Get the free Do Not Resuscitate Procedure Protocol 5-9 - michigan

Date: revised March 25, 2014, Michigan General Procedures DO-NOT-RESUSCITATE Page 1 of 6 Do-Not-Resuscitate The purpose of this policy is to provide a guideline to prehospital providers, who under

How to fill out do not resuscitate procedure

How to fill out a Do Not Resuscitate (DNR) procedure?

1. Determine the patient's eligibility: The first step in filling out a Do Not Resuscitate (DNR) procedure is to confirm whether the patient meets the criteria for the procedure. Typically, this decision is made in consultation with the patient or their legal representative, along with the healthcare team.
2. Obtain the necessary documentation: In order to proceed with the DNR procedure, it is important to have the appropriate forms and documentation. This may include a DNR order form, a physician's signature, and any additional legal or consent forms required by your jurisdiction.
3. Clearly communicate the patient's wishes: It is crucial to have open and honest discussions with the patient or their legal representative to fully understand their wishes regarding resuscitation. This includes discussing the potential risks and benefits of resuscitation, as well as any alternative options or interventions they may prefer.
4. Complete the DNR order form: Once you have gathered all the necessary information and obtained the patient's consent, carefully fill out the DNR order form. Ensure that all relevant details, such as the patient's name, date of birth, and specific instructions regarding resuscitation, are accurately recorded.
5. Review and verify the completed form: Before finalizing the DNR procedure, it is essential to review the completed form for any errors or missing information. Double-check that all sections are properly filled out and that the form is signed by the appropriate healthcare professional or authorized individual.

Who needs a Do Not Resuscitate (DNR) procedure?

1. Patients with terminal illnesses: DNR procedures are commonly considered for patients with terminal illnesses or those who have a limited life expectancy. These individuals may have expressed their desire to forego resuscitation efforts in the event of cardiac arrest or other life-threatening situations.
2. Patients with irreversible conditions: Those with irreversible medical conditions, such as advanced dementia or end-stage organ failure, often opt for a DNR procedure. They may prefer to prioritize comfort and quality of life rather than undergoing potentially invasive and futile resuscitation measures.
3. Patients with a poor prognosis: When patients have an extremely poor prognosis or a high likelihood of an unfavorable outcome even with resuscitation attempts, a DNR procedure may be considered. This decision is made based on the patient's individual circumstances and in consultation with their healthcare team.

Remember, the decision to fill out a Do Not Resuscitate (DNR) procedure is highly personal and should be guided by the patient's wishes, medical condition, and their understanding of the potential consequences. It is important to involve the patient, their loved ones, and the healthcare team in these discussions to ensure the procedure aligns with the patient's values and goals of care.

For pdfFiller’s FAQs

What is do not resuscitate procedure?

Do not resuscitate procedure is a medical order that instructs healthcare providers not to perform CPR (cardiopulmonary resuscitation) if a person's heart stops beating or if the person stops breathing.

Who is required to file do not resuscitate procedure?

Do not resuscitate procedure can be initiated by a patient, their family members, or a healthcare provider such as a physician.

How to fill out do not resuscitate procedure?

Do not resuscitate procedure forms can typically be filled out by a healthcare provider in consultation with the patient or their family members.

What is the purpose of do not resuscitate procedure?

The purpose of do not resuscitate procedure is to honor a person's wishes regarding end-of-life care and to prevent unwanted medical interventions in case of cardiac or respiratory arrest.

What information must be reported on do not resuscitate procedure?

Do not resuscitate procedure forms typically include information about the patient's medical condition, their wishes regarding CPR, and the signatures of the necessary parties involved.

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