Marietta Memorial Administrative Policy and Practice Guide
Advance
Directives
Patient Self
Determination Act
Objective:
Identify the process
for informing patients of their right
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Marietta Memorial Administrative Policy and Practice Guide |
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Patient Self
Determination Act (Living Will)
5.9 The purpose of
this policy is to assure a mechanism is in place to
Federal and State
regulations require all hospitals offer the opportunity for all admitted adults,
18 years or older, to be informed of their right to accept or refuse medical or
surgical treatment and to formulate Advance
Directives.
All admitted adult
patients will be given the following:
·
Written summaries of
the state law concerning healthcare choices
·
Marietta Memorial
Hospital policies regarding Advance
Directives
·
Do Not Resuscitate,
Withholding/Withdrawing of Life-Sustaining Treatments (when appropriate)
·
Any special policies
regarding artificially administered
nutrition/hydration.
If desired, the
patient will also be given an opportunity for individualized discussion on Advance Directives (Living Will and
Durable Power of Attorney for Health Care).
Incorporated within
this policy shall be the philosophy of Marietta
A. Recognize and
honor a patient's right, ethically and under State Law, to make decisions
regarding their healthcare.
B. Participate in
providing information and education regarding Advance Directives
C. Ensure that no
discrimination regarding treatment of patients without an Advance Directive takes
place.
D. Ensure full
compliance with State Law respecting Advance
Directives.
E.
Procedure:
Patient Registration
Clerk
Asks all adults at
the time of admission to Marietta Memorial Hospital if
Provides written
summary of Ohio Law to all patients, along with a brochure on Patient Rights
& Advance Directives.
Documents the
patient's record if he/she has an Advance
Directive. If patient has a copy present, places copy with admission data
for transport with patient to nursing unit. If the patient has no copy present,
requests copy be brought to Marietta Memorial Hospital within 24 hours of
admission.
Admitting RN
Provides opportunity
for individual discussion with designated hospital
Conducts admission
interview regarding Advance
Directives with a patient's authorized representative (surrogate) if patient
lacks decision making capacity
Surrogates may
include:
1. Agent
(Attorney-in-fact) appointed in Durable Power of Attorney for
Healthcare
2.
Guardian
3. Family member
according to designations in Ohio law. Verifies with patient the preliminary
information regarding Advance
Documents patients
response to possessing an Advance
Directive on
At no time will the
original Advance Directive be retained on the chart. A copy will be made and the
original returned to the patient or family. Notifies physician of existence and
makes
notation on the patient care Kardex.
If patient response
is "NO" and patient wishes more information, referral made to Social Services
via computer. If patient response is "NO" and patient wishes no more
information, no referral is made.
Explicitly reassures
patient that the lack of an Advance
Directive will not compromise the care he/she will receive. Informs the patient of his/her right to
refuse treatment. Assures, if the patient is temporarily impaired in decision
making capacity, that all information (written or verbal) regarding Advance Directives is presented to
patient upon return of his/her cognitive functioning. Referral made to Social
Services for this follow-up. Verifies if patient would like to discuss right to
accept or refuse medical/surgical treatment or drafting of Advance Directives further.
Assures that
referrals are appropriate and timely.
1. Social
Services
2. Attending
physician
If Advance Directive
is completed during hospitalization, Social Services will give copy for chart to
Charge Nurse.
1. Place in medical
record behind tab "LEGAL DOCUMENTS"
2. Notify
physician
3. Makes notation in
patient's Kardex
Social Services
Interviews patient,
when requested to do so by Nursing Staff. Responds in general to questions and
concerns regarding Advance
Directives.
Reviews the
intent/purpose of Advance Directives,
emphasizing the patient's right to make his/her healthcare choices.
Encourage patients
to discuss Advance Directives with
their physician, family and/or significant others, Power of Attorney, clergy,
personal attorney.
(1) Clarify that
Attorney at Law is not required to execute a Living Will or Durable Power of
Attorney for Health Care, but legal counsel may be helpful.
(2) Reviews with patient forms included in
the packet for executing Advance
Directives.
(1) If patient
wishes to execute Advance Directives
during hospitalization, will assist by clarification of who may serve as
witnesses and enlisting the aid of hospital and employed notary, if needed.
Reviews with patient
that although there is no expiration period to Advance
Directives, they should be
reviewed in accordance to:
(1) Changes in the
law
(2) Changes in
medical terminology
(3) Changes in
personal preference.
Reviews with patient
any previous existing documents and encourages executing current Advance Directives.
Reviews with patient
how to revoke an Advance
Directive.
Documents the
existence of the patient's new Advance Directive, removes the old copy from the
patient's record and destroys it. Explain to the patient that a copy needs to be
provided on each admission so that the hospital always has the up-to-date
document.
If a patient with an
Advance Directive expires, a copy of the Advance
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