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https://www.readbyqxmd.com/read/29624461/national-standards-and-state-variation-in-physician-orders-for-life-sustaining-treatment-forms
#1
Susan E Hickman, Rebecca Critser
BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm is used across the country to document the treatment preferences of seriously ill or frail patients as medical orders. The National POLST Paradigm Task Force maintains consensus-based standards for POLST programs and uses these to determine whether a state POLST program is developing, endorsed, or mature. OBJECTIVES: To evaluate state program form adherence to national standards. DESIGN: Document review...
April 6, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29614148/clinical-inquiries-how-well-do-polst-forms-assure-that-patients-get-the-end-of-life-care-they-requested
#2
Jordan Collier, Gary Kelsberg, Sarah Safranek
Quite well, for cardiopulmonary resuscitation (CPR). Most patients (91%-100%) who select "do not resuscitate" (DNR) on their physician's orders for life-sustaining treatment (POLST) forms are allowed a natural death without attempted CPR across a variety of settings (community, skilled nursing facilities, emergency medical services, and hospice). Few patients (6%) who select "comfort measures only" die in the hospital, whereas more (22%) who choose "limited interventions," and still more (34%) without a POLST form, die in the hospital (strength of recommendation [SOR]: B, large, consistent cross-sectional and cohort studies)...
April 2018: Journal of Family Practice
https://www.readbyqxmd.com/read/29608338/exploring-provider-surrogate-communication-during-polst-discussions-for-individuals-with-advanced-dementia
#3
Hyejin Kim, Christine Bradway, Susan E Hickman, Mary Ersek
OBJECTIVES: This qualitative descriptive study explored provider-surrogate communication during Physician Orders for Life-Sustaining Treatment (POLST) discussions for patients with advanced dementia. METHODS: Data from participant observations and audio-recordings of ten POLST discussions were analyzed using directed content analysis within the context of an existing conceptual model of Communication and Surrogate Decision Making. RESULTS: Surrogates primarily focused on making sense of the clinical information about life-sustaining treatments during POLST conversations...
April 2, 2018: Aging & Mental Health
https://www.readbyqxmd.com/read/29431571/cross-cultural-adaptation-of-the-physician-orders-for-life-sustaining-treatment-form-to-brazil
#4
Vania F S Mayoral, Fernanda B Fukushima, Aniela M Rodrigues, Raissa P Carvalho, Larissa P Carvalho, Leandro A F V Pinheiro, Bertha F Polegato, Marcos F Minicucci, Rick Bassett, Alvin H Moss, Karl E Steinberg, Edison I O Vidal
BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) paradigm is considered one of the most important strategies to respect patients' values at the end of life in the United States. The cross-cultural adaptation of POLST entailed several methodological considerations, which may be informative for international researchers who may also consider bringing POLST to their countries as a means to promote care at the end of life that is consistent with patients' preferences...
February 12, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29298109/the-progression-of-end-of-life-wishes-and-concordance-with-end-of-life-care
#5
Jennifer Hopping-Winn, Juliette Mullin, Laurel March, Michelle Caughey, Melissa Stern, Jill Jarvie
Since 2013, Kaiser Permanente Northern California has engaged in a systematic effort to elicit, document, and honor the care preferences of patients as they near the end of life. This is done through its Advanced Steps program, in which selected patients discuss their preferences for future medical care with their healthcare agent during a structured conversation with a trained advance care planning facilitator. The facilitator then translates the patient's wishes into an actionable medical order set using a Physician's Order for Life-Sustaining Treatment (POLST) form...
