New Jersey Practitioner Orders for Life-Sustaining Treatment
This document is the New Jersey Practitioner Orders for Life-Sustaining Treatment (POLST) form. It outlines the medical orders based on the patient's current medical condition and their wishes for treatment. Healthcare professionals must follow the instructions for patient care as detailed in this form.
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How do I fill this out?
Filling out the POLST form requires understanding the patient's wishes regarding life-sustaining treatment. Begin by discussing the medical condition and treatment options with the patient or their surrogate. Ensure that all sections are completed clearly and accurately.
How to fill out the New Jersey Practitioner Orders for Life-Sustaining Treatment?
1
Identify the patient's goals of care.
2
Fill out the medical interventions section based on the patient's desires.
3
Specify preferences for nutrition and hydration.
4
Indicate preferences regarding CPR and airway management.
5
Complete the necessary signatures to validate the form.
Who needs the New Jersey Practitioner Orders for Life-Sustaining Treatment?
1
Patients with chronic illnesses who want to outline their care preferences.
2
Healthcare providers needing clear instructions for treatment.
3
Family members or surrogates advocating for a loved one's care.
4
Nursing facilities managing patient treatment plans.
5
Any individual engaged in end-of-life planning.
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1
Upload the POLST PDF file to the PrintFriendly editor.
2
Use the editing tools to modify text or fields as needed.
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What are the instructions for submitting this form?
To submit the POLST form, print the completed document and ensure all necessary signatures are obtained. Then, it can be faxed to the appropriate healthcare provider or facility. Alternatively, a scanned copy can be emailed to the physician's office or uploaded through online patient portals, ensuring that it is accessible in the patient's medical record.
What are the important dates for this form in 2024 and 2025?
Important dates for this form include periodic reviews after significant health changes and updates every August for regulations compliance.
What is the purpose of this form?
The purpose of the POLST form is to ensure that patients' healthcare preferences are honored in emergency situations. It serves as a guiding document for healthcare providers to follow, outlining the specific treatments that the patient desires or declines. This is particularly crucial for individuals with serious or terminal conditions, as it enhances patient autonomy and clarity in care decisions.
Tell me about this form and its components and fields line-by-line.
- 1. Patient's Name: The full name of the individual for whom the POLST is being created.
- 2. Goals of Care: Section where specific treatment goals and preferences are noted.
- 3. Medical Interventions: Instructions about the medical treatments the patient wishes to receive or decline.
- 4. Artificially Administered Fluids and Nutrition: Preferences regarding the use of feeding tubes and IV fluids.
- 5. Cardiopulmonary Resuscitation (CPR): Instructions on whether to attempt resuscitation or allow natural death.
- 6. Airway Management: Decisions regarding intubation or other airway interventions.
- 7. Signatures: Required signatures from the patient or their surrogate to validate the POLST.
- 8. Health Care Representative: Information about the person's healthcare representative.
What happens if I fail to submit this form?
If the POLST form is not submitted, there may be confusion regarding the patient's treatment preferences. This could lead to unwanted medical interventions or failure to provide necessary care.
- Unclear Treatment Preferences: Without the POLST, healthcare providers may not understand the patient's wishes.
- Potential for Inadequate Care: Patients may not receive the appropriate level of care as intended.
- Legal and Ethical Issues: Failure to submit can result in legal complications regarding treatment decisions.
How do I know when to use this form?
- 1. Serious Illness Management: To direct care that aligns with the patient's values and preferences.
- 2. Transition of Care: To ensure continuity and clarity in treatment preferences when moving between facilities.
- 3. End-of-Life Planning: To formally document a patient's wishes for their end-of-life care.
Frequently Asked Questions
What is the POLST form for?
The POLST form is used to document patient's preferences for life-sustaining treatment.
How do I edit the POLST form?
You can upload the form to PrintFriendly, make edits, and then save your changes.
Can I sign the POLST form electronically?
Yes, PrintFriendly allows you to add your electronic signature to the POLST form.
Who needs to fill out the POLST form?
Patients with specific healthcare goals, their surrogates, and healthcare providers need this form.
Is the POLST form legally binding?
Yes, once signed by the appropriate parties, it is a legally binding document.
Can family members modify the POLST form?
Yes, if authorized, family members can modify the POLST based on the patient's wishes.
What happens if I forget to fill out a section?
An incomplete section implies full treatment for that section, so it's essential to fill it out completely.
How do I know when to use the POLST form?
Use this form when discussing treatment preferences for patients with serious medical conditions.
Can I share the POLST form after editing?
Yes, after editing the form, you can easily share it via email or social media.
Where can I find more information on completing the POLST?
PrintFriendly offers guidance on filling out the POLST and understanding its sections.
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