Can dietitians transcribe verbal orders in hospitals?

VERBAL orders can support timely implementation of nutrition care plans and contribute to efficient, client-centred care. CDO does not place restrictions on dietitians transcribing verbal orders. We encourage dietitians instead to follow the policies of their organization. This guidance applies to dietitians practising in Ontario hospitals settings.

What is a verbal order?

A verbal order is a spoken instruction given by an authorized provider (such as a physician or nurse practitioner) to another regulated health professional to carry out a treatment, medication, test, or procedure for a patient.

Verbal orders may be given:

• In person (spoken face-to-face), or
• By telephone or other approved remote technology.

Verbal orders are a type of direct order, meaning they apply to an individual, named patient. They are typically given when written or electronic orders are not feasible.

Public Hospitals Act

The Public Hospitals Act establishes the legislative framework for the operation of public hospitals in Ontario. The Act permits orders for treatment or diagnostic procedures to be dictated and received by individuals — including dietitians — designated by the hospital administrator.The Act states:

24. (2) A physician, dentist, midwife, or registered nurse in the extended class may dictate an order for treatment or for a diagnostic procedure by telephone to a person designated by the administrator to take such orders.

This provision enables dietitians, when designated by their organization, to receive and document verbal orders.

Consulting organizational policies

Dietitians must consult their organizational policies and procedures to confirm they are authorized to transcribe verbal orders and ensure compliance with facility-specific requirements.

Hospital policies may restrict the use of verbal orders to specific circumstances, such as:

• Emergencies.
• Situations where the prescriber cannot write or enter the order (for example, during surgery).
• Situations where delaying care would negatively affect the patient.

Transcribing verbal orders: Documentation requirements 

When permitted by hospital policy, a dietitian may receive and transcribe a verbal order by documenting it in the patient’s health record according to organizational requirements.

The Public Hospitals Act outlines the minimum documentation required by the individual receiving the order, including:

• The order itself.
• The name of the physician or other authorized provider giving the order.
• The date and the time the order was received.
• The name and signature of the person documenting the order (for example, the dietitian).

Additional documentation requirements may be outlined in hospital policy, such as:

• Verification of correct patient identification.
• Use of a read-back process to confirm accuracy and enhance safety.
• Documentation of the prescriber’s professional designation.
• Clear notation that the order was received verbally or by telephone or other remote technology.

Authentication of verbal orders

The Public Hospitals Act also requires that verbal orders be authenticated by the individual who dictated them as soon as possible. Specifically:

24. (1) Every order for treatment or for a diagnostic procedure of a patient shall, except as provided in subsection (2), be in writing and shall be dated and authenticated by the physician, dentist, midwife or registered nurse in the extended class giving the order. 

24. (3)(b) The physician, dentist, midwife, or registered nurse in the extended class who dictated the order shall authenticate the order on the first visit to the hospital after dictating the order.

Key Takeaways

• Dietitians in Ontario hospitals may take and transcribe verbal orders when designated by the hospital administrator and permitted by organizational policy.
• The Public Hospitals Act allows authorized prescribers to dictate treatment or diagnostic orders by telephone to designated individuals, which can include dietitians.
• Verbal orders are typically restricted to specific situations (for example, emergencies or when written or electronic orders are not feasible) and must follow hospital policy.
• Accurate documentation and read‑back processes are required to ensure patient safety and clarity.
• The prescriber must authenticate the verbal order as soon as possible, in accordance with legislative requirements. 

References

Hospital Management Regulation under the Public Hospitals Act (R.R.O. 1990, Reg. 965, ss. 24-26: Orders for Treatment).