Free Washington Do Not Resuscitate Order Template Get Document Here

Free Washington Do Not Resuscitate Order Template

A Washington Do Not Resuscitate (DNR) Order form is a legal document that allows individuals to refuse resuscitation efforts in the event of a medical emergency. This form is crucial for ensuring that a person's wishes regarding end-of-life care are respected. If you are considering completing this form, take the next step by clicking the button below.

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Key takeaways

When considering the Washington Do Not Resuscitate (DNR) Order form, it is essential to understand its significance and the steps involved in filling it out. Here are some key takeaways:

  1. Understanding DNR: A Do Not Resuscitate order is a medical order that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
  2. Eligibility: Any adult who is capable of making informed decisions about their medical care can complete a DNR order.
  3. Consultation Required: It is advisable to discuss your wishes with a healthcare provider before completing the form. They can provide guidance on the implications of a DNR order.
  4. Filling Out the Form: The form must be filled out accurately and signed by the individual or their legal representative. Ensure that all required fields are completed.
  5. Witness Requirement: In Washington, the DNR form must be signed in the presence of a witness who is not related to the individual or a healthcare provider involved in their care.
  6. Placement of the Form: Once completed, the DNR order should be prominently displayed in the individual's home, ideally on the refrigerator or in a location easily accessible to emergency responders.
  7. Revocation: A DNR order can be revoked at any time by the individual. It is important to communicate any changes to healthcare providers and ensure that the new wishes are documented.
  8. Legal Protections: Healthcare providers are legally protected when they follow a valid DNR order. This means they cannot be held liable for not performing CPR when a DNR is in place.
  9. Review Regularly: It is wise to review the DNR order periodically, especially after significant changes in health status or personal circumstances.

These takeaways can help individuals navigate the process of filling out and utilizing the Washington Do Not Resuscitate Order form effectively, ensuring their wishes regarding end-of-life care are respected.

Dos and Don'ts

When filling out the Washington Do Not Resuscitate (DNR) Order form, it's important to approach the process with care and clarity. Here are some key dos and don'ts to consider:

  • Do ensure you understand what a DNR order means. It indicates that you do not wish to receive cardiopulmonary resuscitation (CPR) if your heart stops or you stop breathing.
  • Do discuss your wishes with your healthcare provider. They can provide valuable insights and answer any questions you may have.
  • Do have a conversation with your family or loved ones. Sharing your decision can help them understand your wishes and support your choices.
  • Do fill out the form completely and accurately. Missing information can lead to confusion during a medical emergency.
  • Don't rush the process. Take your time to think through your decisions and ensure you are comfortable with your choices.
  • Don't assume that a verbal agreement is sufficient. A signed DNR order is necessary for it to be legally recognized.
  • Don't forget to keep copies of the signed form in accessible places. Share copies with your healthcare provider and family members.

By following these guidelines, you can ensure that your DNR order reflects your wishes and is honored when needed.

PDF Characteristics

Fact Name Description
Definition A Do Not Resuscitate (DNR) Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) if a patient's heart stops or they stop breathing.
Governing Law In Washington, DNR Orders are governed by the Revised Code of Washington (RCW) 70.122.
Eligibility Any adult who is capable of making their own healthcare decisions can complete a DNR Order.
Form Requirements The DNR Order must be signed by the patient and their healthcare provider to be considered valid.
Emergency Medical Services (EMS) EMS personnel are required to honor valid DNR Orders when they are presented at the scene.
Location of Form The DNR Order should be kept in an easily accessible location, such as on the refrigerator or with the patient's medical records.
Revocation A patient can revoke a DNR Order at any time, and it must be documented in their medical record.
Communication It's important for patients to discuss their DNR wishes with family members and healthcare providers to ensure everyone is informed.
Advance Directives A DNR Order is often part of a broader advance directive, which outlines a person's healthcare preferences in various situations.

Common mistakes

  1. Failing to include all required patient information. Ensure that the patient's full name, date of birth, and medical record number are clearly stated.

