What is a standing order in medical terms?

Standing orders are written protocols that authorize designated members of the health care team (e.g., nurses or medical assistants) to complete certain clinical tasks without having to first obtain a physician order. This can improve efficiency by freeing physicians to focus on more complex care. Several studies have demonstrated that standing orders can increase the delivery of routine preventive care services including immunizations, leading the Centers for Disease Control and Prevention's Community Preventive Services Task Force to strongly recommend their use.

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What is an example of a standing order?
What is a medical standing order?
What is the significance standing orders in patient care?
What are standing orders and where are they used?

For standing orders to be successful, they need broad support. The medical director is responsible for approving standing orders and supervising their use, but all clinicians should agree with them to avoid confusion, mistakes, and care lapses. Begin by developing standing orders for one or two areas where there is clear agreement on the standard and process of care and little potential for patient harm if incorrectly implemented (e.g., urine pregnancy test for women presenting with amenorrhea).

Here are several areas to consider:

Immunizations: influenza, pneumococcal, and human papilloma virus,
Routine labs for chronic disease monitoring: diabetes, hypertension, and hypothyroidism,
Point of care testing: rapid strep test, urine dip, and urine pregnancy.

Read the full FPM article: ”Developing Standing Orders to Help Your Team Work to the Highest Level."

Posted on Apr 24, 2019 by FPM Editors

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Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.

(13) Definitions In this section: (A) The term “authorizing medical professional” means an emergency or other physician, or another medical professional (including an advanced practice registered nurse or physician assistant)— (i) who is registered under this chapter; (ii) who is acting within the scope of the registration; and (iii) whose scope of practice under a State license or certification includes the ability to provide verbal orders. (B) The term “designated location” means a location designated by an emergency medical services agency under paragraph (5). (C) The term “emergency medical services” means emergency medical response and emergency mobile medical services provided outside of a fixed medical facility. (D) The term “emergency medical services agency” means an organization providing emergency medical services, including such an organization that— (i) is governmental (including fire-based and hospital-based agencies), nongovernmental (including hospital-based agencies), private, or volunteer-based; (ii) provides emergency medical services by ground, air, or otherwise; and (iii) is authorized by the State in which the organization is providing such services to provide emergency medical care, including the administering of controlled substances, to members of the general public on an emergency basis. (E) The term “emergency medical services professional” means a health care professional (including a nurse, paramedic, or emergency medical technician) licensed or certified by the State in which the professional practices and credentialed by a medical director of the respective emergency medical services agency to provide emergency medical services within the scope of the professional’s State license or certification. (F) The term “emergency medical services vehicle” means an ambulance, fire apparatus, supervisor truck, or other vehicle used by an emergency medical services agency for the purpose of providing or facilitating emergency medical care and transport or transporting controlled substances to and from the registered and designated locations. (G) The term “hospital-based” means, with respect to an agency, owned or operated by a hospital. (H) The term “medical director” means a physician who is registered under subsection (f) and provides medical oversight for an emergency medical services agency. (I) The term “medical oversight” means supervision of the provision of medical care by an emergency medical services agency. (J) The term “registered emergency medical services agency” means— (i) an emergency medical services agency that is registered pursuant to this subsection; or (ii) a hospital-based emergency medical services agency that is covered by the registration of the hospital under subsection (f). (K) The term “registered location” means a location that appears on the certificate of registration issued to an emergency medical services agency under this subsection or subsection (f), which shall be where the agency receives controlled substances from distributors. (L) The term “specific State authority” means a governmental agency or other such authority, including a regional oversight and coordinating body, that, pursuant to State law or regulation, develops clinical protocols regarding the delivery of emergency medical services in the geographic jurisdiction of such agency or authority within the State that may be adopted by medical directors. (M) The term “standing order” means a written medical protocol in which a medical director determines in advance the medical criteria that must be met before administering controlled substances to individuals in need of emergency medical services. (N) The term “verbal order” means an oral directive that is given through any method of communication including by radio or telephone, directly to an emergency medical services professional, to contemporaneously administer a controlled substance to individuals in need of emergency medical services outside the physical presence of the medical director or authorizing medical professional.

What is an example of a standing order?

Examples of standing orders include immunization administration, health screening activities, preventive care measures, ordering lab tests or treatments for certain categories, diabetes measures, prescription refills, and pre-/post-operative orders.

What is a medical standing order?

A standing order is an order conditioned upon the occurrence of certain clinical events. The important characteristic of a standing order is that all the patients who meet the criteria for the order receive the same treatment. A common use of standing orders is in public health clinics that treat specific diseases.

What is the significance standing orders in patient care?

Standing orders and protocols allow patient care to be shared among non-clinician members of the care team, like medical assistants and nurses. Standing orders are often based on national clinical guidelines, but practices may customize those guidelines based on their own patient population or care environment.

What are standing orders and where are they used?

A standing order is an automated payment method where a person or business instructs their bank to pay another person or business a fixed amount of money at regular (fixed) intervals. The payer controls the standing order; they set it up themselves and choose the amount and frequency.