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Advance Directives, DNR Orders and Health Care Powers of Attorney

Sets out how the Agency informs adult patients about Ohio advance directives (living will declarations and durable powers of attorney for health care), records whether each adult patient has one, honors Ohio do-not-resuscitate orders and DNR identification under the Ohio DNR protocol, handles revocation and transfers, and educates staff and the community.

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About this policy
Policy number
OH-HSP-PR-03
Version
1.0
Main rule
ORC Chapter 2133
Library
Ohio hospice · 60 policies
Category
Client rights
Sections
24

In short

  • At the start of care, give every adult patient the advance directive information and ask if they have a living will, a health care power of attorney or a DNR order.
  • Record the answer on the advance directive form and keep copies at the front of the record.
  • Follow a State of Ohio DNR order or approved DNR identification. Never require a DNR order for admission.
  • If a patient with a DNR asks for CPR, honor it: call 911, start CPR if trained and tell the on-call nurse.
  • When a patient with a DNR moves to another facility, tell the facility and the transport crew and send the DNR form.

What's inside

24 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • Terms of Reference
  • 1. Purpose
  • 2. Scope
  • 3. Definitions
  • 4. Policy Statement (ORC Chapter 2133; OAC 3701-19-23(C)(7); 42 CFR §418.52(a)(2))
  • 5. Information at the Start of Care
  • 6. Statement on Conscience
  • 7. Asking About and Recording Advance Directives
  • 8. Helping a Patient Make an Advance Directive
  • 9. Ohio DNR Orders and DNR Identification
  • 9.1 Issuing a DNR Order
  • 9.2 Approved DNR Identification
  • 9.3 At Home and on Visits
  • 9.4 Revocation of DNR Status
  • 10. Living Wills, Health Care Powers of Attorney and Conflicts
  • 11. Transfers and Patients in Facilities
  • 12. Staff and Community Education
  • 13. Responsibilities
  • 14. Records and Compliance Monitoring
  • 15. Staff Training
  • 16. References
  • 17. Related Policies and Forms
  • 18. Approval
  • 19. Revision History

An inspector may ask

  • Where in this record do you document whether the patient has prepared an advance directive?
  • What written information about Ohio law on advance directives do patients receive, and when?

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