{"ref":"MO-HSP-IDG-03","title":"Authorized Prescriber Orders, Verbal Orders and Standing Orders","category":"Hospice care","summary":"Sets out Missouri's rules for authorized prescriber orders: medications, treatments and procedures only with an order; written orders dated and signed when written; oral orders received only by persons authorized within their scope of practice, immediately written down, signed by the receiver, and signed and dated by the prescriber within 30 days (the Agency's own time frame, which may be shorter, is 14 days); the content of medication orders; and standing orders, which must be specific, individualized, signed and in the record, reviewed by the medical director at least annually, with an Agency time frame for notifying the prescriber when a standing order is used.","inShort":["Never give a medication, treatment or procedure without an order from an authorized prescriber.","Only licensed nurses, pharmacists and therapists (for therapy orders) may take an oral order. Write it down at once, read it back, sign and date it.","The prescriber must sign an oral order within 14 days, and never later than 30 days.","Medication orders need the drug, dose, how often and route. \"As needed\" orders need a maximum and the reason.","Standing orders must name one drug and dose, be signed for this patient, and be in the record. After using one, tell the prescriber by the end of the next business day."],"primaryCitation":"19 CSR 30-35.010(2)(E)","citations":["19 CSR 30-35.010(2)(E)","19 CSR 30-35.010(1)(A)1, 37","19 CSR 30-35.010(2)(H)2-3","19 CSR 30-35.010(2)(D)4.D","19 CSR 30-35.010(2)(G)2.E","19 CSR 30-35.010(2)(K)5.A"],"federalCitations":["42 CFR §418.106(b)","42 CFR §418.104(a)(7), (b)","42 CFR §418.56(c)"],"surveyorAsks":["Show me the oral orders taken in the last month. Who received them, and when did the prescriber sign each one?","Are any oral orders unsigned more than 30 days after they were given?"],"forms":[{"ref":"MO-HSP-IDG-03-A","title":"Standing Order Use and Prescriber Notification Log"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (19 CSR 30-35.010(2)(E))","5. Who May Give Orders","6. Written Orders","7. Oral Orders","7.1 Tracking unsigned orders","8. Content of Medication Orders","9. Standing Orders","9.1 Notifying the prescriber when a standing order is used","10. Electronic, Faxed and Facility Orders","11. Conflicting or Duplicate Orders","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"mo-hospice","state":"Missouri","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}