Free Ohio Do Not Resuscitate Order Template Get Document Here

Free Ohio Do Not Resuscitate Order Template

A Do Not Resuscitate (DNR) Order in Ohio is a legal document that allows individuals to refuse cardiopulmonary resuscitation (CPR) in the event of a medical emergency. This form ensures that a person's wishes regarding resuscitation are respected, particularly when they are unable to communicate. To learn more about this important document and how to fill it out, click the button below.

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Key takeaways

Here are key takeaways regarding the Ohio Do Not Resuscitate Order form:

  1. The form must be completed and signed by a physician.
  2. It is important for the patient or their legal representative to understand the implications of the order.
  3. The order should be clearly visible and accessible in the patient's medical records.
  4. Patients can revoke the Do Not Resuscitate Order at any time.
  5. Emergency medical services must honor the order when presented properly.
  6. It is advisable to discuss the order with family members and caregivers.
  7. The form must be filled out accurately to avoid any confusion during emergencies.
  8. Ohio law requires that the order be printed on a specific color of paper for recognition.
  9. Regular review of the order is recommended, especially if the patient's health status changes.

Dos and Don'ts

When filling out the Ohio Do Not Resuscitate Order form, it’s important to approach the process with care and consideration. Here are some key dos and don’ts to keep in mind:

  • Do ensure that the form is completed in full, providing all necessary information.
  • Do discuss your wishes with your healthcare provider to ensure they understand your intentions.
  • Don't sign the form without consulting with family members or loved ones, as their support can be crucial.
  • Don't forget to keep a copy of the completed form in a safe place and share it with your healthcare team.

PDF Characteristics

Fact Name Description
Purpose The Ohio Do Not Resuscitate Order (DNR) form allows individuals to refuse resuscitation efforts in the event of cardiac or respiratory arrest.
Governing Law The DNR form is governed by Ohio Revised Code Section 2133.21 through 2133.27.
Eligibility Any adult can complete a DNR order, provided they are competent to make healthcare decisions.
Signature Requirement The form must be signed by the individual or their legal representative, along with a physician's signature.
Validity The DNR order remains valid until revoked by the individual or their representative.
Emergency Medical Services Emergency Medical Services (EMS) personnel must honor the DNR order in accordance with Ohio law.
Form Availability The DNR form is available online and can be printed for use by individuals and healthcare providers.
Notification Individuals should inform family members and healthcare providers of the DNR order to ensure it is respected.
Revocation Process The DNR order can be revoked verbally or in writing at any time by the individual or their representative.

Common mistakes

  1. Not consulting with a healthcare provider: One common mistake is filling out the Do Not Resuscitate Order (DNR) form without first discussing it with a doctor or healthcare professional. This can lead to misunderstandings about the implications of the order.

  2. Inaccurate personal information: People sometimes fail to provide accurate personal details, such as their full name, date of birth, or medical record number. This can create confusion and may result in the form not being honored.

  3. Not signing the form: A DNR order must be signed by the patient or their legal representative. Forgetting to sign the document is a critical oversight that can invalidate the order.

  4. Failing to communicate the order: Once the DNR form is completed, it's essential to share it with family members and healthcare providers. Neglecting to do so can lead to unwanted resuscitation attempts during emergencies.

  5. Not updating the form: Life circumstances can change. Failing to review and update the DNR order when health status or personal wishes change can lead to situations that may not align with the individual's current preferences.

Similar forms

The Ohio Do Not Resuscitate (DNR) Order form is similar to an Advance Directive. An Advance Directive is a legal document that allows individuals to outline their preferences for medical treatment in the event they become unable to communicate their wishes. Like the DNR, it provides guidance to healthcare providers and family members about the individual's desires regarding life-sustaining measures, including resuscitation efforts.

Another document akin to the Ohio DNR is the Living Will. A Living Will specifies the types of medical treatment a person wishes to receive or avoid when facing terminal illness or incapacitation. This document is often used to express preferences about resuscitation and other critical care decisions, similar to the DNR, but it can cover a broader range of medical interventions.

The Medical Power of Attorney (POA) shares similarities with the Ohio DNR as it designates an individual to make healthcare decisions on behalf of another person. While the DNR specifically addresses resuscitation efforts, the Medical POA can encompass a wide array of medical choices, including those related to end-of-life care. This document ensures that the appointed person understands and respects the individual's wishes regarding treatment.

The Physician Orders for Life-Sustaining Treatment (POLST) form is another document that parallels the Ohio DNR. The POLST is designed for individuals with serious health conditions and translates their treatment preferences into actionable medical orders. Like the DNR, it addresses resuscitation and other life-sustaining treatments, providing clear instructions for healthcare providers in emergency situations.

Healthcare proxies, similar to the Medical POA, allow individuals to appoint someone to make healthcare decisions on their behalf. While the Ohio DNR focuses specifically on resuscitation preferences, a healthcare proxy can address a broader range of medical decisions. This document ensures that the appointed individual is aware of the person’s wishes regarding treatment and end-of-life care.

The Do Not Intubate (DNI) order also shares common ground with the Ohio DNR. A DNI order specifically indicates that a patient does not wish to be placed on a ventilator or receive intubation in the event of respiratory failure. While the DNR focuses on resuscitation efforts, the DNI addresses a specific aspect of life-sustaining treatment, providing clarity to healthcare providers about the patient's preferences.

