1 / 24

POLST: Physicians Orders for Life Sustaining Treatment Ordenes Medicas para Sostener Tratamientos de Vida.

lynne
Télécharger la présentation

POLST: Physicians Orders for Life Sustaining Treatment Ordenes Medicas para Sostener Tratamientos de Vida.

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. POLST: Physicians Orders for Life Sustaining Treatment Ordenes Medicas para Sostener Tratamientos de Vida. Terri Schmidt MD Department of Emergency Medicine Center for Ethics in Health Care Oregon Health & Sciences University Ordenes Medicas para sostener tratamientos de vida.Ordenes Medicas para sostener tratamientos de vida.

    3. Muchas gracias por la oportunidad de hablar con ustedes

    4. Definitions Advance directives Directive to physicians/living will Power of attorney for health care Do not attempt resuscitation-DNR POLST *Indicates need to have these items in appendices*Indicates need to have these items in appendices

    5. Purpose of POLST To provide a mechanism to communicate patient preferences for end-of-life treatment across treatment settings Dar la oportunidad de comunicar la preferencia de los pacientes sobre el fin de la vida.

    6. Development of the POLST in Oregon Consensus development Began in 1991 Voluntary process Fue desarrollado por consenso Comenz en 1991 Proceso voluntario

    7. What Is POLST A physician/nurse practitioner order A portable document that transfers from one setting to another with the patient May function as a DNR order Provides treatment direction for multiple situations Es una orden mdica Un documento porttil que se transfiere con el paciente Puede ser una orden DNR Proveer informacin de tratamiento en muchas situaciones

    9. Requirements to make the form valid (Requisitos para hacer la orden vlida) Patient name Resuscitation orders Physician/NP signature all other information is optionaldoes not require signature of patient Nombre del paciente rdenes de resucitacin La firma del mdico Otra informacion no es necesaria No requiere la firma de paciente Requisitos para hacer la orden vlida.Requisitos para hacer la orden vlida.

    10. Section A: Resuscitation DNR orders only apply if a person is pulseless and apneic La orden de DNR slo se aplica cuando el paciente no tiene pulso y no esta respirando

    11. Section B

    12. Sections C and D Antibiotics No antibiotics Antibiotics IV and Tube Feeding No tube feeding/IV fluids Defined trial period Long term Antibioticos Si, antibiotios No antibiotics Alimentacin intravenosa y por sonda Negar alimentacin intravenosa y por sonda Prueba de alimentacin por tiempo definido Alimentacin a largo plazo

    13. Basis of POLST Discussion with patient Discussion with surrogate decision maker Despues de hablar con el paciente Discusin con otra persona que puede hacer decisiones por el paciente

    14. Where to keep the POLST The front of the chart Enfrente del registro mdico In a red envelope on the fridge En un sobre rojo en la refrigeradora Enfrente del registro mdico En un sobre rojo en la refrigeradoraEnfrente del registro mdico En un sobre rojo en la refrigeradora

    15. Prior Validation of POLST Dunn PM, Schmidt TA et al: A method to communicate patient preferences about medically indicated life sustaining treatment JAGS 1996;44:785 Tolle SW, Tilden VP, Nelson CA, Dunn PM: A Prospective study of the efficacy of the POLST JAGS 1998;46:1097 *Include all articles in appendix*Include all articles in appendix

    16. Lee MA, Brummel-Smith K et al: Physician orders for life-sustaining treatment (POLST): Outcomes in a PACE program JAGS 2000; 48:1-6. Schmidt TA, Hickman S, Tolle SW, Brooks HS (2004). "The Physician Orders for Life-Sustaining Treatment (POLST) Program:Oregon Emergency Medical Technicians' Practical Experiences and Attitudes." J Amer Geriatric Soc in press.

    17. Methods Anonymous survey Stratified random sample 1050 EMT-I and EMT-P in the state of Oregon Mailed June-August 2002

    18. 73% treated a patient with a POLST form 78% had received some education about the POLST Program 73% han tratado un paciente con POLST 78% han recibido educacin del programa de POLST

    19. 93% agreed POLST provides clear instructions when the patient is in cardiopulmonary arrest 63% agreed POLST provides clear instructions in other circumstances When present the POLST changed treatment plans is 45% of cases 93% creen que POLST provee instruciones claras cuando el paciente no tiene pulso 63% creen que POLST provee instruciones claras en otras situaciones El POLST cambio el tratamiento en 45% de los patientes

    21. The form was completed correctly 87% of the time. 5% were not signed 6% had conflicting orders 2% were incomplete La forma fue completa correctamente el 87% del tiempo. 5% no fueron firmadas 6% tuvieron ordenes contrarias 2% estaban incompletas

    22. Conclusion The POLST form is widely used throughout Oregon El POLST se utiliza extensamente a travs de Oregon

    23. EMTs report that (EMTs nos informan que el POLST) form is usually easy to find useful in making treatment decisions changes treatment plans in many cases es fcil de encontrar Ayuda hacer decisiones de tratamientos Muchas veces cambia el tratamiento

    24. Center for Ethics in Health Care 503 494-4466 Fax: 503 494-1260 Ethics@ohsu.edu www.ohsu.edu/ethics

More Related