Improving Completion Rates of Physician Orders for Life-Sustaining Treatment Forms in an Assisted Living Facility
Research Poster Health & Life Sciences 2025 Graduate ExhibitionPresentation by Karissa Barachie
Exhibition Number 66
Abstract
Background: Advance care plans and living wills are not readily available during emergencies. Physician orders for life-sustaining treatment (POLST) forms are a standardized form that provides orders in emergencies to provide or withhold care. Local Problem: POLST forms are not being completed upon admission to an assisted living facility (ALF). Methods: A quality improvement project using quantitative and qualitative data analysis which including POLST form completion rates, code status selected, and POLST Knowledge survey for staff and resident and/or surrogate decision makers. Qualitative data included questions at the end of the POLST Knowledge Surveys. Interventions: Licensed practical nurses (LPNs) completed a pre- and post- POLST Knowledge Survey’s after education on the Respecting Choices® Decision Aids. After education, implementation of Respecting Choice® Decision Aids into POLST conversations occurred with residents and/or surrogate decision makers upon admission to the ALF. Results: The LPNs did not have a knowledge deficit on POLST forms prior to project implementation. Residents and/or surrogate decision makers lacked understanding of POLST forms after utilizing the Respecting Choices® Decision Aids. POLST form completion rate remained the same as pre-intervention. Conclusions: LPNs found the use of Respecting Choices® Decision Aids beneficial to POLST conversations. The POLST Knowledge Survey for Residents and/or surrogate decision makers showed a knowledge deficit related to POLST forms. POLST completion rate can improve closer to 100% since those that received the Respecting Choices® Decision Aids had a POLST completion rate of 100%. Project site to continue utilizing Respecting Choices® Decision Aids.
Importance
The significance is that POLST forms are not being completed at assisted living facilities. The project suggests that there is a need for a standardized process for POLST form discussions. The project showed that the Respecting Choices Decision Aids may benefit POLST form discussions and improve completion rates.