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Frequently Asked Questions

  1. What is the Hawaii POLST form?

    The Hawaii Provider Orders for Life-Sustaining Treatment (POLST) form is a medical document that outlines a person's preferences for medical treatment in emergencies. It is designed for individuals with serious illnesses or those who are nearing the end of life. The form includes specific instructions regarding resuscitation, medical interventions, and nutrition, ensuring that healthcare providers understand the patient's wishes.

  2. Who should complete the POLST form?

    The POLST form must be completed by a healthcare professional, such as a physician or an Advanced Practice Registered Nurse (APRN), based on the patient's medical condition and preferences. It's important that the form reflects the patient's wishes accurately, as it guides care decisions in critical situations.

  3. What happens if a section of the POLST form is not completed?

    If any section of the POLST form is left blank, it is interpreted as a request for full treatment in that area. For example, if the section regarding resuscitation is not filled out, healthcare providers will assume that the patient wants all available life-saving measures taken.

  4. Can the POLST form be modified or revoked?

    Yes, the POLST form can be modified or revoked at any time. If the patient has decision-making capacity, they can request a different treatment plan. If they lack capacity, a legally authorized representative can make these changes. To void the form, simply draw a line through the sections and write "VOID" on the original and all copies, then sign and date it.

  5. How often should the POLST form be reviewed?

    It is recommended to review the POLST form periodically, especially when there is a significant change in the patient's health status, when transferring to a different care setting, or if the patient's treatment preferences change. Regular reviews ensure that the form remains aligned with the patient's current wishes and medical condition.

  6. What should be done with the POLST form during transfers or discharges?

    The POLST form should always accompany the patient whenever they are transferred or discharged from a healthcare facility. This ensures that the new care team is aware of the patient's treatment preferences and can provide care accordingly.

  7. Where can I find more information about the POLST form in Hawaii?

    For additional information about the POLST form, you can visit the Kōkua Mau website at www.kokuamau.org/polst. This site offers resources, downloadable copies of the POLST form, and further guidance on the implementation of POLST in Hawaii.

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Steps to Writing Hawaii Polst

Filling out the Hawaii POLST form is an important step in ensuring that a person’s medical preferences are clearly communicated and respected. This form captures specific medical orders based on an individual's current health condition and their wishes regarding treatment. Below are the steps to properly complete the form.

  1. Begin by entering the patient's Last Name, First/Middle Name, and Date of Birth at the top of the form.
  2. Indicate the Date Form Prepared.
  3. In Section A, choose between Atempt Resuscitation/CPR or Do Not Attempt Resuscitation/DNAR based on the patient’s wishes.
  4. In Section B, select the appropriate medical interventions:
    • Comfort Measures Only
    • Limited Additional Interventions
    • Full Treatment
  5. In Section C, determine the patient’s preferences regarding artificially administered nutrition. Check one of the options provided.
  6. In Section D, confirm whether the patient or a legally authorized representative (LAR) has discussed the orders. If an LAR is involved, select the appropriate option that describes their relationship to the patient.
  7. Obtain the Signature of Provider (Physician/APRN) and ensure to include their name, phone number, and license number.
  8. Have the patient or their legally authorized representative sign the form, confirming that the orders align with their wishes.
  9. Complete the Summary of Medical Condition section to provide a brief overview of the patient’s health status.
  10. Ensure that the form is signed and dated by all required parties.

Once the form is completed, it is essential to keep it accessible and to send it with the patient whenever they are transferred or discharged from a healthcare facility. Regular reviews of the POLST form are recommended to ensure that it remains consistent with the patient’s current health status and treatment preferences.

Misconceptions

Misconceptions about the Hawaii POLST form can lead to confusion regarding its purpose and use. Here are nine common misconceptions, along with clarifications:

  1. The POLST form is the same as a living will. While both documents express a person's wishes regarding medical treatment, a POLST form is a medical order that is actionable by healthcare providers, whereas a living will is a legal document that outlines general preferences.
  2. POLST is only for end-of-life situations. This is not accurate. The POLST form is designed for individuals with serious health conditions, regardless of their current prognosis. It reflects their treatment preferences in any medical situation.
  3. Completing a POLST form means giving up on treatment. This is a misconception. The POLST form allows individuals to specify the types of treatment they want or do not want, ensuring their wishes are respected.
  4. Healthcare providers can ignore a POLST form. Healthcare professionals are required to follow the orders outlined in a POLST form, as long as it is valid and signed by a licensed provider.
  5. A POLST form can be completed by anyone. Only licensed healthcare professionals can complete and sign a POLST form. It must reflect the patient’s preferences based on their medical condition.
  6. Once signed, a POLST form cannot be changed. This is incorrect. Individuals with capacity or their legally authorized representatives can modify or revoke a POLST at any time, ensuring it remains aligned with their wishes.
  7. POLST forms are not legally valid if photocopied. In fact, photocopies and faxes of signed POLST forms are considered legal and valid, making it easier for patients to carry their preferences across different care settings.
  8. Only doctors can discuss POLST with patients. While physicians play a key role, any qualified healthcare professional can discuss the POLST form with patients and their families to ensure understanding and compliance.
  9. POLST forms are only for patients who are incapacitated. This is misleading. Any individual, regardless of their capacity, can complete a POLST form to express their treatment preferences, ensuring their wishes are known and respected.

Understanding these misconceptions is crucial for making informed decisions regarding medical care and ensuring that individual preferences are honored. It is always advisable to consult with healthcare professionals for guidance on completing and using the POLST form effectively.