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Based on review of Emergency Room (ER) clinical records and interview, the facility failed to assure physician orders were timed and dated for 9 (#1-9) of 10 (#1-10) ER clinical records. The failed practice did not assure orders were followed according to timeframes determined by the physician and had the potential to affect all patients treated in the ER. Findings follow:

A. Review of ER clinical record for Patient #1 revealed ER Orders for IV/Heplock (intravenous heparin lock), CT (computerized tomography) head without contrast, CT Maxifacial without contrast and orders to transfer the patient were not dated or timed by the physician.
B. Review of ER clinical record for Patient #2 revealed orders to discharge the patient home were not dated or timed by the physician.
C. Review of the ER clinical record for Patient #3 revealed ER Orders for US (ultrasound) carotid, CBC (complete blood count), CMP (comprehensive metabolic panel), EKG (electrocardiogram) or ASA (aspirin) were not dated or timed by the physician.
D. Review of the ER clinical record for Patient #4 revealed ER Orders for CBC, CMP, Amylase and Lipase, UA (urinalysis), X-ray acute abdomen, fleets enema, NS (normal saline) 1 liter bolus, Morphine 4 mg (milligrams) IVP (intravenous push), Zofran 8 mg IVP and Toradol 30 mg IV (intravenous) and to discharge home were not dated or timed by the physician.
E. Review of the ER clinical record for Patient #5 revealed ER Orders for CBC, CMP, EKG and TSH (thyroid-stimulating hormone) and to discharge home were not dated or timed by the physician.
F. Review of the ER clinical record for Patient #6 revealed ER Orders to monitor, pulse ox (oximetry) CBC, CMP, urine drug screen, Dilantin or ETOH (ethyl alcohol), Ativan 0.2 mg IV STAT (immediately), and discharge were not dated or timed by the physician.
G. Review of the ER clinical record for Patient #7 revealed ER Orders for CBC, UA (urinalysis), IV/Heplock, IVP/ultrasound, Toradol 30 mg, Zofran 4 mg, and Morphine 2 mg were not dated or timed by the physician.
H. Review of the ER clinical record for Patient #8 revealed orders to discharge the patient home were not dated or signed by the physician.
I. Review of the ER clinical record for Patient #9 revealed ER Orders to clean the wound, Augmentin 175 mg PO (by mouth) and to discharge with Rx (prescription) were not dated or timed by the physician.
J. Findings were verified with the Director of Nursing on 02/23/12 at 0930.