Experiences with POLST: Opportunities for Improving Advance Care Planning

Braun, Ursula K.

doi:10.1007/s11606-016-3795-y

Cited by 11 publications

(4 citation statements)

References 6 publications

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“…What may be applicable in the acute prehospital, however, and can change acute management is a form similar to the Physician Orders of Life-Sustaining Treatment (POLST) form. Designed to be portable and applicable across the spectrum of care, including prehospital care, POLST forms are medical orders and valid in the 40 states where programs have been established [ 23 ]. They are designed to be easily and rapidly interpreted and honored, regardless of a patient’s physical location [ 24 ].…”

Section: Communication During Prehospital Trauma Carementioning

confidence: 99%

Prioritizing Communication in the Provision of Palliative Care for the Trauma Patient

2020

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Purpose of Review Communication skills in the ICU are an essential part of the care of trauma patients. The goal of this review is to summarize key aspects of our understanding of communication with injured patients in the ICU. Recent Findings The need to communicate effectively and empathetically with patients and identify primary goals of care is an essential part of trauma care in the ICU. The optimal design to support complex communication in the ICU will be dependent on institutional experience and resources. The best/worst/most likely model provides a structural model for communication. Summary We have an imperative to improve the communication for all patients, not just those at the end of their life. A structured approach is important as is involving family at all stages of care. Communication skills can and should be taught to trainees.

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Section: Communication During Prehospital Trauma Carementioning

confidence: 99%

Prioritizing Communication in the Provision of Palliative Care for the Trauma Patient

2020

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“…While the use of POLST program was positively associated with increased hospice referrals, (35,36) and EoL care discussions, (37)(38)(39)(40) an association between a state's POLST program maturity status and NH residents outcomes is unclear. The aim of this study is to examine the impact of POLST maturity status on the NH death among elderly residents.…”

Section: Introductionmentioning

confidence: 99%

Impact of the Physician Orders for Life-Sustaining Treatment (POLST) Program Maturity Status on the Nursing Home Resident’s Place of Death

Tark

Agarwal

Dick

et al. 2020

Am J Hosp Palliat Care

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The Physician Orders for Life-Sustaining Treatment (POLST) program was developed to enhance quality of care delivered at End-of-Life (EoL). Although positive impacts of the POLST program have been identified, the association between a program maturity status and nursing home resident’s likelihood of dying in their current care settings remain unanswered. This study aims to evaluate the impact of the POLST program maturity status on nursing home residents’ place of death. Using multiple national-level datasets, we examined total 595,152 residents and their place of death. The result showed that the long-stay residents living in states where the program was mature status had 12% increased odds of dying in nursing homes compared that of non-conforming status. Individuals residing in states with developing program status showed 11% increase in odds of dying in nursing homes. The findings demonstrate that a well-structured and well-disseminated POLST program, combined with a continued effort to meet high standards of quality EoL care, can bring out positive health outcomes for elderly patients residing in care settings.

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“…However, additional research is needed on cultural differences in values and preferences around advance care planning, as well as dissemination strategies to increase access to POLST paradigm programs [ 23 ]. Further study should also explore potential ethical downsides of POLST forms, including concerns regarding self-determination if patients feel pressured into unwanted orders, or possible over-emphasis on technical treatment options rather than eliciting patient values and priorities [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Navigating end-of-life decision-making in nursing: a systematic review of ethical challenges and palliative care practices

Alanazi,

Shaban,

Ramadan

et al. 2024

BMC Nurs

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Objectives This systematic review aimed to synthesize evidence on the ethical dilemma’s nurses encounter in end-of-life care and effective palliative care practices. The objectives were to understand key ethical issues, evaluate communication and decision-making strategies, and identify approaches to support nurses and patients. Methods A comprehensive search of major databases was conducted according to the PRISMA guidelines. Studies directly relating to nursing ethics, challenges in end-of-life decision-making, and palliative care practices were included. The risk of bias was assessed using ROBVIS-II. Data on ethical issues, palliative interventions, and outcomes was extracted and analyzed thematically. Results 22 studies met the inclusion criteria. Key themes that emerged were: (1) Effective communication and involving patients in decision-making are essential but complex. (2) Nurses face dilemmas around balancing autonomy, beneficence and relational issues. (3) Integrating palliative care principles enhances symptom management and aligns care with patient values. (4) Education and organizational support are needed to equip nurses with skills and coping strategies. Conclusion Navigating end-of-life care requires addressing interconnected ethical, communication and support needs. While studies provided insights, further research is required on cultural competence training, standardized education programs and longitudinal evaluations.

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Experiences with POLST: Opportunities for Improving Advance Care Planning

Cited by 11 publications

References 6 publications

Prioritizing Communication in the Provision of Palliative Care for the Trauma Patient

Prioritizing Communication in the Provision of Palliative Care for the Trauma Patient

Impact of the Physician Orders for Life-Sustaining Treatment (POLST) Program Maturity Status on the Nursing Home Resident’s Place of Death

Navigating end-of-life decision-making in nursing: a systematic review of ethical challenges and palliative care practices

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