TY - JOUR
T1 - The Role of Advanced Practice Registered Nurses in the Completion of Physician Orders for Life-Sustaining Treatment
AU - Hayes, Sophia A.
AU - Zive, Dana
AU - Ferrell, Betty
AU - Tolle, Susan W.
N1 - Publisher Copyright:
© 2017, Mary Ann Liebert, Inc.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm records advance care planning for patients with advanced illness or frailty as actionable medical records. The National POLST Paradigm Task Force recommends that physicians, advanced practice registered nurses (APRNs), and physician assistants (PAs) be permitted to execute POLST forms. Objective: To investigate the percentage of Oregon POLST forms signed by APRNs, and examine the obstacles faced by states attempting to allow APRNs to sign POLST forms. Design: Cross-sectional. Setting/subjects: 226,101 Oregon POLST Registry forms from 2010 to 2015. Measurements: POLST forms in the Oregon Registry were matched with signer type (MD, DO, APRN, PA). Results: 226,101 POLST forms have been added to the Oregon POLST Registry from 2010 to 2015: 85.3% of forms were signed by a physician, 10.9% of forms were signed by an APRN, and 3.8% of forms were signed by a PA. From 2010 to 2015, the overall percentage of POLST forms signed by an APRN has increased from 9.0% in 2010 to 11.9% in 2015. Physicians are authorized signers in all 19 states with endorsed POLST Paradigm programs; 16 of these states also authorize APRN signature, and 3 states (LA, NY, and GA) allow only physicians to sign. Conclusions: More than 10% of Oregon POLST forms are signed by APRNs. Given the need for timely POLST form completion, ideally by a member of the interdisciplinary team who knows the patient's preferences best, these data support authorizing APRNs to complete POLST forms.
AB - Background: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm records advance care planning for patients with advanced illness or frailty as actionable medical records. The National POLST Paradigm Task Force recommends that physicians, advanced practice registered nurses (APRNs), and physician assistants (PAs) be permitted to execute POLST forms. Objective: To investigate the percentage of Oregon POLST forms signed by APRNs, and examine the obstacles faced by states attempting to allow APRNs to sign POLST forms. Design: Cross-sectional. Setting/subjects: 226,101 Oregon POLST Registry forms from 2010 to 2015. Measurements: POLST forms in the Oregon Registry were matched with signer type (MD, DO, APRN, PA). Results: 226,101 POLST forms have been added to the Oregon POLST Registry from 2010 to 2015: 85.3% of forms were signed by a physician, 10.9% of forms were signed by an APRN, and 3.8% of forms were signed by a PA. From 2010 to 2015, the overall percentage of POLST forms signed by an APRN has increased from 9.0% in 2010 to 11.9% in 2015. Physicians are authorized signers in all 19 states with endorsed POLST Paradigm programs; 16 of these states also authorize APRN signature, and 3 states (LA, NY, and GA) allow only physicians to sign. Conclusions: More than 10% of Oregon POLST forms are signed by APRNs. Given the need for timely POLST form completion, ideally by a member of the interdisciplinary team who knows the patient's preferences best, these data support authorizing APRNs to complete POLST forms.
KW - POLST
KW - advanced care planning
KW - advanced practice registered nurse
KW - end-of-life care
KW - scope of practice
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U2 - 10.1089/jpm.2016.0228
DO - 10.1089/jpm.2016.0228
M3 - Article
C2 - 27767363
AN - SCOPUS:85017190016
SN - 1096-6218
VL - 20
SP - 415
EP - 419
JO - Journal of palliative medicine
JF - Journal of palliative medicine
IS - 4
ER -