Providers

The POLST Form

What is POLST

The Provider Order for Life-Sustaining Treatment (POLST) is both a medical order and legal document that translates a conversation between a patient and their provider regarding end-of-life treatment wishes to an actionable medical order, which all healthcare providers are to honor.

POLST, ADs and DNRs

Who should have a polst

Any patient, whose death in the next year would not surprise you, is a candidate for POLST. The very frail elderly, those near the end of a life-limiting illness or those who are candidates for hospice are typical POLST candidates.

Appropriate Use

starting the Conversation

Integral to the POLST process is a conversation with the patient, or if lacking capacity, their representative or surrogate. It is important to explain what the POLST choices will most likely mean for the patient should they experience a life-threatening crisis.

How and What to Say

How to Complete a

POLST form

After identifying the appropriate patient and having "the conversation", it is time to complete the Nevada POLST form.

Step-by-step instructions for completing POLST

Nevada POLST Training

There are several ways to obtain training on the POLST process. And, CEU credit is available for nursing and social work.

Learn more about POLST training

EMS & POLST

EMS plays a critical role in the POLST process. It is important to know when and how to use the POLST and what legal the legal implications are.

Find out what EMS needs to know

Videos

RESOURCES

Ordering Forms

State printed Nevada POLST forms are preferred as they are the approved color and weight. You may order them through Nevada POLST without any additional charge.

Order Nevada POLST Forms

Printing Forms

A Nevada POLST form not yet completed and given to a patient should be clearly marked "Sample" since it is a Medical Order.

Printing POLST Forms

POLST in Other Languages

Nevada POLST is now available in Spanish to be used for education and translation.

Print Spanish POLST

Patient handouts

When you click the "Patient Handouts" link, scroll to the bottom of the page for printable handouts in layman's term on artificial nutrition and hydration, ventilators and CPR.

Patient Handouts

POLST Research & Resources

There is a growing body of research on POLST; see what is working, best practices, challenges. And, help your patients make the right choices for themselves with our many patient resources

Research & Resources