Of Unverified?
Body Fluids Microbiology Urine
Are automatically entered as Unverified. Would be listed under Laboratory. Orders begin with BF. Are automatically entered as Unverified. Would be listed under Laboratory. Are automatically entered as Unverified. Would be listed under Laboratory. Orders begin with U_.
Examples would be BF-Amylase, BF-Cell Count. These orders are not verified when processing new admit or post-op orders. They are verified when the specimen is obtained. Examples would be Urine CS, MRSA, VRE. These orders are not verified when processing new admit or post-op orders. They are verified when the specimen is obtained. Examples would be U Sodium, U Osmo, UA. These orders are not verified when processing new admit or post-op orders. They are verified when the specimen is obtained.
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Now that you have learned about how orders
get a status of UNV, why they are UNV, and
when they are changed to a VER status, lets
talk about the Steps you need to know to process
DEH, HEH, PACU post op orders, and post procedure
orders.
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Step 1--Transfer The Patient Into Your Census

• Locate the patient in their present location,
  such as DEH or PACU.
• Using the ADT function transfer the patient into
  your census. Be sure to use the correct Pt Type
  for the unit/bed.
• Always check the patients D.O.B., MR and/or PT
  Number for identification verification. There
  could be patients with similar or same names.

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Step 2--Print the Unverified/Standby Orders
Report

• From the Census screen, click on the patients
  name.
• Click on (5) Order Functions
• Click on (38) Print Reports
• Click on (7) Print All Unv/Standby Orders
• You must do this step before you can move onto
  Step 3.

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Step 3Verifying Orders

• Click on the patients name. Now click on (5)
  Order Functions then (32) Enter POM Orders.
• The first screen that comes up is the Unverified
  Orders screen. (Unverified orders are green!)
• Click on all the orders you need to verify. (Only
  exceptions-Body Fluids, Micro, Urine)
• Click on the Verify button. VER will appear to
  the left side of the display screen next to each
  order.
• Click on Enter Order Changes at the bottom of the
  screen.
• You will see the Orders Waiting For Signature
  screen with all the orders that have been
  verified. Now click on Sign Orders.

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Step 4Orders You Do Not Verify

• These orders would be listed in the Laboratory
  section.
• Body Fluids, Micro orders and Urines are left
  unverified until the specimens are obtained.
• Orders in all the other sections such as Nursing,
  Radiology, Rehab, Pharmacy etc should never be
  left unverified.

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Double Check Double Check

• After signing off the orders with your password,
  return to the Unverified screen.
• Have you verified everything except Body Fluids,
  Micro Orders, and Urines?
• Remember these would be listed under
  Laboratory.
• Medication orders may still be on the Unverified
  screen with a status of REV.

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Medication Orders With A Status of REV

• Once medication orders are verified they change
  to a status of REV(Review).
• The Pharmacy Department must review and validate
  all medication orders.
• Once the Pharmacy has validated the medication
  order, the status will change to VER (Verified)
  and these orders will no longer appear on the
  Unverified screen.

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How Can I Prevent Missing Unverified Orders?

• Always go back and check, after signing the
  orders, that you have verified all orders except
  BF, Micro, Urines.
• Check the status of all orders on the Order
  Session print. Orders could have been entered
  from a Procedure area or if a doctor clicked on
  Write Postop/Postproc Orders instead of Write
  Orders, in error, those orders have a status of
  UNV.