Advanced Directives
POLICY:
The Surgery Center will always attempt to resuscitate a patient and transfer that patient to a hospital in the event their condition deteriorates. The center will make every reasonable attempt to obtain and file in the patient’s medical record copies of existing documents including: Living Will and Healthcare instructions regarding Do Not Resuscitate orders, Durable Power of Attorney, Documents regarding Anatomical Gift and Designation of Conservator of the Person for Future Incapacity. Do Not Resuscitate orders will be suspended while the patient is at The Surgery Center of Rhode Island, LLC and the patient will be required to sign a waiver of these orders.
PROCEDURE:
The Surgery Center of RI acknowledges the four types of Advanced Directives and the policy of each is as follows:
- Living Will and Health Care Instructions including Do Not Resuscitate orders– the center will always attempt to resuscitate a patient and transfer that patient to a hospital in the event their condition deteriorates. The patient will be required to sign a waiver for Do Not Resuscitate orders.
- Durable Power of Attorney or Healthcare Representative– the center will honor this document providing the document has been provided to the center
- Documentation of Anatomical Gift or organ donor– the center will attempt to resuscitate a patient and transfer that patient to a hospital in the event their condition deteriorates. The hospital will be given a copy of this document as long as it has been provided to the center.
- Designation of a Conservator of the Person for My Future Incapacity– the center will honor this document as long as a copy of the document has been provided to the center.
The preoperative nurse and preoperative assessment will ask if the patient has an Advanced Directive and document the type of Advanced Directive accordingly. The patient will be instructed to bring a copy of these documents if they exist.
Patients will be informed of the Advanced Directives/ Do Not Resuscitate policy preoperatively by the brochure and the Preoperative information on the Medical Passport preoperative assessment site.
The policy of the facility is to suspend Do Not Resuscitate while the patient is at the facility.
Patients will sign a waiver releasing the facility from the Do Not Resuscitate order and if available a copy of the Order will accompany the patient to any transfer facility and will be reinstated following the patient’s discharge/transfer from the facility.
The anesthesiologist in charge of the patient’s care will explain the Do Not Resuscitate policy to the patient and offer them the opportunity to reschedule if they so desire.
A signed waiver will be completed by the patient, witnessed and signed by the anesthesiologist in charge of the patient’s care prior to surgery.
If an emergency transfer did occur, all chart information would be copied and sent with the patient to the hospital, including the patient’s information regarding Advanced Directives including Do Not Resuscitate orders, if given to the center by the patient on admission.