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https://www.readbyqxmd.com/read/28413928/the-oncology-specialist-s-role-in-polst-form-completion
#1
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...
January 1, 2017: 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
#2
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
#3
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
#4
Dan Chen, Daidre Azueta
No abstract text is available yet for this article.
March 16, 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
#5
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...
February 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28196448/provider-perspectives-on-advance-care-planning-documentation-in-the-electronic-health-record
#6
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...
January 1, 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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27802064/the-quality-of-physician-orders-for-life-sustaining-treatment-decisions-a-pilot-study
#10
Susan E Hickman, Bernard J Hammes, Alexia M Torke, Rebecca L Sudore, Greg A Sachs
BACKGROUND: Physician Orders for Life-Sustaining Treatment (POLST) forms are used to document patient treatment preferences as medical orders. Prior research demonstrates that use of POLST alters medical treatments in a way that is consistent with the POLST orders. However, there are minimal data about the quality of POLST decisions, including whether they reflect the current preferences of well-informed patients. OBJECTIVE: Evaluate the quality of POLST decisions...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27767363/the-role-of-advanced-practice-registered-nurses-in-the-completion-of-physician-orders-for-life-sustaining-treatment
#11
Sophia A Hayes, Dana Zive, Betty Ferrell, Susan W Tolle
BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm records advance care planning for patients with advanced illness or frailty as actionable medical records. The National POLST Paradigm Task Force recommends that physicians, advanced practice registered nurses (APRNs), and physician assistants (PAs) be permitted to execute POLST forms. OBJECTIVE: To investigate the percentage of Oregon POLST forms signed by APRNs, and examine the obstacles faced by states attempting to allow APRNs to sign POLST forms...
April 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27696173/implementation-of-a-novel-electronic-health-record-embedded-physician-orders-for-life-sustaining-treatment-system
#12
Dana M Zive, Jennifer Cook, Charissa Yang, David Sibell, Susan W Tolle, Michael Lieberman
In April 2015, Oregon Health & Science University (OHSU) deployed a web-based, electronic medical record-embedded application created by third party vendor Vynca Inc. to allow real-time education, and completion of Physician Orders for Life Sustaining Treatment (POLST). Forms are automatically linked to the Epic Systems™ electronic health record (EHR) patient header and submitted to a state Registry, improving efficiency, accuracy, and rapid access to and retrieval of these important medical orders. POLST Forms, implemented in Oregon in 1992, are standardized portable medical orders used to document patient treatment goals for end-of-life care...
November 2016: Journal of Medical Systems
https://www.readbyqxmd.com/read/27669131/overcoming-legal-impediments-to-physician-orders-for-life-sustaining-treatment
#13
Marshall B Kapp
The Physician Orders for Life-Sustaining Treatment (POLST), otherwise known as the POLST paradigm, represents the next generation in end-of-life (EOL) planning for certain patients who wish to exercise prospective control over their own medical treatment in their final days. As is true for any physician treatment orders, a POLST is written in consultation with the patient or patient's surrogate. There are a number of practical impediments to widespread adoption and implementation of the POLST paradigm in medical practice...
September 1, 2016: AMA Journal of Ethics
https://www.readbyqxmd.com/read/27442346/the-role-of-health-care-provider-goals-plans-and-physician-orders-for-life-sustaining-treatment-polst-in-preparing-for-conversations-about-end-of-life-care
#14
Jessica Russell
The Physician Orders for Life-Sustaining Treatment (POLST) is a planning tool representative of an emerging paradigm aimed at facilitating elicitation of patient end-of-life care preferences. This study assessed the impact of the POLST document on provider goals and plans for conversations about end-of-life care treatment options. A 2 (POLST: experimental, control) Ă— 3 (topic of possible patient misunderstanding: cardiopulmonary resuscitation, medical intervention, artificially administered nutrition) experimental design was used to assess goals, plan complexity, and strategies for plan alterations by medical professionals...
September 2016: Journal of Health Communication
https://www.readbyqxmd.com/read/27400923/experiences-with-polst-opportunities-for-improving-advance-care-planning-editorial-comment-on-use-of-physician-orders-for-life-sustaining-treatment-among-california-nursing-home-residents
#15
https://www.readbyqxmd.com/read/27392597/failure-of-the-current-advance-care-planning-paradigm-advocating-for-a-communications-based-approach
#16
Laura Vearrier
The purpose of advance care planning (ACP) is to allow an individual to maintain autonomy in end-of-life (EOL) medical decision-making even when incapacitated by disease or terminal illness. The intersection of EOL medical technology, ethics of EOL care, and state and federal law has driven the development of the legal framework for advance directives (ADs). However, from an ethical perspective the current legal framework is inadequate to make ADs an effective EOL planning tool. One response to this flawed AD process has been the development of Physician Orders for Life Sustaining Treatment (POLST)...
December 2016: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/27203483/emergency-physicians-experience-with-advance-care-planning-documentation-in-the-electronic-medical-record-useful-needed-and-elusive
#17
Joshua R Lakin, Eric Isaacs, Erin Sullivan, Heather A Harris, Ryan D McMahan, Rebecca L Sudore
OBJECTIVE: For patients' preferences to be honored, emergency department (ED) physicians must be able to find and use advance care planning (ACP) information in the electronic medical record (EMR). ED physicians' experiences with ACP EMR documentation and their documentation needs are unknown. METHODS: We surveyed 70 ED physicians (81% response rate) from a tertiary and county ED. Our primary outcome was confidence finding and using ACP EMR documentation (percentage reporting very/extremely on a five-point Likert scale)...
June 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27188700/use-of-the-physician-orders-for-life-sustaining-treatment-among-california-nursing-home-residents
#18
Lee A Jennings, David Zingmond, Rachel Louie, Chi-Hong Tseng, Judy Thomas, Kate O'Malley, Neil S Wenger
BACKGROUND: Physician Orders for Life-Sustaining Treatment (POLST) is a tool that facilitates the elicitation and continuity of life-sustaining care preferences. POLST was implemented in California in 2009, but how well it disseminated across a large, racially diverse population is not known and has implications for end-of-life care. OBJECTIVE: To evaluate the use of POLST among California nursing home residents, including variation by resident characteristics and by nursing home facility...
October 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27032129/physician-orders-for-life-sustaining-treatment
#19
Samantha Scotti
No abstract text is available yet for this article.
March 2016: NCSL Legisbrief
https://www.readbyqxmd.com/read/26957461/what-actually-happened
#20
(no author information available yet)
The medical team found the patient to lack medical decisionmaking capacity. However, the team felt that the patient was still able to respond appropriately to some situations. KS had displayed a consistent refusal of all medical treatments that made her uncomfortable or caused pain. During her sister's visits, the patient would be much more receptive to eating. A meeting was planned with the patient's sister in which the ethicist explained that the patient was not able to make her own decisions. The patient's sister agreed that she would honor the patient's wishes but would let the team make any decisions outside of what she knew about the patient's preferences...
April 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
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