ISMP Develops Guidelines for Standard Order Sets

Horsham, PA, March 12, 2010—Computerized prescriber order entry (CPOE) for medications gives healthcare organizations the ability to provide prescribers with a collection, or set, of predefined standardized orders that address common patient conditions. These order sets can be used for paper based as well as CPOE systems. New guidelines from the Institute for Safe Medication Practices (ISMP) can help ensure that such order sets are carefully designed, reviewed, and maintained in order to prevent errors.

ISMP has long advocated the use of standard order sets to minimize incorrect or incomplete prescribing, standardize patient care, and ensure clarity when medical orders are communicated. Consistent use of well-designed standard order sets also is important because they are often an essential part of clinical protocols, algorithms, and critical pathways.

The new ISMP guidelines, available at www.ismp.org/Tools/guidelines, are in the form of a checklist covering three different areas where potential problems are frequently observed:
• Content—Making sure orders are complete, including information beyond what the prescriber may initially consider (e.g., monitoring requirements), reflecting best practices, and standardizing order sets among practitioners who provide patient care.
• Format—Determining appropriate symbols, abbreviations, dose designations, punctuation, patient information prompts, layout, and directions for use.
• Approval and Maintenance—Managing initial approval as well as subsequent revisions, keeping order sets current, and preventing unacceptable variations in care.

Because consistent use and maintenance of standard order sets requires vigilance and a team approach, ISMP recommends that healthcare organizations establish an interdisciplinary implementation process. Professional staff also need clear directions to follow if they encounter order sets that do not comply with the established rules.

The cover story in the March 11, 2010 issue of the ISMP Medication Safety Alert! newsletter presents an overview of ISMP’s guidelines as well as links to other resources on standard order sets. A copy is available at: http://www.ismp.org/Newsletters/acutecare/articles/20100211.asp

About ISMP
The Institute for Safe Medication Practices (ISMP) is an independent, nonprofit charitable organization that works closely with healthcare practitioners and institutions, regulatory agencies, consumers, and professional organizations to provide education about medication errors and their prevention. ISMP represents more than 35 years of experience in helping healthcare practitioners keep patients safe, and continues to lead efforts to improve the medication use process. ISMP is a federally certified patient safety organization (PSO), providing healthcare practitioners and organizations with the highest level of legal protection and confidentiality for patient safety data and error reports they submit to the Institute. For more information on ISMP, or its medication safety alert newsletters and other tools for healthcare professionals and consumers, visit www.ismp.org.