HI Provider Orders for Life-Sustaining Treatment (POLST) 2009 free printable template

Kokua Mau The Hawaii Hospice and Palliative Care Organization Kokua Mau is the lead agency for implementation of POLST in Hawaii. HIPAA PERMITS DISCLOSURE OF POLST TO OTHER HEALTH CARE PROFESSIONALS AS NECESSARY Physician Orders for Life-Sustaining Treatment POLST Patient s Last Name First follow these orders then contact physician* This is a Physician Order Sheet based on the person s current medical condition and wishes. Any section not completed implies full treatment for that section*...

How to fill out HI Provider Orders for Life-Sustaining Treatment POLST

How to fill out HI Provider Orders for Life-Sustaining Treatment (POLST)

1. Begin by obtaining a POLST form from a qualified healthcare provider or the appropriate health department.
2. Review the patient's medical history and current health condition to ensure the form reflects their wishes regarding life-sustaining treatment.
3. Discuss options with the patient or their legal representative, focusing on preferences for resuscitation, medical interventions, and other life-sustaining measures.
4. Complete each section of the POLST form carefully, ensuring clarity and accuracy in the choices made.
5. Sign and date the POLST form, and ensure any witnesses or additional signatures are in accordance with state regulations.
6. Provide copies of the signed POLST form to the patient, any healthcare providers involved in their care, and keep a copy in the patient's medical records.

Who needs HI Provider Orders for Life-Sustaining Treatment (POLST)?

1. Individuals with serious or terminal illnesses who wish to have their treatment preferences documented.
2. Patients who might be at a higher risk for medical emergencies and need clear instructions for medical personnel.
3. Older adults, particularly those in nursing homes or receiving home care, who want to communicate their end-of-life wishes.

Instructions and Help about HI Provider Orders for Life-Sustaining Treatment POLST

Good afternoon thank you all for joining us for lunchtime learning presentations I am Rachel I'm working them all this department at the hospital, and today we are lucky to have Dr. Jim little junior joining us this afternoon Dr. little Junior is a family physician and medical director at st. John's family health and urgent care in 2010 he was instrumental in bringing the pulse program to Wyoming as a pilot project and helped get it passed on Tuesday live in 2015 so before Dr. little speaks to us this afternoon I'm actually going to introduce Stephanie who works with the library, and she's going to share a little about the resources that the library has available for you all his have been to these before you know we have the table set up there we've just pulled some books in our collection about the topic, and we have some research forms if anyone would like to do further research on the topic we can help you with filling those forms out or just come to the research desk we've got you can also make purchase suggestions if you know of other titles that we maybe don't have but just stop by and see what we've got there on your way out please welcome Dr. Jim middle GA thanks Rachel can everyone hear me okay I'll try to walk around a little feel free I'm going to i only have a few slides say it most of the time to answer questions and have a discussion is I think ultimately a lot of this is about kind of the conversation that we all need to have with ourselves with our families with our caregivers or providers about kind of what we believe and what our values are so the goals today we're going to talk a little about the importance of having advanced records and Holst Eminem kind of compare and contrast the two so that you understand what they are we'll go over what the POST form looks like there is a handout with your copy of the pulse form that's there for everybody, and we'll talk a little about the implementation of the pulse law in the state of Wyoming and how that came to be medicine we always start these talks with the disclosures I don't have any conflicts of interest I am a family physician employed by Stan Cohen's medical center I'm not an attorney so if you're looking for legal advice, or you will this is not the proper venue, but we're going to talk about how those documents interface a little with the healthcare system and how important it is to make sure that again your family your caregivers your providers I know what your wishes are so advanced directives have been for about the past hundred years and the United States and the guidance that we use in terms of what some of these end-of-life wishes are I'm going to talk a little in more detail about what advanced bizarre, but basically it's a document that is a legal document it is written by an attorney, and it is intended to express what your wishes are in a situation where you're not able to express your wishes DPO AHC a durable power of attorney for health care we love abbreviations...

People Also Ask about

What is the POLST law in Hawaii?

POLST contains medical orders indicating what medical care you want or don't want if you become unable to make the decisions yourself. Your doctor, APRN or PA, who is licensed in the State of Hawai'i (or allowed to practice if from the Military or VA) MUST review and sign the POLST form.

What is the difference between a POLST and a DNR form?

The primary difference between and POLST and DNR is that a POLST covers a variety of end-of-life treatments. A DNR only gives instructions about CPR. With a POLST, seniors can specify: If they do or don't want CPR.

Can I print a POLST form?

Print BOTH pages as a double-sided form on a single sheet of paper. Health care providers should complete this form only after a conversation with their patient or the patient's representative.

What is the difference between POLST and DNR and advance directive?

An advance directive is a direction from the patient, not a medical order. In contrast, a POLST form consists of a set of medical orders that applies to a limited population of patients and addresses a limited number of critical medical decisions.

Is a POLST form mandatory?

POLST is intended for patients with a serious illness or frailty, whose current health status indicates the need for standing medical orders. Completing a POLST form is always voluntary for the patient.

Are DNR and POLST the same thing?

Like a DNR, a POLST form lets EMS know whether or not the patient wants CPR. DNR orders only apply when a person does not have a pulse, is not breathing and is unresponsive. However, in most medical emergencies, a person does have a pulse, is breathing or is responsive. That's where POLST is different.

Is a copy of a POLST valid?

Photocopies and FAXes of signed POLST forms are legal and valid. A copy should be retained in patient's medical record, on Ultra Pink paper when possible.

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What is HI Provider Orders for Life-Sustaining Treatment (POLST)?

HI Provider Orders for Life-Sustaining Treatment (POLST) is a medical orders form that outlines a patient's preferences for life-sustaining treatments based on their values and goals of care. It is intended for patients with serious illnesses or advanced age.

Who is required to file HI Provider Orders for Life-Sustaining Treatment (POLST)?

Healthcare providers, including physicians, nurse practitioners, and physician assistants, are required to file HI Provider Orders for Life-Sustaining Treatment (POLST) for patients who have serious illnesses, a progressive condition, or are at the end of life.

How to fill out HI Provider Orders for Life-Sustaining Treatment (POLST)?

To fill out HI Provider Orders for Life-Sustaining Treatment (POLST), healthcare providers should ensure they have a discussion with the patient or their authorized representative about treatment options, document the conversations, and complete the POLST form clearly indicating the patient's preferences regarding treatments such as resuscitation, intubation, and artificial nutrition.

What is the purpose of HI Provider Orders for Life-Sustaining Treatment (POLST)?

The purpose of HI Provider Orders for Life-Sustaining Treatment (POLST) is to ensure that patients' treatment preferences are documented and respected, particularly in emergencies where medical personnel may not be able to communicate with the patient directly.

What information must be reported on HI Provider Orders for Life-Sustaining Treatment (POLST)?

The information that must be reported on HI Provider Orders for Life-Sustaining Treatment (POLST) includes the patient's demographic information, specific medical orders regarding resuscitation status, other preferences for care, and signatures from both the patient (or their representative) and the healthcare provider.