Final Paper Review: The Three Scenarios – Choose One

Final Paperreview The Three Scenarios Below Choose One Of Them And Ad

Review the three scenarios below. Choose one of them and address the questions asked within your selected scenario in the form of a written analysis. Scenario No. 2: DNR Project Assignment: Review your State Government’s website and search for its official Do Not Resuscitate (DNR) Form. Along with the form will be information and instructions regarding the form. In addition, research three area hospitals to determine if they provide separate DNR forms. Then, perform additional research regarding DNR and prepare your Final Paper by analyzing the issues through these steps: Analyze the requirements of your State Government’s DNR. Identify the requirements of the three hospital’s DNRs. Examine the differences and similarities between the state’s and the three hospital’s DNR requirements, and address the following questions: What are they? Which one should you follow? Explain how a DNR is applied if a patient is under hospice care and EMTs are called.

Paper For Above instruction

Introduction

The implementation and understanding of Do Not Resuscitate (DNR) orders play a vital role in patient-centered care, especially at the end of life. In Alabama, DNR forms are an essential component of advance directives, allowing patients to specify their preferences regarding resuscitative efforts in emergencies. This paper aims to analyze Alabama's official DNR form, compare it with those provided by three local hospitals—Jackson Hospital in Montgomery, the University of Alabama in Birmingham, and Baptist Hospitals in Montgomery—and evaluate their similarities and differences. Additionally, the paper will explore the application of DNR orders in hospice care, particularly when Emergency Medical Technicians (EMTs) are involved.

Alabama's DNR Form and State Requirements

In Alabama, the DNR form is standardized and regulated by the Alabama Department of Public Health. According to the state's guidelines, the DNR form must be signed by the patient (or legal representative) and a healthcare provider, ensuring that the patient’s wishes are explicitly documented and legally recognized (Alabama Department of Public Health, 2019). The form includes critical information such as patient identification, medical directives, and signatures, and it serves as an official document to be presented during emergencies.

The Alabama DNR form specifies that it is valid only when signed and dated by the appropriate healthcare providers and the patient or their legal surrogate. It emphasizes that the DNR order is applicable in all settings, including hospitals, nursing homes, and during pre-hospital emergencies. Importantly, the form is designed to be easily identifiable and portable, often in the form of a bracelet or card, to alert emergency responders to respect the patient's wishes.

Hospital DNR Forms: Jackson Hospital, University of Alabama, Baptist Hospitals

Jackson Hospital in Montgomery, the University of Alabama in Birmingham (UAB), and Baptist Hospitals in Montgomery, along with Corollary facilities like St. Vincent's and Brookwood, all have their own DNR forms, but these are generally consistent with state regulations. Each hospital provides a separate DNR form that patients can complete, often with slight variations in language, layout, and supplementary instructions.

Jackson Hospital’s DNR form aligns with state standards, requiring signatures from the patient and healthcare provider, with clear indication of the patient's wishes. It includes instructions for hospital staff and emergency personnel, emphasizing respecting the patient’s end-of-life decisions (Jackson Hospital, 2020).

The University of Alabama Hospital emphasizes a comprehensive approach by providing a detailed DNR form, which includes sections for specific medical interventions that the patient wishes to avoid and instructions for family members and healthcare providers (UAB Medicine, 2021).

Baptist Hospitals’ form is similarly structured but emphasizes rapid recognition and action. It includes information about the patient’s identifiers, the specific DNR order, and instructions for EMS to honor the document promptly (Baptist Health System, 2022).

Comparison of State and Hospital DNR Requirements

In comparing Alabama’s state-mandated DNR form with those of the hospitals, it is evident that all forms adhere to core requirements established by state law, including signatures from authorized healthcare providers and the patient, clear indication of the patient’s wishes, and instructions for emergency personnel. However, differences arise in presentation, supplementary guidance, and the level of detail concerning specific interventions.

While the state form provides a standardized and legally recognized document applicable broadly, hospitals often customize their DNR forms to include hospital-specific protocols, contact information, and educational resources. This variation ensures clarity across different care settings but maintains legal consistency when the forms are signed according to state law.

When determining which form to follow, healthcare providers and emergency responders primarily rely on the legally valid, signed state DNR form. Hospital-specific forms are important within the hospital setting or in transfer scenarios but should always be backed by the state’s legal framework to ensure enforceability during emergencies.

Application of DNR Orders in Hospice and Emergency Situations

In hospice care, the DNR order is integral to honoring patient wishes regarding end-of-life care. When a patient under hospice care has a documented DNR order, EMTs and emergency personnel are expected to respect this directive, which indicates that resuscitative efforts should not be initiated. The presence of a valid DNR form, whether in paper or bracelet form, signals to responders that the patient has opted against resuscitation efforts such as CPR.

During emergencies, EMTs assess the validity of the DNR by checking for the physical DNR bracelet or card and verifying documentation. If a valid DNR is present, EMTs will withhold resuscitative measures, providing comfort care instead. The legal standing of Alabama’s DNR form ensures that such orders are respected across the state, aligning with the patient’s preferences for end-of-life care (Alabama Department of Public Health, 2019). It prevents unnecessary and potentially painful interventions, respecting the patient’s autonomy.

In hospice settings, the integration of DNR orders aligns with palliative goals, avoiding aggressive treatments that do not improve quality of life. Clear communication and proper documentation are essential for ensuring that EMTs and other emergency providers adhere to the patient’s wishes, which is fundamental for ethical and legal compliance.

Conclusion

Alabama’s DNR protocols and forms provide a structured framework for respecting patient autonomy at the end of life. Comparing state and hospital-specific forms reveals consistency in legal requirements but variation in presentation and supplementary instructions. The DNR order’s application during emergencies, especially in hospice care, ensures that patients’ wishes are honored, minimizing unwanted interventions and aligning care with personal values. Healthcare providers must understand and correctly implement these directives to uphold ethical standards and legal obligations in patient care.

References

• Alabama Department of Public Health. (2019). Alabama DNR form and guidelines. Retrieved from https://www.alabamapublichealth.gov
• Baptist Health System. (2022). DNR policy and form. Baptist Health Montgomery.
• Jackson Hospital. (2020). DNR form and policy. Montgomery, AL.
• UAB Medicine. (2021). Advance directives and DNR procedures. Birmingham, AL.
• American Medical Association. (2013). AMA Code of Medical Ethics. Retrieved from https://www.ama-assn.org
• Dobbs, B. J., & Smith, R. A. (2020). End-of-life decision-making in the United States: A review of policies and practices. Journal of Palliative Medicine, 23(4), 534-540.
• Johnson, T. M., & Lee, K. Y. (2019). Emergency response and legal considerations for DNR orders. Emergency Medicine Journal, 36(12), 728-733.
• Roberts, C., & Hill, J. (2021). Ethical aspects of advance directives at the end of life. The Journal of Medical Ethics, 47(8), 543-548.
• Singh, A., & Patel, R. (2022). Hospital policies on advance care planning. Health Policy and Ethics, 12(3), 112-120.
• Williams, D. et al. (2018). Respecting patient autonomy in end-of-life care: Legal and ethical perspectives. Journal of Healthcare Law & Policy, 30(2), 211-234.