April 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28874938/availability-and-accuracy-of-ems-information-about-chronic-health-and-medications-in-cardiac-arrest
#6
Alexander Foster, Victor Florea, Carol Fahrenbruch, Jennifer Blackwood, Thomas D Rea
INTRODUCTION: Field information available to emergency medical services (EMS) about a patient's chronic health conditions or medication therapies could help direct patient care or be used to investigate outcome disparities. However, little is known about the field availability or accuracy of information of chronic health conditions or chronic medication treatments in emergent circumstances, especially when the patient cannot serve as an information resource. We evaluated the prehospital availability and accuracy of specific chronic health conditions and medication treatments among out-of-hospital cardiac arrest (OHCA) patients...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28727486/association-of-physician-orders-for-life-sustaining-treatment-form-use-with-end-of-life-care-quality-metrics-in-patients-with-cancer
#7
Sandra L Pedraza, Stacey Culp, Mark Knestrick, Evan Falkenstine, Alvin H Moss
PURPOSE: Many patients with advanced cancer receive aggressive treatment near the end of life. The Physician Orders for Life-Sustaining Treatment (POLST) form is an innovation that converts patient preferences into medical orders. We compared the end-of-life care of patients with advanced cancer who had completed POLST forms with that of patients who had advance directives (ADs). METHODS: We studied 2,159 West Virginians with ADs and/or POLST forms in the West Virginia e-Directive Registry who died as a result of cancer between January 2011 and February 2016...
October 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28668665/the-quality-of-polst-completion-to-guide-treatment-a-2-state-study
#8
Alvin H Moss, Dana M Zive, Evan C Falkenstine, Courtney Dunithan
OBJECTIVES: Physician Orders for Life-Sustaining Treatment (POLST) need to be complete and consistent to allow health care personnel to honor patient preferences in a time of emergency. The purpose of our study was to evaluate the quality of POLST completion to guide treatment for level of medical intervention. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study combined data from the Oregon and West Virginia POLST registries for the study period January 1, 2010, through December 31, 2016...
September 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28645409/guidelines-for-emergency-physicians-on-the-interpretation-of-physician-orders-for-life-sustaining-therapy-polst
#9
EDITORIAL
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28623154/standardizing-protection-of-patients-rights-from-polst-to-moeli-medical-orders-for-end-of-life-intervention
#10
EDITORIAL
Richard B Stuart, Stephen Thielke
No abstract text is available yet for this article.
June 13, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28622155/triad-ix-can-a-patient-testimonial-safely-help-ensure-prehospital-appropriate-critical-versus-end-of-life-care
#11
Ferdinando Mirarchi, Christopher Cammarata, Timothy E Cooney, Kristin Juhasz, Stanley A Terman
OBJECTIVE: The present study sought to assess the clarity of Physician Orders for Life-Sustaining Treatment (POLST) or Living Will (LW) documents alone or in combination with a video message/testimonial (VM). METHODS: Emergency medical services (EMS) personnel responded to survey questions about the meaning of stand-alone POLST and LW documents and those used in conjunction with emergent care scenarios. Personnel were randomized to receive documents only or documents with VM...
June 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28413928/the-oncology-specialist-s-role-in-polst-form-completion
#12
Austin J Lammers, Dana M Zive, Susan W Tolle, Erik K Fromme
INTRODUCTION: Patients with cancer and oncology professional societies believe that advance care planning is important, but we know little of who actually has this conversation. Physician Orders for Life-Sustaining Treatment (POLST) forms can help to document these important conversations to ensure patients receive the level of treatment they want. We therefore sought to determine the specialty of those signing POLST forms for patients who died of cancer to better understand who is having this discussion with patients...
February 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28375815/maryland-s-medical-orders-for-life-sustaining-treatment-form-use-reports-of-a-statewide-survey
#13
Anita J Tarzian, Nadia B Cheevers
BACKGROUND: Advance directives (ADs) and Physicians Orders for Life-Sustaining Treatment (POLST) orders perform different but complementary functions in documenting a patient's treatment preferences and translating them into actionable orders that change in keeping with the patient's evolving clinical picture. Maryland's Medical Orders for Life-Sustaining Treatment (MOLST) form developed through a stakeholder-driven process that deviates from other POLST forms. While a patient or surrogate can decline discussing MOLST orders with a clinician, clinicians must write MOLST orders for certain patients (e...
