POLST Does Not Replace Advance Care Planning
On April 25, 2018 by Elizabeth Sether, RN, MHA, LNHA
There are important differences between the POLST (Provider Orders for Life-Sustaining Treatment) and Advance Care Planning. To help members better understand POLST, we are providing the following overview and resources:
A POLST does not replace Advance Care Planning.
The POLST is a medical order for the specific medical treatments a person wants to receive during a medical emergency signed by either a physician, advance practice registered nurse or physician assistant. POLST forms are appropriate for individuals with a serious illness or advanced frailty near the end-of life and can help facilitate communication regarding treatments they do and do not want to receive at the time of an emergency.
It is important to know that a POLST is not required, nor can it be used to name a health care agent.
The POLST form should be kept in a location where it can be readily available and visible in case EMS professionals are called. Without a signed POLST form or an order for “NO CPR” in the medical record, the current standard of care when EMS is called requires a full code that could include CPR, intubation, mechanical ventilation and ICU admission.
The POLST should be placed by health care providers in the client’s health care record. Residents or tenants should keep a copy of the form with them, whether they are at home, in the hospital, or in another residence or care facility. Photocopied, faxed or electronic versions of the POLST form are all valid and recognized.
It is recommended that the signed POLST form be reviewed periodically, particularly when:
- there is a substantial change in the health status; or
- the resident or tenant is transferred from one care setting or level of care to another (including upon admission or at discharge); or
- the resident or tenant goals of care and/or treatment preferences change; or
- the primary health care provider changes.
Do not modify the POLST form’s design in any way. No organizational names, logos, bar codes, or other items should be added to the form.
Additional helpful resources can be found at the POLST website, including:
Answers to Frequently Asked Questions – such as does the POLST replace advance care planning and health care directives, when should a POLST form be reviewed, does an existing POLST need to be replaced with the newest version, and many more.