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Providers Orders for Life Sustaining Treatment

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1. The Role of Health Care Provider Goals, Plans, and Physician Orders for Life-Sustaining Treatment (POLST) in Preparing for Conversations About End-of-Life Care. (PubMed)

The Role of Health Care Provider Goals, Plans, and Physician Orders for Life-Sustaining Treatment (POLST) in Preparing for Conversations About End-of-Life Care. The Physician Orders for Life-Sustaining Treatment (POLST) is a planning tool representative of an emerging paradigm aimed at facilitating elicitation of patient end-of-life care preferences. This study assessed the impact of the POLST document on provider goals and plans for conversations about end-of-life care treatment options. A 2 (...) (POLST: experimental, control) × 3 (topic of possible patient misunderstanding: cardiopulmonary resuscitation, medical intervention, artificially administered nutrition) experimental design was used to assess goals, plan complexity, and strategies for plan alterations by medical professionals. Findings suggested that the POLST had little impact on plan complexity or reaction time with initial plans. However, preliminary evidence suggested that the utility of the POLST surfaced with provider responses

2017 Journal of health communication

2. Physician orders for life-sustaining treatment (POLST) and quality end-of-life care: a systematic review

Physician orders for life-sustaining treatment (POLST) and quality end-of-life care: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files (...) animals in the meta-analysis by dividing the number of animals in the control group by the number of treatment groups served. Where applicable, Holm-Bonferroni correction for testing multiple subgroup analyses will be performed. If one or more subgroup analyses cannot be performed due to insufficient data, the p-value will be adjusted accordingly. ">Other Subgroup analysis or meta-regression are used to explore between-study heterogeneity and can provide insight into the relationship between study

2019 PROSPERO

3. The Association of Physician Orders for Life-Sustaining Treatment With Intensity of Treatment Among Patients Presenting to the Emergency Department. (PubMed)

The Association of Physician Orders for Life-Sustaining Treatment With Intensity of Treatment Among Patients Presenting to the Emergency Department. Physician Orders for Life-Sustaining Treatment (POLST) forms are intended to help prevent the provision of unwanted medical interventions among patients with advanced illness or frailty who are approaching the end of life. We seek to evaluate how POLST form completion, treatment limitations, or both influence intensity of treatment among patients (...) ) or aggressive treatment (aOR=0.87; 95% CI 0.5 to 1.52), but were associated with lower odds of ICU admission (aOR=0.31; 95% CI 0.16 to 0.61).Among patients presenting to the ED with POLST, the majority of POLST forms had orders for full treatment and were not accessed by emergency providers. These findings may partially explain why we found no association of POLST with treatment intensity. However, treatment limitations on POLST forms were associated with reduced odds of ICU admission. Implementation

2019 Annals of Emergency Medicine

4. A Tool to Assess Patient and Surrogate Knowledge about the POLST (Physician Orders for Life-Sustaining Treatment) Program. (PubMed)

A Tool to Assess Patient and Surrogate Knowledge about the POLST (Physician Orders for Life-Sustaining Treatment) Program. It is especially important that patients are well-informed when making high stakes, preference-sensitive decisions like those on the Physician Orders for Life-Sustaining Treatment (POLST) form. However, there is currently no way to easily evaluate whether patients understand key concepts when making these important decisions.To develop a POLST knowledge survey.Expert (n (...) in multivariate analyses.The 19-item POLST Knowledge Survey demonstrated adequate reliability and responsiveness to change. Findings suggest the survey could be used to identify knowledge deficits and provide targeted education to ensure adequate understanding of key clinical decisions when completing POLST.Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

2019 Journal of pain and symptom management

5. Improving Advanced Care Planning through Physician Orders for Life-Sustaining Treatment (POLST) Expansion across the United States: Lessons Learned from State-Based Developments. (PubMed)

Improving Advanced Care Planning through Physician Orders for Life-Sustaining Treatment (POLST) Expansion across the United States: Lessons Learned from State-Based Developments. The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm is an effective advance care planning tool. However, barriers to implementation persist. In the United States, POLST program development occurs at the state-level. Substantial differences between states has left POLST implementation largely (...) to adequately assess expansion, lack of provider support, and legislative concerns. Medical barriers (mean [standard deviation]: 5.0 [0.2]) were rated higher than legislative (3.0 [0.6]; P < .001).POLST programs continue to grow, but not without barriers. Based on the experiences of developing coalitions, we were able to identify strategies to expand POLST programs and overcome barriers. Ultimately the "lessons learned" in this study can serve as a guide to improve the reach of POLST or similar programs.