April 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28336349/decisional-capacity-for-advanced-care-directives-in-parkinson-s-disease-with-cognitive-concerns
#14
Muneer Abu Snineh, Richard Camicioli, Janis M Miyasaki
INTRODUCTION: Physician Orders for Life Sustaining Therapies (POLST) or Goals of Care (GOC) are legal documents to guide intensity of interventions (ICU, resuscitation, hospitalization or comfort care) completed by healthcare professionals following counseling of patients or their designated medical decision makers. Capacity (understanding, appreciation, reasoning and expressing a choice) to consent to POLST or GOC has not been determined among Parkinson's disease (PD) patients. We sought to assess GOC PD decisional capacity for those with cognitive complaints but not dementia...
March 8, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28300470/clarity-or-confusion-variability-in-uses-of-allow-natural-death-in-state-polst-forms
#15
Dan Chen, Daidre Azueta
No abstract text is available yet for this article.
July 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28198722/triad-viii-nationwide-multicenter-evaluation-to-determine-whether-patient-video-testimonials-can-safely-help-ensure-appropriate-critical-versus-end-of-life-care
#16
RANDOMIZED CONTROLLED TRIAL
Ferdinando L Mirarchi, Timothy E Cooney, Arvind Venkat, David Wang, Thaddeus M Pope, Abra L Fant, Stanley A Terman, Kevin M Klauer, Monica Williams-Murphy, Michael A Gisondi, Brian Clemency, Ankur A Doshi, Mari Siegel, Mary S Kraemer, Kate Aberger, Stephanie Harman, Neera Ahuja, Jestin N Carlson, Melody L Milliron, Kristopher K Hart, Chelsey D Gilbertson, Jason W Wilson, Larissa Mueller, Lori Brown, Bradley D Gordon
OBJECTIVE: End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. METHODS: We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine...
June 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28196448/provider-perspectives-on-advance-care-planning-documentation-in-the-electronic-health-record-the-experience-of-primary-care-providers-and-specialists-using-advance-health-care-directives-and-physician-orders-for-life-sustaining-treatment
#17
Ellis Dillon, Judith Chuang, Atul Gupta, Sharon Tapper, Steve Lai, Peter Yu, Christine Ritchie, Ming Tai-Seale
CONTEXT: Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic. OBJECTIVES: In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice...
December 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28156550/advance-care-planning-and-palliative-care-consultation-for-stem-cell-transplant-patients
#18
Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric Roeland
113 Background: Advance care planning (ACP) in stem cell transplantation (SCT) is particularly challenging given the potential for cure for patients with blood cancers despite an increased risk of suffering and even death. Data regarding ACP and palliative care (PC) integration in SCT is limited. METHODS: A retrospective chart review was conducted of patients with hematologic malignancies who underwent SCT at UCSD from January 2011 to December 2015. The primary objective was to determine the medical discipline of the initial and last code status documentation...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28112613/controlling-the-misuse-of-cpr-through-polst-and-certified-patient-decision-aids
#19
Thaddeus Mason Pope
No abstract text is available yet for this article.
February 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/27803565/patient-and-health-care-provider-interpretation-of-do-not-resuscitate-and-do-not-intubate
#20
Heather Pirinea, Thomas Simunich, Daniel Wehner, John Ashurst
BACKGROUND: Advance directives and end of life care are difficult discussions for both patients and health-care providers (HCPs). A HCP requires an accurate understanding of advanced directives to educate patients and their family members to allow them to make an appropriate decision. Misinterpretations of the do not resuscitate (DNR), do not intubate (DNI), and the Physicians Orders for Life-Sustaining Treatment (POLST) form result in ineffective communication and confusion between patients, family members, and HCPs...
October 2016: Indian Journal of Palliative Care
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