SCAN
NCH
February 2013

Ethics Policy Update

The Do Not Resuscitate (DNR) administrative policy PC-030 was recently reviewed and revised with the intent of adding clarification to the process for ordering a DNR order at Northwest Community Hospital (NCH). There are two types of DNR orders, the IDPH DNR and the NCH DNR via CPOE.

Uniform IDPH Do-Not-Resuscitate (DNR) form

  • Created by state of Illinois
  • A "portable" document used by the patient in all healthcare settings
  • A legal document
  • NCH provides this form to our patients as a "service"
  • Must be followed by law

NCH doctor's DNR order via CPOE

  • An order entered by a physician stating a patient is a DNR
  • Only used at NCH
  • Not portable for the patient
  • Cannot be used in other healthcare settings
  • Must be followed at NCH like any other order

Key points of revised policy

  1. Patients at NCH who have been designated as DNR must have a physician order for DNR in the medical record, with the following exception:
    • When a patient provides a valid IDPH DNR form, the patient is a DNR during the time period it takes for the nurse to obtain a physician order.
  2. If a patient becomes a new DNR while hospitalized, a physician order for DNR must be placed and the IDPH DNR Form completed as soon as possible, with the following exception:
    • If the patient's condition is such that it is unlikely he or she will survive to be discharged, the IDPH DNR order form does not need to be completed.
  3. When the patient is discharged, a copy of the IDPH DNR Form is scanned into the medical record and a copy is sent with the patient.

More information about this policy is available on the Ethics Committee resource page on the NCH Intranet, which provides a single destination for physicians to conveniently access NCH policies and procedures related to ethics, as well as legally-binding documents such as DNRs, Living Wills and Advance Directives. Support materials are also available, including a decision-making capacity flow chart, patient rights and responsibilities, and guidelines on how to care for patients of various religions. The Ethics Committee Resource page is only available when logged on to the NCH network.

For more information about these services and resources, please contact Gloria Reidinger at 847.618.7970.