Advanced Directives Policy and Implementation Guidelines

Purpose

To establish standardized procedures for obtaining, documenting, and implementing advanced directives for geriatric patients, ensuring compliance with state laws and patient autonomy.

Policy Statement

All patients aged 65 and older shall be provided with information regarding advanced directives upon initial visit or admission, with documentation and regular updates maintained in their medical records.

Procedures

1. Initial Assessment

• Screen all new geriatric patients for existing advanced directives
• Document findings in designated EMR section
• Provide state-approved advanced directive forms if needed

2. Required Documentation

• Living Will
• Durable Power of Attorney for Healthcare
• Do Not Resuscitate (DNR) orders, if applicable
• POLST/MOLST forms as per state requirements

3. Staff Responsibilities

Medical Provider

• Review advanced directives with patients
• Ensure medical orders align with stated preferences
• Update documentation annually or upon significant changes

Nursing Staff

• Flag charts with advanced directive status
• Facilitate completion of forms
• Maintain current copies in designated location

Administrative Staff

• Scan documents into EMR
• Maintain paper copies in patient charts
• Track renewal dates

4. Quality Assurance

• Quarterly audit of advanced directive documentation
• Annual staff training on policy requirements
• Regular updates to reflect changes in state laws

References

• State Healthcare Decisions Act
• Federal Patient Self-Determination Act
• Facility Compliance Guidelines