Dragon Copilot (nurses) verbalization guide

Purpose of this guide

This guide helps you master verbal documentation using Dragon Copilot’s ambient technology. It provides general tips and best practices followed by tips specific to LDAs to ensure that your documentation is captured accurately and seamlessly and in real time.

General verbalization best practices/ user tips

  • Wait and restate: When corrections are needed, wait a few seconds and speak a clean sentence for precise extraction.

  • Pulses: Verbalize location + strength using flowsheet terms (e.g., ““right radial 2+,” “left radial 2+”); avoid “positive pulses” without sites.

  • Glasgow coma scale (GCS): State individual subscores (Eye/Verbal/Motor), then the total; don’t rely on the product to calculate the score.

  • Intake/Output (I&O): For clarity, always state route + units (e.g., “P.O. intake 70 mL,” “urine output 550 mL”); avoid “fluids given” without specifying the route.

  • Time change expectation — Don’t expect to edit time with voice. Change it manually before filing.

    • I&O timing: Don’t expect verbalized times (e.g., “voided 150 mL at 1900”) to backfill. The time reflects the recording time unless changed manually.

  • Recording hygiene: Mute TV, use the pause function during sidebar conversations.

  • Orientation/Alert and oriented: Verbalize person, place, time, situation or use “Neuro WDL” in chart by exception schemas.

  • Avoid generic “good”: Replace with WDL or scales (e.g., pulses 1+/2+/3+/4+); always specify site.

Verbalization of LDAs for accurate ambient documentation

LDA Best practices

  • LDA clarity: State action or timing, LDA type, location (and side); status, and measurements or units when applicable. Use present or past tense once an action is complete (avoid future tense), e.g., “Right forearm PIV; dressing clean, dry, intact.”
  • LDA placement vs. presence: Say inserted/placed/applied + site when placement is intended. In place indicates presence only and does not document a new LDA.
  • LDA separation: Describe one LDA at a time.
  • Clinical terms: Use standard clinical terms. Avoid slang, jargon, or vague language.
  • Monologue: Use a brief, clear monologue statement to capture LDA details, even if the rest of the interaction is conversational.
  • Terms and abbreviations: You may use familiar names and abbreviations that map to clinical terms (flowsheet‑dependent), such as:
    • Product names: Foley catheter, JP drain (Jackson‑Pratt), Hemovac, PureWick (specify male or female)
    • Common abbreviations: PIV, PICC, Hep loc, NG tube Ambient‑enabled public macros may also work if supported by your organization.

Sample LDA verbalizations

  • Peripheral IV: Left forearm PIV. Site clean, dry, intact. Transparent dressing clean, dry, intact. Line flushed and saline locked."
  • PICC: “Left upper arm PICC. Site clean, dry, intact. Blood return noted. Line flushed. Cap changed.”
  • Foley catheter and output: “Foley catheter. Urine output 350 milliliters. Urine yellow and cloudy."
  • JP drain: “JP drain at the abdominal surgical site emptied, 60 milliliters serosanguinous. Site warm and red.”
  • Wound or incision: (Speak each wound separately.) “Abdominal incision. Site clean and dry. Edges approximated. ABD dressing clean, dry, intact. Scant serosanguinous drainage.”
  • Removal: “Left forearm 20‑gauge PIV removed at 2 p.m.”
  • Addition: “New peripheral IV 22-gauge placed in right forearm.”

Dragon Copilot experience for nurses quick start guide

Dragon Copilot experience for nurses best practices and tips

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