Updated POLST released

The Physician Orders for Life-Sustaining Treatment (POLST) form has been revised, based on months of discussion. The POLST is the medical order form that allows any individual with a serious illness or frailty to summarize their wishes regarding life-sustaining treatment.

View the new POLST: Polst Master 2017

Among the updates:

Form header

• Added the letters “(POLST)” following the title
• Revised the sentence: “The POLST form is always voluntary” to say “Completing a POLST form is always voluntary.”
• Deleted the Gender section
• Added the word “(optional)” to the “Last 4 #SSN” section

Section A

• Reworded and reformatted this section to support consistency throughout the form
• Reversed the order of requested interventions such that they are now (top to bottom): Full Treatment, Selective Treatment, and Comfort-focused Treatment. The primary goal of each treatment is now listed.
• The previous “Limited Additional Interventions” section is now titled “Selective Treatment.”
• In the “Comfort-focused Treatment” section, revised the EMS line to insert the word “consider.”

Section B

• Reversed the order of requested interventions such that they are now (top to bottom): Full Treatment, Selective Treatment, and Comfort-focused Treatment. The primary goal of each treatment is now listed.
• The previous “Limited Additional Interventions” section is now titled “Selective Treatment.”
• In the “Comfort-focused Treatment” section, revised the EMS line to insert the word “consider.”

Top of page 2 (Previously titled “Other Contact Information”)

• Title changed to: “Patient and Additional Contact Information (if any)”
• Added Patient Name, DOB, Phone to page 2
• Removed “Name of Health Care Professional Preparing Form”

Section D

• Revised and reworded the “Antibiotics” section to reflect feedback we have received. The options are now:
  • “Use antibiotics for prolongation of life.”
  • “Do not use antibiotics except when needed for symptom management.”
• Revised the bullet that previously stated: “The POLST must be completed by a health care provider based on the patient’s preferences and medical condition” so that it now says: “Treatment choices documented on this form should be the result of shared decision-making by an individual or their surrogate and medical provider based on the person’s preferences and medical condition.”

Directions for Health Care Professionals

• Revised the bullet that previously stated: “The POLST must be completed by a health care provider based on the patient’s preferences and medical condition” so that it now says: “Treatment choices documented on this form should be the result of shared decision-making by an individual or their surrogate and medical provider based on the person’s preferences and medical condition.”

The Washington State Medical Association has a new website, called Honoring Choices Pacific Northwest that includes a multitude of resources for physicians, nurses, social workers, chaplains and other health care professionals in Washington state.

Read the American Nurses Association’s position paper “Nurses’ Roles and Responsibilities in Providing Care and Support at the End of Life.”