Policy Manual sample

MDT Home Health Care Agency, Inc. DO NOT RESUSCITATE (DNR) DO NOT INTUBATE (DNI) POLICY: All clients without observable signs of life will be resuscitated unless a valid “Do Not Resuscitate” (DNR) order is in the client record/patient home folder copy. PROCEDURE: 1. When a client * s clinical condition and/or diagnosis warrant the consideration of a “Do Not Resuscitate” order and the client/significant other have requested same, skilled field personnel will: (a) contact the client * s physician with a report of the clinical findings, and request an order; (b) inform the supervisor. 2.When a verbal order has been obtained from the physician, it will be reduced to writing and sent, within twenty-four (24) hours to the physician for signature. Signed order shall be returned to Agency as soon as possible, but not longer than seven (7) working days of order. Telephone order is witnessed by a second person who is on line at time order is received. 3.The signed order is placed in the clinical record and another copy is placed in a noticeable, easily accessible place such as the head or foot of a bed, or on the refrigerator. It should be readily available in the event of an emergency to ensure that the patient’s last wishes will be honored. 4.“DNR” does not preclude client from receiving emergency care to treat suffering or other medical conditions. Client/Care giver should call 911 to summon emergency. If paramedics are summoned, they must promptly on arrival be shown DNR order and Client Advance Directives. 5. A copy of this policy is available to physicians, clients, families and the public. 6. Do Not Intubate: in the event of acute or impending respiratory failure, endotracheal intubation to provide sustained assisted ventilation shal not be performed. Do Not Intubate does not prohibit emergency management to prevent or reverse acute airway obstruction with oral, nasal, or esophageal obturator airways or treatment of transient respiratory insufficiency with oxygen or short trials of assisted ventilation with positive pressure ventilation equipment or Ambu bags. L-15 Home Health Agency Client Assessments