In addition to these essential healthcare directives, it's important to consider estate planning documents like the Durable Power of Attorney. A Durable Power of Attorney form in New York allows you to appoint someone to make decisions on your behalf if you become unable to do so. This legal document remains effective even if you become incapacitated, ensuring your wishes are honored. Understanding its importance can help you secure your financial and medical interests in challenging times, and you can find the necessary paperwork at NY PDF Forms.

Another related document is the Comfort Care Order. This document outlines the preference for comfort-focused care rather than aggressive life-sustaining treatments. It is similar to the Ohio DNR in that both documents prioritize the patient's comfort and quality of life over invasive procedures, particularly in end-of-life scenarios.

The Do Not Hospitalize (DNH) order is also comparable to the Ohio DNR. A DNH order indicates that a patient should not be transferred to a hospital for treatment, particularly in cases where hospitalization may not improve the quality of life. This document complements the DNR by providing additional guidance on the patient's wishes regarding their care in specific situations.

Finally, the End-of-Life Care Plan is another document that aligns with the Ohio DNR. This plan outlines an individual's preferences for care during their final days, including pain management, emotional support, and specific medical interventions. While the DNR addresses resuscitation, the End-of-Life Care Plan provides a comprehensive view of the individual's wishes for their overall care at the end of life.

Discover Some Other Do Not Resuscitate Order Templates for Different States

Your Questions, Answered

What is a Do Not Resuscitate (DNR) Order in Ohio?

A Do Not Resuscitate Order is a legal document that allows a person to refuse resuscitation efforts in the event of a medical emergency. In Ohio, this order is specifically designed for individuals who wish to avoid life-sustaining treatments, such as CPR, in situations where they are unable to communicate their wishes. It is important to have this document in place if you have specific preferences regarding your medical care.

Who can complete a DNR Order in Ohio?

In Ohio, a DNR Order can be completed by any adult who is capable of making their own healthcare decisions. This includes individuals who are at least 18 years old and are competent to understand the implications of their choices. Additionally, a parent or legal guardian can complete a DNR for a minor. It is advisable to consult with a healthcare professional to ensure that the order is filled out correctly.

How is a DNR Order created in Ohio?

To create a DNR Order in Ohio, follow these steps:

  1. Obtain the official Ohio DNR form, which can be found online or through healthcare providers.
  2. Fill out the form with the necessary personal information, including your name and date of birth.
  3. Sign the form in the presence of a witness or a notary public, as required.
  4. Provide copies of the signed DNR Order to your healthcare providers and keep a copy for your records.

Where should I keep my DNR Order?

It is crucial to keep your DNR Order in a place where it can be easily accessed by healthcare providers. Common recommendations include:

  • Storing a copy in your medical records at your healthcare provider's office.
  • Keeping a copy in a visible location at home, such as on the refrigerator or in a designated folder.
  • Carrying a wallet card that indicates you have a DNR Order in place.

Can I change or revoke my DNR Order?

Yes, you have the right to change or revoke your DNR Order at any time. If you decide to make changes, ensure that you complete a new DNR form and distribute it to your healthcare providers. To revoke the order, you can verbally inform your healthcare provider or destroy the existing DNR document. It is important to communicate your wishes clearly to avoid any confusion.

What should I discuss with my healthcare provider regarding a DNR Order?

When considering a DNR Order, it is essential to have an open and honest conversation with your healthcare provider. Discuss the following:

  • Your health condition and prognosis.
  • The potential benefits and burdens of resuscitation efforts.
  • Your personal values and preferences regarding end-of-life care.
  • Any other advance directives you may wish to establish.

Is a DNR Order valid in all healthcare settings in Ohio?

Yes, a properly completed DNR Order is valid across all healthcare settings in Ohio, including hospitals, nursing homes, and emergency medical services. However, it is essential to ensure that the order is readily available and recognized by healthcare providers. Always inform your family members and caregivers about your DNR Order to ensure that your wishes are respected in any medical situation.

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Ohio Do Not Resuscitate Order Template

This Do Not Resuscitate (DNR) Order is created in accordance with Ohio law and expresses the wishes of the patient regarding resuscitation efforts in the event of a medical emergency.

Please fill in the necessary information below:

  • Patient Name: ________________________
  • Patient Date of Birth: ________________________
  • Patient Address: ________________________
  • Patient Medical Record Number: ________________________

This DNR Order is effective immediately and should be honored by all medical personnel and facilities. Please indicate the patient's wishes:

  • Patient's Wishes: (Check one)
    • ☐ I do not wish to receive CPR or other resuscitation measures.
    • ☐ I wish to receive CPR or other resuscitation measures.

The following individuals may be contacted for verification of this order:

  • Health Care Agent Name: ________________________
  • Health Care Agent Phone Number: ________________________
  • Alternate Contact Name: ________________________
  • Alternate Contact Phone Number: ________________________

Patient Signature: ________________________ Date: ________________________

Witness Signature: ________________________ Date: ________________________

Printed Name of Witness: ________________________

This document should accompany the patient to all medical facilities and is a crucial component of the patient’s health care planning.