Advanced Directives Policy and Implementation Guidelines for Neurosurgical Care

1. Purpose

To establish standardized procedures for handling advanced directives in neurosurgical settings, ensuring compliance with legal requirements and patient wishes.

2. Scope

Applies to all healthcare providers and staff involved in neurosurgical care delivery.

3. Policy Components

3.1 Patient Admission Procedures

• Verify existence of advanced directives during pre-surgical assessment
• Document directive status in EMR
• Obtain copies for medical record
• Flag cases requiring ethics consultation

3.2 Required Documentation

• Living Will
• Durable Power of Attorney for Healthcare
• Do Not Resuscitate (DNR) orders
• Specific neurosurgical interventions preferences

3.3 Staff Responsibilities

Admitting Staff

• Initial advanced directive screening
• Documentation collection
• EMR update

Neurosurgeons

• Review directives pre-surgery
• Document surgical plan compliance
• Discuss modifications if needed

Nursing Staff

• Verify documentation
• Communicate status to care team
• Monitor compliance

4. Special Considerations

4.1 Emergency Situations

• Protocol for emergency surgery when directives unavailable
• Documentation requirements
• Family notification procedures

4.2 Capacity Assessment

• Criteria for determining decision-making capacity
• Protocol for surrogate decision-makers
• Documentation requirements

5. Compliance Monitoring

• Regular audit procedures
• Staff training requirements
• Policy review schedule

6. References

• State-specific legal requirements
• Hospital policies
• Professional guidelines