Physician Orders for Life-Sustaining Treatment (POLST) |
Introduction
Not all states have a state-approved Physician Orders for Life-Sustaining Treatment (POLST), Medical Order for Life-Sustaining Treatment (MOLST), or DNR (Do Not Resuscitate) order form.
Not all states have a state-approved Physician Orders for Life-Sustaining Treatment (POLST), Medical Order for Life-Sustaining Treatment (MOLST), or DNR (Do Not Resuscitate) order form.
Recent studies and viewpoint on have found the following associations and concluded the following: Among patients presenting to the ED with POLST, the majority of POLST forms had orders for full treatment and were not accessed by emergency providers. These findings may partially explain why we found no association of POLST with treatment intensity. However, treatment limitations on POLST forms were associated with reduced odds of ICU admission. Implementation and accessibility of POLST forms are crucial when considering their effect on the provision of treatment consistent with patients' preferences.1 Among patients with POLSTs and with chronic life-limiting illness who were hospitalized within 6 months of death, treatment-limiting POLSTs were significantly associated with lower rates of ICU admission compared with full-treatment POLSTs. However, 38% of patients with treatment limiting POLSTs received intensive care that was potentially discordant with their POLST.2 Addressing advance care planning and decisions about do-not-resuscitate orders is imperative during novel coronavirus 2019 (COVID-19).3
Objective
The goals of this survey are (1) to assess the Society of Academic Emergency Medicine (SAEM) membership’s familiarity with each member’s respective state’s POLST, MOLST, or DNR form, (2) to assess the frequency that specific groups of patient have a signed POLST, MOLST, or DNR form by SAEM members who provide direct patient care, and (3) to increase awareness on Orders for Life-Sustaining Treatments for patients.
Method
SAEM survey template will be used for the questions, and survey will be implemented via SAEM social media. Specific groups of interest are (1) geriatric patients who are older than 65 years-old, (2) patient who have a malignancy and are on active treatment, (3) patients with end-stage conditions such as advanced heart failure, end-stage lung disease, end-stage renal stage, and end-stage liver disease, and (4) patient with COVID-19. The survey questions were reviewed by members of Academy of Geriatric Emergency Medicine and Palliative Care and Critical Care Interest Groups, an independent survey expert, and an independent researcher on this topic.
Frequently Asked Questions
References
Objective
The goals of this survey are (1) to assess the Society of Academic Emergency Medicine (SAEM) membership’s familiarity with each member’s respective state’s POLST, MOLST, or DNR form, (2) to assess the frequency that specific groups of patient have a signed POLST, MOLST, or DNR form by SAEM members who provide direct patient care, and (3) to increase awareness on Orders for Life-Sustaining Treatments for patients.
Method
SAEM survey template will be used for the questions, and survey will be implemented via SAEM social media. Specific groups of interest are (1) geriatric patients who are older than 65 years-old, (2) patient who have a malignancy and are on active treatment, (3) patients with end-stage conditions such as advanced heart failure, end-stage lung disease, end-stage renal stage, and end-stage liver disease, and (4) patient with COVID-19. The survey questions were reviewed by members of Academy of Geriatric Emergency Medicine and Palliative Care and Critical Care Interest Groups, an independent survey expert, and an independent researcher on this topic.
Frequently Asked Questions
References