Purpose
To establish guidelines for the documentation, implementation, and respect of patient advanced directives in dermatological care settings.
Policy Statement
This dermatology practice recognizes and honors patients' rights to make informed decisions about their medical care, including the right to accept or refuse treatment and to formulate advanced directives.
Procedures
1. Documentation Requirements
- Ask all new patients if they have an advanced directive
- Document the existence or absence of advanced directives in the patient's medical record
- Maintain copies of advanced directives in a prominent section of the medical record
- Update information annually or when patients indicate changes
2. Staff Responsibilities
Front Desk Staff
- Inquire about advanced directives during initial registration
- Provide advanced directive forms when requested
- Forward documentation to clinical staff
Clinical Staff
- Review advanced directives with patients
- Document discussions in medical record
- Ensure compliance with stated preferences
3. Types of Advanced Directives Recognized
- Living Will
- Durable Power of Attorney for Healthcare
- Do Not Resuscitate (DNR) Orders
- POLST Forms (Physician Orders for Life-Sustaining Treatment)
4. Implementation
For Routine Procedures
- Review advanced directives before any procedure
- Confirm current validity with patient
- Document any modifications
For Emergency Situations
- Follow emergency protocols unless specifically contradicted by valid advanced directives
- Contact designated healthcare proxy when applicable
Compliance
- Annual staff training required
- Quarterly audits of documentation compliance
- Regular policy review and updates
References
- State Medical Board Guidelines
- American Academy of Dermatology Association Guidelines
- Federal Patient Self-Determination Act