MT Provider Orders for Life-Sustaining Treatment (POLST) 2026

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  1. Click ‘Get Form’ to open the MT Provider Orders for Life-Sustaining Treatment (POLST) in the editor.
  2. Begin by entering the patient's legal last name, first name, middle name, and date of birth in the designated fields.
  3. In Section A, select one box only regarding cardiopulmonary resuscitation (CPR): either 'YES CPR' or 'NO CPR'. Ensure you understand the implications of your choice.
  4. Proceed to Section B and choose one treatment option: 'Full Treatment', 'Selective Treatment', or 'Comfort-focused Treatment'. Each option has specific instructions regarding medical interventions.
  5. In Section C, indicate preferences for artificially administered nutrition by selecting one of the options provided.
  6. Ensure all necessary signatures are obtained from the patient or their legal decision-maker and healthcare provider. This is mandatory for validation.

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A do-not-resuscitate order (DNR), also known as Do Not Attempt Resuscitation (DNAR), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), no code or allow natural death, is a medical order, written or oral depending on the jurisdiction, indicating that a person should not receive cardiopulmonary resuscitation (CPR)
POLST is appropriate for patients at increased risk of a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. POLST provides additional specificity about the types of treatments and interventions these patients may wish to receive or avoid. Provider Orders for Life-sustaining Treatment (POLST) American Association of Nurse Practitioners Policy Briefs American Association of Nurse Practitioners Policy Briefs
Downsides of DNRs Research consistently shows that DNRs are associated with worse health outcomes and death. A DNR is also specific, limited to measures such as CPR, intubation, and ventilation. Many health care decisions can have quality versus quantity of life considerations that are outside the scope of a DNR.
A POLST is more comprehensive than a Do Not Resuscitate order. A DNR is a stand-alone document that tells emergency medical personnel whether to perform CPR if your heart and breathing stop and you are unresponsive. A POLST includes your instructions about whether or not to perform CPR, but it doesnt stop there.
The Physician Orders for Life Sustaining Treatment (POLST) form is a written medical order from a physician, nurse practitioner or physician assistant that helps give people with serious illnesses more control over their own care by specifying the types of medical treatment they want to receive during serious illness. What is a POLST? - Advance Care Planning - UCLA Health UCLA Health programs resources wha UCLA Health programs resources wha

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A DNR order does not mean that no medical assistance will be given. For example, emergency care and other health care providers may continue to administer oxygen therapy, control bleeding, position for comfort, and provide pain medication and emotional support.

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