  2. Not obtaining the necessary signatures. Both the patient (or their legal representative) and the physician must sign the form for it to be valid.

  3. Using outdated forms. Always use the most current version of the Washington Do Not Resuscitate Order form to ensure compliance with state regulations.

  4. Overlooking the need for witness signatures. Depending on the situation, a witness may be required to validate the document.

  5. Leaving sections blank. All sections of the form should be completed to avoid confusion or misinterpretation of the patient's wishes.

  6. Not discussing the order with healthcare providers. It's essential to communicate the patient's wishes to all relevant medical personnel to ensure adherence to the order.

  7. Failing to review the order periodically. Regularly check and update the Do Not Resuscitate Order as the patient’s condition or preferences may change.

Similar forms

A Living Will is a document that outlines a person's wishes regarding medical treatment in situations where they are unable to communicate. Like the Washington Do Not Resuscitate Order (DNR), it provides guidance to healthcare providers about the individual's preferences for end-of-life care. Both documents serve to ensure that a person's choices are respected, especially when they cannot express them due to illness or injury. While a DNR specifically addresses resuscitation efforts, a Living Will covers a broader range of medical interventions.

A Healthcare Power of Attorney allows an individual to designate someone else to make medical decisions on their behalf. This document is similar to a DNR in that it ensures a person's wishes regarding medical treatment are followed. If a person becomes incapacitated, the appointed agent can make choices that align with the individual’s values and preferences. While a DNR is focused on resuscitation, a Healthcare Power of Attorney can address various treatment options and decisions.

In navigating complex medical decisions, individuals may also encounter the Access-A-Ride NYC Application form, which is crucial for those who need transportation services under the Commuter Benefits Program Access-A-Ride/Paratransit plan. This form not only requires proof of eligibility but also plays a vital role similar to other documents mentioned, as it helps ensure that individuals receive necessary support during challenging times. For guidance on filling out this application, you can find useful resources at https://nytemplates.com/.

An Advance Directive combines a Living Will and a Healthcare Power of Attorney into one document. It provides comprehensive instructions about medical care preferences and appoints an agent to make decisions if needed. Similar to the DNR, it ensures that a person's wishes are honored, particularly in critical situations. This document can help avoid confusion among family members and healthcare providers about what actions to take.

A Physician Orders for Life-Sustaining Treatment (POLST) form is another document that outlines a person's preferences for medical treatment. It is similar to a DNR because it provides specific instructions about resuscitation and other life-sustaining measures. Unlike a DNR, which is often used by those with serious health conditions, a POLST is designed for individuals with a serious illness or frailty, ensuring that their treatment preferences are clearly communicated and legally binding.

An Organ Donation Card indicates a person’s wishes regarding organ donation after death. While it serves a different purpose than a DNR, both documents express important personal choices about end-of-life care. A DNR focuses on resuscitation efforts, while an organ donation card addresses the potential for life-saving contributions to others after death. Both reflect a commitment to personal autonomy and respect for individual wishes.

A Do Not Hospitalize (DNH) order is a document that expresses a patient's desire to avoid hospitalization in certain situations. This document is similar to a DNR in that it outlines preferences for medical care during critical times. Both documents aim to respect the individual's wishes regarding the level of medical intervention they want, particularly in emergencies. A DNH focuses on avoiding hospital care, while a DNR centers on resuscitation efforts.

A Comfort Care Order emphasizes providing comfort and relief from pain rather than aggressive treatment. This document is similar to a DNR in that it prioritizes the patient's quality of life over invasive medical interventions. Both documents aim to ensure that individuals receive care that aligns with their values and preferences, especially in end-of-life situations. A Comfort Care Order specifically focuses on palliative measures, while a DNR addresses resuscitation efforts.

An End-of-Life Care Plan is a comprehensive document that outlines a person’s wishes for their care as they approach the end of life. It is similar to a DNR in that it aims to ensure that healthcare providers understand and respect the individual’s preferences. Both documents seek to minimize unnecessary medical interventions and focus on providing care that aligns with the individual’s values. An End-of-Life Care Plan can encompass a wide range of topics, including pain management and emotional support, while a DNR specifically addresses resuscitation decisions.