2019 American Journal of Hospice and Palliative Medicine

6. Provider's Orders for Life Sustaining Treatment

Provider's Orders for Life Sustaining Treatment Providers Orders for Life Sustaining Treatment Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Provider's Orders for Life Sustaining Treatment Provider's Orders for Life Sustaining Treatment Aka: Provider's Orders for Life Sustaining Treatment , Do-Not-Reuscitate , DNR , POLST , Do Not Attempt Resuscitation , DNAR From Related Chapters II. Types: Do Not Resuscitate (DNR) or Do Not Attempt Resuscitation (DNAR) Order prohibits (CPR) Includes Do-Not-Intubate (DNI) Implementation varies by state (e.g. DNR as outpatient) Independent of Do Not Attempt Resuscitation (DNAR) Reflects

2018 FP Notebook

7. Reversals and limitations on high-intensity, life-sustaining treatments. (PubMed)

Reversals and limitations on high-intensity, life-sustaining treatments. Critically ill patients often receive high-intensity life sustaining treatments (LST) in the intensive care unit (ICU), although they can be ineffective and eventually undesired. Determining the risk factors associated with reversals in LST goals can improve patient and provider appreciation for the natural history and epidemiology of critical care and inform decision making around the (continued) use of LSTs.This (...) is a single institution retrospective cohort study of patients receiving life sustaining treatment in an academic tertiary hospital from 2009 to 2013. Deidentified patient electronic medical record data was collected via the clinical data warehouse to study the outcomes of treatment limiting Comfort Care and do-not-resuscitate (DNR) orders. Extended multivariable Cox regression models were used to estimate the association of patient and clinical factors with subsequent treatment limiting orders.10,157

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2018 PLoS ONE

8. Development of a Tailored Life-Sustaining Treatment Decision Support Intervention for Stroke Surrogate Decision Makers

number of saved studies (100). Please remove one or more studies before adding more. Development of a Tailored Life-Sustaining Treatment Decision Support Intervention for Stroke Surrogate Decision Makers The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details (...) Development of a Tailored Life-Sustaining Treatment Decision Support Intervention for Stroke Surrogate Decision Makers Development of a Tailored Life-Sustaining Treatment Decision Support Intervention for Stroke Surrogate Decision Makers - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum

2018 Clinical Trials

9. Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life

away from minimization of short-term morbidityandmortalitytowardsoptimizingimmunestatus and general health for a full and productive adult life. This mirrors the general trend in global treatment guidelines that now include higher CD4 thresholds for ART initiation and an increased number of clinical indications in both adults and children [2–6]. The aim is to provide a practical guide to treatment rather than a comprehensive review of all the evidence on ART in children. More detailed information (...) Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life ABamford,*ATurkova,*HLyall, CFoster, NKlein, DBastiaans, DBurger, SBernardi, KButler, EChiappini, 1 2 3 3 4 5 5 6 7 8 P Clayden, 9 M Della Negra, 10 V Giacomet, 11 C

2018 The Children's HIV Association

10. Life-Sustaining Treatment Status at the Time of Death in a Japanese Pediatric Intensive Care Unit. (PubMed)

Life-Sustaining Treatment Status at the Time of Death in a Japanese Pediatric Intensive Care Unit. Substantial variability exists among countries regarding the modes of death in pediatric intensive care units (PICUs). However, there is limited information on end-of-life care in Japanese PICUs. Thus, this study aimed to elucidate the characteristics of end-of-life care practice for children in a Japanese PICU.We examined life-sustaining treatment (LST) status at the time of death based (...) was longer than that in the no-limitation group (13.5 vs 2.5 days; P = .01). The median time to death after the decision to limit LST was 2 days (interquartile range: 1-5.5 days), and 94% of the patients were on mechanical ventilation at the time of death in the limitation group.Although limiting LST was a common practice in end-of-life care in a Japanese PICU, a severe limitation of LST such as withdrawal from the ventilator was hardly practiced, and a considerable LST was still provided at the time

