News and Events
Some articles below are provided as summaries of original publications not readily available online without special access priveleges. A link to the original documents are provided for those who may have such access.
Study Demonstrates Efficacy of POLST
The Journal of the American Geriatric Society has released the newest POLST research manuscript: Association between Physician Order for Life-Sustaining Treatment for Scope of Treatment and in-Hospital Death in Oregon. This study of 17,900 decedents demonstrates a strong associated between POLST choices and where patients die and that the POLST is very effective in assuring patient preferences will be honored.
Researchers looked at the preferences documented on the POLST form and where that person died. Of those choosing Comfort Measures Only, 6.4% died in the hospital. For those choosing Limited Interventions, 22.4% died in the hospital and for those desiring Full Treatment, 44.2% died in the hospital. For patients without a POLST, 34% died in the hospital.
The study also demonstrated that decedents strongly preferred Comfort Measures Only, 66.1% vs. 26.7% preferring Limited Interventions and only 6.4% choosing Full Treatment.
Vastly more who complete a POLST choose Comfort Measures Only. Those with POLSTs for Comfort Measures Only were significantly LESS likely to die in a hospital and those with orders for full treatment were MORE likely to die in the hospital than those without a POLST. This holds for each of the top 10 causes of death. The study strongly supports POLST in that end-of-life preferences to avoid hospitalization as documented in POLST orders are shown to be honored, whether the patient wishes more or less treatment.
To Assure Success, Nevada POLST Offers FREE Training for Your Office or Facility.
The Nevada POLST form has many nuances that providers should be aware of when signing their names to the Nevada POLST form. Be sure you understand who the form is for, what the different sections mean, what to watch for when reviewing it, and how to avoid contradictory or confusing POLST orders.
It is important for providers to offer the Nevada POLST to their qualified patients, but more important that it is completed correctly so it provides the comfort and reassurance to patients and their families that is intended…and to you, their provider, that what you and your patient have agreed to is carried out by other providers.
Nevada State Deputy Attorney General Provides Legal Opinion regarding Required Signatures.
Nevada POLST has just received word from the Nevada State Deputy Attorney General (DAG) for Health Care regarding questions about who may sign the POLST form. The statute was not entirely clear, so Nevada POLST sought the DAG’s official opinion on this. The conclusion is that the statute as written requires the signature of the physician AND one of the following:
- If the patient is 18 years of age or older and of sound mind, the patient;
- If the patient is 18 years of age or older and incompetent, the representative of the patient; or
Note: legally, the “representative” is ONLY the person designated on the patient’s durable power of attorney for health care [DPOA], guardian or parent. Next of kin does not qualify unless they are designated as the DPOA;
- If the patient is less than 18 years of age, the patient and a parent or legal guardian of the patient.
The Nevada POLST is not valid unless signed by the physician and one of those noted above.
Next of kin cannot sign unless they are the designated durable power of attorney for health care (DPOA) as stipulated in the patient’s advance directive. Additional signatures of witnesses to consent of the next of kin is not valid.
Please be sure all who are involved in your Nevada POLST Program are aware of this determination.
Nevada POLST welcomes any questions or concerns you may have regarding this issue…or any other!