Virginia POLST Portable Medical Orders Document
The Virginia POLST Form is a critical medical order for patients with serious life-limiting conditions. It provides clear instructions regarding resuscitation and treatment preferences. This form should be completed with a healthcare professional to ensure patient wishes are appropriately documented.
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How do I fill this out?
To fill out the POLST form, begin by discussing the patient's medical condition and treatment preferences with a healthcare provider. Ensure that all necessary sections are completed accurately based on the patient's wishes. Finally, have the required signatures from both the patient and the healthcare provider.
How to fill out the Virginia POLST Portable Medical Orders Document?
1
Discuss the patient's condition and preferences with a healthcare provider.
2
Complete all necessary sections of the POLST form.
3
Ensure the form is signed by the patient and healthcare provider.
4
Print the form in accordance with provided instructions.
5
Keep a copy for medical records and provide a copy to the patient.
Who needs the Virginia POLST Portable Medical Orders Document?
1
Patients with serious health conditions need this form to clarify their treatment preferences.
2
Healthcare professionals require this form to ensure they follow patients' wishes during emergencies.
3
Families of patients need this form to understand and advocate for their loved ones' treatment choices.
4
Hospice care providers use this form to align care protocols with patient wishes.
5
Legal representatives may need this document to uphold the patient's medical decisions.
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Open the POLST form on PrintFriendly's PDF editor.
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Make the necessary edits to the form fields.
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Preview your changes to ensure accuracy.
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Save the updated document locally.
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Share the document with healthcare providers or family.
What are the instructions for submitting this form?
To submit the completed POLST form, take the following steps: Provide a signed copy to your healthcare provider or facility where you receive care. You may also send a fax to your provider's office at the designated fax number. Additionally, ensure that a copy accompanies you during any transfer to another healthcare setting.
What are the important dates for this form in 2024 and 2025?
Important dates regarding the POLST form include ongoing updates applicable each year, generally observed in alignment with new healthcare regulations, and individual review dates that may be established by healthcare providers or patients for annual check-ins regarding treatment preferences.
What is the purpose of this form?
The purpose of the POLST form is to effectively communicate a patient's treatment preferences in medical emergencies. It empowers patients with serious life-limiting conditions to express their wishes regarding life-sustaining treatments. By having a completed POLST form, healthcare providers are better equipped to honor these preferences during critical care situations.
Tell me about this form and its components and fields line-by-line.
- 1. Patient Information: This section includes the patient's name, date of birth, and emergency contact details.
- 2. CPR Orders: Patients indicate their preferences regarding cardiopulmonary resuscitation.
- 3. Treatment Orders: This outlines the patient's desired level of medical intervention.
- 4. Nutrition Orders: Preferences for medically assisted nutrition are documented here.
- 5. Signatures: Required signatures from both the patient and healthcare provider validate the orders.
What happens if I fail to submit this form?
Failing to submit a POLST form may result in the absence of clear medical directives, leaving healthcare providers uncertain about a patient's wishes. This could lead to unwanted or unnecessary treatments being administered during critical care situations. It is vital to ensure that this form is filled out and properly submitted to uphold patient-centered care.
- Unclear Treatment Preferences: Without a submitted POLST form, healthcare providers may not know how to proceed with care.
- Risk of Inappropriate Interventions: Patients may receive treatments they would have otherwise refused.
- Compromised Health Outcomes: Delays in care decisions could negatively affect patient outcomes.
How do I know when to use this form?
- 1. Serious Illness: Patients with terminal illnesses should have a POLST form to guide their care.
- 2. Emergency Situations: This form ensures that first responders know the patient's wishes.
- 3. Healthcare Transitions: Whenever a patient moves between care settings, the POLST form should be reviewed and updated.
Frequently Asked Questions
What is the POLST form?
The POLST form is a medical order that outlines a patient's treatment preferences, particularly for those with serious health conditions.
How do I fill out the POLST form?
Fill out the POLST form by discussing it with a healthcare provider who can guide you on your treatment options.
Can I edit the POLST form on PrintFriendly?
Yes, you can edit the POLST form on PrintFriendly by using our PDF editor to make necessary adjustments.
Is my signature valid on the POLST form?
Yes, your eSignature on the POLST form is valid and legally binding.
Who can access my POLST form?
Your POLST form can be accessed by healthcare providers and legally authorized representatives involved in your care.
Can I share my POLST form electronically?
Absolutely, after editing, you can generate a shareable link to send to others.
What happens if I don’t fill out a POLST form?
If you don’t complete a POLST form, your treatment preferences may not be clearly communicated during medical emergencies.
Do I need to update my POLST form?
Yes, it is advisable to review and update your POLST form whenever there is a change in your health status.
Where should I store my POLST form?
You should keep your POLST form in an easily accessible place and share copies with anyone involved in your healthcare.
Can I void my POLST form?
Yes, you can void your POLST form if your preferences change; simply destroy the old form and obtain a new one.
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