Discover Some Other Do Not Resuscitate Order Templates for Different States

Your Questions, Answered

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

A Do Not Resuscitate Order (DNR) is a legal document that allows a person to refuse resuscitation efforts in the event of cardiac arrest or respiratory failure. In Washington, this order is specifically designed for individuals who do not wish to receive CPR or other life-saving measures when their heart stops or they stop breathing.

Who can request a DNR Order?

In Washington, any adult who is capable of making their own healthcare decisions can request a DNR Order. This includes individuals who are facing a terminal illness or have a serious medical condition. If a person is unable to make decisions for themselves, a legally authorized representative can request the order on their behalf.

How do I obtain a DNR Order form in Washington?

You can obtain a DNR Order form from various sources, including:

  • Your healthcare provider or doctor’s office
  • Hospitals and clinics
  • The Washington State Department of Health website

It’s important to ensure that the form is filled out correctly and signed by both the patient and their physician.

What information is required on the DNR Order form?

The DNR Order form typically requires the following information:

  1. The patient’s name and date of birth
  2. The name of the physician who is signing the order
  3. The date the order is signed
  4. Clear instructions indicating that the patient does not wish to receive resuscitation

Make sure all sections are completed to avoid confusion during a medical emergency.

Is a DNR Order legally binding in Washington?

Yes, a properly completed and signed DNR Order is legally binding in Washington. Medical personnel are required to honor the wishes expressed in the order. It’s crucial to keep a copy of the DNR Order accessible, such as on the refrigerator or with other important documents, to ensure it can be easily found in an emergency.

Can I change or revoke my DNR Order?

Absolutely. You can change or revoke your DNR Order at any time. To do so, you should inform your healthcare provider and ensure that any new orders are properly documented. It’s wise to communicate your wishes to family members and caregivers as well.

Will having a DNR Order affect my overall medical care?

No, having a DNR Order does not affect your overall medical care. You will still receive appropriate medical treatment for your condition, excluding resuscitation efforts. Healthcare providers will continue to provide comfort measures and palliative care as needed.

What should I discuss with my doctor before completing a DNR Order?

Before completing a DNR Order, it’s important to have an open discussion with your doctor about:

  • Your medical condition and prognosis
  • The implications of a DNR Order
  • Alternative treatment options available
  • Your goals for care and quality of life

This conversation can help ensure that your wishes are respected and understood.

Can family members override a DNR Order?

In general, a DNR Order is a legally binding document that reflects the wishes of the patient. Family members cannot override it. However, if there are concerns about the order or if the patient’s condition changes, it’s best to discuss these issues with the healthcare team to clarify any misunderstandings.

Where should I keep my DNR Order?

Keep your DNR Order in a place that is easily accessible, such as:

  • On your refrigerator
  • In your medical file
  • With your healthcare proxy or family members

Make sure that anyone involved in your care knows where to find it, so your wishes can be honored in an emergency.

Form Preview

Washington Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is in accordance with Washington State law (RCW 70.122) regarding medical treatment preferences.

Patient Information:

  • Patient Name: _______________________
  • Date of Birth: _______________________
  • Address: ____________________________
  • City, State, Zip: ____________________

Healthcare Provider Information:

  • Provider Name: _______________________
  • Facility Name: _______________________
  • Phone Number: _______________________

This DNR Order indicates that the patient does not wish to receive resuscitative efforts in case of cardiac arrest or respiratory failure.

Patient’s Specify Understanding (check one):

  • ___ I understand the implications of this order.
  • ___ I do not understand the implications of this order.

Signatures:

By signing below, the patient, or their representative, acknowledges understanding of this DNR order:

  • Patient/Representative Signature: _______________________
  • Date: _______________________

Witness Signature:

  • Witness Name: _______________________
  • Witness Signature: _______________________
  • Date: _______________________

This order remains in effect until revoked and should be kept accessible by the patient and healthcare providers.