2017 American Journal of Hospice and Palliative Medicine

11. The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form. (PubMed)

The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form. To evaluate the consistency between treatments provided and Physician Orders for Life-Sustaining Treatment (POLST) orders.Retrospective chart abstraction.Stratified, random sample of 90 nursing facilities in Oregon, Wisconsin, and West Virginia.Eight hundred seventy living and deceased nursing facility residents aged 65 and older with a minimum 60-day (...) treatments was nearly always consistent with POLST orders to provide or withhold life-sustaining interventions. The POLST program is a useful tool for ensuring that the treatment preferences of nursing facility residents are honored.© 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

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2011 Journal of the American Geriatrics Society

12. Physician Orders for Life-Sustaining Treatment (POLST): Lessons Learned from Analysis of the Oregon POLST Registry. (PubMed)

Physician Orders for Life-Sustaining Treatment (POLST): Lessons Learned from Analysis of the Oregon POLST Registry. Physician Orders for Life-Sustaining Treatment (POLST) has become a common means of documenting patient treatment preferences. In addition to orders either for Attempt Resuscitation or Do Not Attempt Resuscitation, for patients not in cardiopulmonary arrest, POLST provides three levels of treatment: Full Treatment, Limited Interventions, and Comfort Measures Only. Oregon has (...) an electronic registry for POLST forms completed in the state. We used registry data to examine the different combinations of treatment orders.We analyzed data from forms signed and entered into the Oregon POLST Registry in 2012. The analysis included 31,294 POLST forms. The mean Registrant age was 76.7 years. 21,396 (68.4%) had Do Not Attempt Resuscitation (DNR) orders and 9900 (31.6%) had orders for "Attempt Resuscitation". The 6 order combinations were: Do Not Resuscitate (DNR)/Comfort Measures Only

2014 Resuscitation

13. Provider's Orders for Life Sustaining Treatment

Provider's Orders for Life Sustaining Treatment Providers Orders for Life Sustaining Treatment Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Provider's Orders for Life Sustaining Treatment Provider's Orders for Life Sustaining Treatment Aka: Provider's Orders for Life Sustaining Treatment , Do-Not-Reuscitate , DNR , POLST , Do Not Attempt Resuscitation , DNAR From Related Chapters II. Types: Do Not Resuscitate (DNR) or Do Not Attempt Resuscitation (DNAR) Order prohibits (CPR) Includes Do-Not-Intubate (DNI) Implementation varies by state (e.g. DNR as outpatient) Independent of Do Not Attempt Resuscitation (DNAR) Reflects

2015 FP Notebook

14. Sustainable Solutions for Paediatric Basic Life Support Training in Day Care Centres

participants in a randomised order . Primary Purpose: Other Official Title: Sustainable Solutions for Paediatric Basic Life Support Training in Day Care Centres: A Comparative Effectiveness Trial Actual Study Start Date : December 7, 2015 Actual Primary Completion Date : April 5, 2017 Actual Study Completion Date : July 5, 2017 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Experimental: Dyad training The participants (...) training provides a low cost solution with improved flexibility. Consequently a non-inferiority design is chosen as the benefits of dyad training with the same learning outcomes favours the dyad training method. Prior to the training both groups are informed about and have access to a website with videos, quizzes, pictures and text information on paediatric basic life support and foreign body airway obstruction management. Condition or disease Intervention/treatment Phase Cardiopulmonary Resuscitation

2018 Clinical Trials

15. End of life care for infants, children and young people with life-limiting conditions: planning and management

to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. End of life care for infants, children (...) and young people with life-limiting conditions: planning and management (NG61) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 44they are more anxious or concerned the child or young person's condition deteriorates a significant change to the treatment plan is needed. 1.1.20 Provide children and young people and their parents and carers with the information they need on: their role and participation in Advance Care

