The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form.
The consistency between treatments provided to nursing facility residents and orders on the physician orders for life-sustaining treatment form.
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DOI：
10.1111/j.1532-5415.2011.03656.x
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发表时间：
2011-11
影响因子：
6.3
通讯作者：
Hammes BJ
中科院分区：
文献类型：
--
作者：
Hickman SE;Nelson CA;Moss AH;Tolle SW;Perrin NA;Hammes BJ
POLST（医生维持生命治疗订单）计划旨在通过将患者的治疗偏好记录为医疗订单来确保患者的治疗偏好得到尊重。本研究的目的是评价提供的治疗与POLST订单之间的一致性。回顾性图表抽象。分层，随机抽样的90个护理设施在俄勒冈州，威斯康星州，西弗吉尼亚州。870名65岁及以上的护理设施居民，至少停留60天。图表数据POLST形式的订单和相关的治疗超过60天的时间进行了抽象。创建决策规则以确定每种治疗的依据是否与POLST命令一致。在审查期间，大多数居民（85.2%）都有相同的POLST表格。大多数治疗提供给居民的订单舒适措施（74.3%）和有限的抗生素（83.3%）是一致的POLST订单，因为他们主要是舒适为重点，而不是延长生命。然而，向32.1%的居民提供了抗生素，但没有抗生素的订单。复苏（98%）、医疗干预（91.1%）、抗生素（92.9%）和饲管（63.6%）的治疗和POLST订单之间的总体一致率较高。总之，POLST顺序与94.0%的时间提供的治疗一致。除了喂食管和抗生素的使用在居民的订单没有抗生素，使用医疗几乎总是与POLST命令提供或保留维持生命的干预措施一致。研究结果表明，POLST计划是一个有用的工具，以确保护理设施居民的治疗偏好得到尊重。
The POLST (Physician Orders for Life-Sustaining Treatment) program is designed to ensure patients’ treatment preferences are honored by documenting preferences as medical orders. The goal of this study was to evaluate the consistency between treatments provided and POLST orders. Retrospective chart abstraction. Stratified, random sample of 90 nursing facilities in Oregon, Wisconsin, and West Virginia. 870 living and deceased nursing facility residents aged 65 and older with a minimum 60-day stay. Chart data about POLST form orders and related treatments over a 60-day period were abstracted. Decision rules were created to determine whether the rationale for each treatment was consistent with POLST orders. Most residents (85.2%) had the same POLST form in place during the review period. A majority of treatments provided to residents with orders for comfort measures only (74.3%) and limited antibiotics (83.3%) were consistent with POLST orders because they were primarily comfort focused rather than life-prolonging. However, antibiotics were provided to 32.1% of residents with orders for no antibiotics. Overall consistency rates between treatments and POLST orders were high for resuscitation (98%), medical interventions (91.1%), antibiotics (92.9%), and modest for feeding tubes (63.6%). In all, POLST orders were consistent with treatments provided 94.0% of the time. With the exception of feeding tubes and antibiotic use in residents with orders for no antibiotics, the use of medical treatments was nearly always consistent with POLST orders to provide or withhold life-sustaining interventions. Findings suggest the POLST program is a useful tool for ensuring that the treatment preferences of nursing facility residents are honored.
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DOI：
10.1177/1049909110380200
发表时间：
2010-11-01
影响因子：
1.9
作者：
LeGrand, Susan B.;Walsh, Declan
通讯作者：
Walsh, Declan
DOI：
10.1111/j.1532-5415.1998.tb06647.x
发表时间：
1998-09-01
影响因子：
6.3
作者：
Tolle, SW;Tilden, VP;Dunn, PM
通讯作者：
Dunn, PM
DOI：
10.1111/j.1532-5415.2000.tb02594.x
发表时间：
2000-10-01
影响因子：
6.3
作者：
Lee, MA;Brummel-Smith, K;London, MR
通讯作者：
London, MR
影响因子：
2.8
作者：
Hickman, Susan E.;Nelson, Christine A.;Tolle, Susan W.
通讯作者：
Tolle, Susan W.
DOI：
10.1111/j.1532-5415.1999.tb05211.x
发表时间：
1999-10-01
影响因子：
6.3
作者：
Finucane, TE;Harper, GM
通讯作者：
Harper, GM