Advance Directives, Out-of-Hospital DNR Orders and POLST
Sets out how the Agency gives written information on advance directives and Pennsylvania law, asks about and records living wills, health care powers of attorney and out-of-hospital do-not-resuscitate orders, honors them or helps transfer the patient where it cannot, handles revocations and countermands, treats POLST forms as physician orders, and educates staff and the community.
About this policy
- Policy number
- PA-HSP-PR-03
- Version
- 1.0
- Main rule
- 20 Pa.C.S. Ch. 54
- Library
- Pennsylvania hospice · 60 policies
- Category
- Client rights
- Sections
- 21
In short
- At admission, give the advance directive information, ask about living wills, powers of attorney, DNR orders and POLST, and copy them into the record.
- Never require a DNR or an advance directive as a condition of care, and never assume a patient does not want CPR.
- Keep the original out-of-hospital DNR order where EMS will find it. If the patient has no DNR order or decision to withhold CPR, call 911 and start CPR if you are certified.
- A patient can revoke a DNR or living will at any time, in any way, even by saying so. Report it to the RN coordinator at once.
- Treat a POLST as physician orders: confirm it with the physician and record it in the plan of care.
What's inside
21 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §418.52(a)(2); 42 CFR §489.102)
- 5. Giving the Written Information
- 6. Recording Directives and Orders
- 7. Honoring Directives
- 7.1 Out-of-hospital DNR orders
- 7.2 When a patient stops breathing or has no pulse
- 7.3 POLST forms
- 8. Revocation and Countermand
- 9. Statement of Limitation and Transfer
- 10. Complaints, Staff Education and Community Education
- 11. Responsibilities
- 12. Records and Compliance Monitoring
- 13. Staff Training
- 14. References
- 15. Related Policies and Forms
- 16. Approval
- 17. Revision History
An inspector may ask
- Show me the written information on advance directives you gave this patient, including the description of Pennsylvania law. When was it given?
- Where in the record is it documented whether this patient has executed an advance directive?
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