Use of the physician orders for life-sustaining treatment program in oregon nursing facilities: Beyond resuscitation status
Use of the physician orders for life-sustaining treatment program in oregon nursing facilities: Beyond resuscitation status
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DOI：
10.1111/j.1532-5415.2004.52402.x
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发表时间：
2004-09-01
影响因子：
6.3
通讯作者：
Carley, MM
中科院分区：
文献类型：
--
作者：
Hickman, SE;Tolle, SW;Carley, MM
目的：该计划旨在以医嘱的形式传达住院医师/代理人的治疗偏好。评估全州护理机构使用医生生命维持治疗医嘱（POLST）的情况，并确定记录在居民POLST表格上的医嘱模式。设计：电话调查;现场POLST表格审查。设置：俄勒冈州护理机构。参与者：电话调查中的146家护理机构。在POLST表格审查中，七家护理机构的356名65岁及以上的护理机构居民。测量方法：电话调查;现场POLST表格审查。结果：在电话调查中，71%的设施报告至少有一半的居民使用POLST计划。在POLST表格审查中，88%的POLST表格中存在不复苏（DNR）命令。在表示DNR的表格中，77%的人反映了至少在另一个类别中超过最低治疗水平的偏好。在POLST表格中显示复苏命令，47%的人反映了在至少一个其他类别中低于最高治疗水平的偏好。年龄最大的老年人（大于或等于85，n=167）比年轻的老年人（65-74，n=48）更有可能有订单，以限制复苏，医疗，人工营养和hydration.Conclusion：POLST程序被广泛用于俄勒冈州护理设施。大多数有DNR命令的人要求其他形式的延长生命的治疗，高龄与限制治疗的命令有关。
Objectives: Program was designed to communicate resident/surrogate treatment preferences in the form of medical orders. To assess statewide nursing facility use of the Physician Orders for Life-Sustaining Treatment (POLST) and to identify the patterns of orders documented on residents' POLST forms.Design: Telephone survey; on-site POLST form review.Setting: Oregon nursing facilities.Participants: One hundred forty-six nursing facilities in the telephone survey; 356 nursing facility residents aged 65 and older at seven nursing facilities in the POLST form review.Measurements: A telephone survey; onsite POLST form reviews.Results: In the telephone survey, 71% of facilities reported using the POLST program for at least half of their residents. In the POLST form review, do-not-resuscitate (DNR) orders were present on 88% of POLST forms. On forms indicating DNR, 77% reflected preferences for more than the lowest level of treatment in at least one other category. On POLST forms indicating orders to resuscitate, 47% reflected preferences for less than the highest level of treatment in at least one other category. The oldest old (greater than or equal to85, n=167) were more likely than the young old (65-74, n=48) to have orders to limit resuscitation, medical treatment, and artificial nutrition and hydration.Conclusion: The POLST program is widely used in Oregon nursing facilities. A majority of individuals with DNR orders requested some other form of life-extending treatment, and advanced age was associated with orders to limit treatments.