Please Credit Christine Nelson, RN, PhD, Oregon Health & Science University
Patient ID Code: ______
OR HOSPITAL CHART REVIEW FORM
1. Today’s Date ______
2. Age in Years ______
3. Gender
Female Male
4. Race/Ethnicity:
White African American/Black Native Hawaiian/Pacific Islander Asian American Indian/Alaskan Native Hispanic Other not available
5. Education
No Schooling 8th Grade/less 9 – 11th grades
High School Technical/trade school some college
Bachelor’s degree Graduate degree not available
6. Discharge destination
Bethany St. Joseph’s Bethany Riverside Hillview
St. Joseph’s Onalaska Care Mulders
Lakeview Rolling Hills Morrow Home
7.Admission/Discharge:
- Primary reason for hospitalization______
- Reason for discharge to nursing home
□ rehabilitation□ long term care□ other ______
- Is this a new discharge to a nursing home?□ yes□ no
- Did the resident have a POLST at admission to the hospital? □ yes□ no
If the resident had a POLST at admission, was the POLST changed at discharge? yes no not applicable
8. Primary service admitted to:______
Discharge Service: ______
Date of admission______Date of Discharge ______
HOSPITAL PREFERENCES, ORDERS, & LIFE-SUSTAINING TREATMENTS
9. PREFERENCES: Is there evidence of a discussion about treatment preferences in the chart at discharge: □ yes □ no
If yes, describe:
Date of Discussion / Staff involved? Identify. / Patient/family involved? Identify. / Was surrogate authorized? If so, describe role.a. Where is this documented? ______
b. Who documented the discussion? ______
c. Length of discussion
□ 0-15 min.□ 15-30 min.□ 30-45 min□ no time listed
d. What was discussed? Please describe treatment preferences or plans.
______
- a.What, if any, advance directive forms are present in the chart? (Check all that apply)
Advance directive/living will (circle type used and indicate date of document)
- LaCrosse Respecting Choices POAHC_____/_____/______Date
- Addendum to POAHC_____/_____/______Date
- Statement of Treatment Preference form_____/_____/______Date
- Wisconsin Statutory POAHC_____/_____/______Date
- Wisconsin Declaration to Physiciansor
other Living Will_____/_____/______Date
Designated Decision-maker (named by resident)_____/_____/______Date
Legal Guardian_____/_____/______Date
Other (describe) ______/_____/______Date
No form present
b. Who is making decisions at this point in time?
Patient
Healthcare Agent
Legal Guardian
Designated Decision-maker
Next of kin
Other:______
11. Document all treatment preferences in the table below.(See advance directive)
IF I AM CLOSE TO DEATH:I want feeding tubes/artificial nutrition and hydration.
I want tube feedings only as my physician recommends
I do not want feeding tubes/artificial nutrition and hydration
No preference indicated
I want any other life support that may apply
I want life support only as my physician recommends
I want NO life support
No preference indicated / IF I AM PERMANENTLY UNCONSCIOUS/PERISTENT VEGETATIVE STATE:
I want to receive tube feeding
I want tube feeding only as my physician recommends
I do not want tube feeding
No preference indicated
I want any other life support that may apply
I want life support only as my physician recommends.
I want NO life support
No preference indicated
KIDNEY DIALYSIS
I do want kidney dialysisI do not want kidney dialysis
No preference indicated /
VENTILATOR SUPPORT
I do want ventilator supportI do not want ventilator support
No preference indicated.
RESUSCITATION (preferences, not orders)
I do want cardiac resuscitation
I do not want cardiac resuscitation
I want CPR under certain circumstances as MD recommends
No preference indicated / LOSS OF ABILITY TO RELATE TO SELF, OTHERS AND ENVIRONMENT
I do not want CPR
I do not want antibiotics
I do not want a feeding tube, artificial hydration and nutrition
No preference indicated
ANTIBIOTICS
I do want antibioticsI do not want antibiotics
No preference indicated /
TRANSFUSION
I do want transfusionI do not want transfusion
No preference indicated
PAIN AND SYMPTOM CONTROL IF EFFORTS TO PROLONG LIFE ARE STOPPED
I want to be kept comfortable even if it risks my dying soonerNo preference indicated /
HOSPITALIZATION
I do want ______ I do not want ______
No preference indicated
Agent authority to admit me to a nursing home or community-based residential facility for the purpose of long-term care:
Yes
No / Agent authority to order the withholding or withdrawal of feeding tube and IV hydration:
Yes
No
OTHER PREFERENCES
12. ORDERS RE LIFE-SUSTAINING TREATMENT: Document all medical orders written in the medical chart in the table below.
TREATMENT CATEGORY
/CHECK
BOX
/WRITTEN ORDERS
/DATE OF ORDER
Resuscitation/Medical
Intervention / Full Code
O-DNR
O-DNR/DNI
P-DNR
Other Orders (specify)
13. TREATMENTS: Document life-sustaining treatments below.
TREATMENT PROVIDED / Date(s) of occurrences / Treatments Provided &Other Relevant Information
Resuscitation: / 1)______
2)______
EMS visit with/without transport
(indicate treatments provided by EMS): / 1) ______
2) ______
3) ______
4) ______/ 1) ______
2) ______
3) ______
4) ______
Emergency Department Visit without hospitalization (indicate treatments provided in ED): / 1) ______
2) ______
3) ______
4) ______/ 1) ______
2) ______
3) ______
4) ______
Hospitalization: / 1) ______
2) ______
Surgery: / 1) ______
2) ______
Transfusion: / 1) ______
2) ______
3) ______
4) ______
Intubation: / 1) ______
2) ______
3) ______
4) ______
Dialysis: / 1) ______
2) ______
3) ______
4) ______
Antibiotics: / 1) ______
2) ______
3) ______
4) ______
Feeding Tubes: / 1) ______
2) ______
3) ______
4) ______
IV Fluids: / 1) ______
2) ______
3) ______
4) ______
Chemotherapy: / 1) ______
2) ______
3) ______
4) ______
Ventilator/Respirator: / 1) ______
2) ______
3) ______
4) ______
14. At discharge are there orders for life-sustaining treatment out in the community?
□ yes□ no
If yes, what type of orders?
□ Wisconsin DNR order form/bracelet_____/_____/______Date
□ POLST (Please document orders found on POLST below)
a. Is document signed? □ yes□ no
b. Is document dated?□ yes□ no
If yes, date signed:_____/_____/______Date
c. Is there a resident/surrogate signature on back? □ yes□ no
d. What parts of document have been completed?
□ A □ B□ C□ D□ E
15. POLST ORDERS AT DISCHARGE
TREATMENT CATEGORY
/CHECK
BOX
/WRITTEN ORDERS
/DATE OF ORDER
A. Resuscitation / DNR/DNARFull Code
B. Medical Interventions / Comfort measures only….allow a natural death to occur
Do not hospitalize
Limited/advanced treatments
Full treatment
C. Antibiotics / No antibiotics
No IM/IV antibiotics
Antibiotics
D. Artificial Nutrition and Hydration / No artificial nutrition or hydration
Limited trial for _____ days
Artificial nutrition and hydration
HOSPITAL CHART REVIEW FORM: page 1
Created on10/16/2018