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

16. Identifying the Effects of Home Care on Improving Health Outcomes, Client Satisfaction and Health System Sustainability

in Tables 2-5. For the systematic reviews included in the tables, we provide the focus of the review, key findings, last year the literature was searched, and the proportion of studies conducted in Canada. In the key findings provided, we focused on extracting information related to the three outcomes prioritized in the question, which include health outcomes, client satisfaction and system sustainability (e.g., cost considerations). Given the short timeline for this rapid synthesis (three business days (...) Health Outcomes, Client Satisfaction and Health System Sustainability 6 Evidence >> Insight >> Action Table 1: Summary of findings from systematic reviews that provide general/broad assessments of the effects of home care Document type Focus of systematic review Key findings Year of last search AMSTAR (quality) rating Proportion of studies that were conducted in Canada Overview of systematic reviews Impact of home care versus alternative locations of care on elder health outcomes (7) The overview

2018 McMaster Health Forum

17. The Oregon Physician Orders for Life-Sustaining Treatment Registry: A Preliminary Study of Emergency Medical Services Utilization. (PubMed)

The Oregon Physician Orders for Life-Sustaining Treatment Registry: A Preliminary Study of Emergency Medical Services Utilization. The Physician Orders for Life-Sustaining Treatment (POLST) form translates patient treatment preferences into medical orders. The Oregon POLST Registry provides emergency personnel 24-h access to POLST forms.To determine if Emergency Medical Technicians (EMTs) can use the Oregon POLST Registry to honor patient preferences.Two telephone surveys were developed: one (...) for the EMT who made a call to the Registry and one for the patient or the surrogate. The EMT survey was designed to determine if the POLST form accessed through the Registry changed the care of the patient. The patient/surrogate survey was designed to determine if the care provided matched the preferences on the POLST. When feasible, the Emergency Medical Services (EMS) record was reviewed to determine whether or not treatment was provided.During the study period there were 34 EMS calls with matches

2013 Journal of Emergency Medicine

18. Supporting vulnerable people on Glasgow streets: views of service providers

sleeping and drug misuse, there is increasing recognition that a multi-faceted public health response needs to be employed that can operate across organisational boundaries and policy areas in order to better meet the physical, social, and mental health needs of vulnerable populations who are at risk of adversities such as these. Figures for rough sleeping are not routinely collected and estimates provided by the organisations involved vary. In 2016 a coalition of three prominent charities (Crisis (...) representative highlighted the work of its rough sleepers and vulnerable people (RSVP) outreach scheme that sought out homeless people on the street on a daily basis, offering support and organising rapid accommodation where required. The work of outreach teams was valued across the organisations and demonstrated considerable perseverance in building relationships in order to provide services and support: “Somebody …went to meet this woman ten times, and ten times she wasn’t there and he went back

2019 Glasgow Centre for Population Health

19. Interventions to reduce stigma among health care providers working with substance users

Interventions to reduce stigma among health care providers working with substance users Interventions to reduce stigma among health care providers working with substance users | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Interventions to reduce stigma among health care providers working with substance users Interventions to reduce stigma among health care providers working with substance users , , , , , Questions What are effective interventions for reducing stigma (...) service providers and people who inject drugs by reducing discriminatory attitudes. It included personal narratives taken from real-life experiences of people who inject drugs, and included discussion on attitudes and behaviours towards this population. Providers were given a survey to measure their attitudes towards people who inject drugs. They were also asked to respond to hypothetical scenarios indicating how likely they were to support negative actions of others when working with people who

2018 Ontario HIV Treatment Network

20. Investment for health and well-being: a review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by building on Health 2020

. These require investing in social, economic and environmental determinants along the life-course (18) plus multidisciplinary, cross-sectoral action and public engagement and participation in decision-making (11,13,24,25,49–54). This report aims to inform and support the development and implementation of the proposed roadmap to implement the 2030 Agenda, building on Health 2020, in order to strengthen the capacities of Member States to achieve better, more equitable, sustainable health and well-being for all (...) -being: a review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by building on Health 2020 Mariana Dyakova | Christoph Hamelmann | Mark A. Bellis | Elodie Besnier Charlotte N.B. Grey | Kathryn Ashton | Anna Schwappach | Christine ClarAbstract Governments across the WHO European Region need to take urgent action to address the growing public health, inequality, economic and environmental challenges in order to achieve

2017 WHO Health Evidence Network

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