P23 - Retrospective Chart Review on POLST

Life expectancy all over the world is increased, and people live longer with chronic illness. The prevalence of chronic, progressive illnesses that lead to terminal conditions brings healthcare system’s attention to have end-of-life discussions. When people anticipate death, their preferences about the care they wish to receive should be communicated clearly to the healthcare providers. Advance directives are the means of communicating end-of-life discussions, and there is an increased need to involve patients and families in end-of-life discussions. Physician order for life-sustaining treatment (POLST) is an advanced care planning document that is used to communicate patient wishes in the form of a medical order. A retrospective chart review of 247 charts was done in a selected long-term care facility to assess the utilization of POLST and the consistency between treatment given and patient wishes. The findings of the study show that patient wishes are honored 100% of the time. 91 patients had completed POLST forms. Cancer was the most common admitting diagnosis of those patients with POLST. Females had the highest number of forms. In regards to race, compared to black patients, white patients had more completed forms. During the study period, there were a total of 162 hospitalizations, and patients with POLST forms had 26 hospitalizations. Data analysis showed that patients with POLST forms had fewer numbers of hospitalizations, and every year there was an increase in the number of active POLST forms. POLST forms helps nurses to direct nursing care towards meeting the end-of-life care needs of patients. Nurses can use POLST interventions in order to minimize unwanted treatment and transfer to hospitals.