What is the NJ POLST Form Green and How Is It Used for Patients?

Definition & Meaning of the NJ POLST Form Green

The NJ POLST (Practitioner Orders for Life-Sustaining Treatment) green form is a legally binding medical order designed for seriously ill patients in New Jersey. It allows patients to specify their preferences regarding end-of-life care, particularly concerning interventions like cardiopulmonary resuscitation (CPR), artificial hydration, and nutrition. This form is distinct from an advance directive, as it is actionable and recognized by healthcare providers across various settings, ensuring that a patient's wishes are honored during critical medical situations.

How to Use the NJ POLST Form Green

The NJ POLST form is utilized by patients, their surrogates, and healthcare providers to communicate treatment preferences. Here are key points on its usage:

• Completion: The form must be filled out by the patient or their authorized representative, in consultation with a healthcare provider.
• Signature Requirement: Both the patient (or surrogate) and the healthcare provider must sign the form for it to be valid.
• Distribution: Once completed, copies should be distributed to all relevant healthcare providers and kept in the patient's medical record.

How to Obtain the NJ POLST Form Green

The NJ POLST form can be obtained through several avenues:

• Healthcare Providers: Many hospitals, nursing homes, and healthcare facilities have copies available.
• Online Resources: The New Jersey Department of Health provides downloadable versions of the NJ POLST form on its website.
• Local Advocacy Groups: Organizations that focus on end-of-life care may also distribute the form and provide guidance on its use.

How to Fill Out the NJ POLST Form Green

Filling out the NJ POLST form involves several clear steps:

• Patient Information: Start by entering the patient's name, date of birth, and other identifying details.
• Medical Preferences: Indicate the patient's preferences regarding CPR, medical interventions, and artificial nutrition.
• Signature Section: Ensure that both the patient (or surrogate) and the healthcare provider sign the form.

Key Elements of the NJ POLST Form Green

The NJ POLST form contains several critical components:

• Patient Identification: Basic information about the patient to ensure accurate identification.
• Medical Orders: Specific instructions regarding life-sustaining treatments, including preferences for CPR and other interventions.
• Signatures: Required signatures from both the patient (or surrogate) and a licensed healthcare provider to validate the form.

Who Typically Uses the NJ POLST Form Green

The NJ POLST form is primarily used by:

• Seriously Ill Patients: Individuals with life-limiting conditions who wish to express their treatment preferences.
• Frail Elderly Individuals: Older adults who may be at risk of a medical crisis and want to ensure their wishes are documented.
• Healthcare Providers: Doctors, nurses, and emergency medical personnel who need clear directives for patient care.

Legal Use of the NJ POLST Form Green

The NJ POLST form is recognized as a legal medical order in New Jersey. This means:

• Legally Binding: Once signed, it must be followed by healthcare providers in all settings.
• Portability: The form is valid across different healthcare facilities, ensuring continuity of care.
• Protection of Patient Wishes: It helps prevent unwanted medical interventions that do not align with the patient's preferences.

Examples of Using the NJ POLST Form Green

Real-world scenarios illustrate the importance of the NJ POLST form:

• Emergency Situations: A patient with a POLST form indicating "Do Not Resuscitate" (DNR) status is found unresponsive. Emergency responders will honor the DNR order, preventing unwanted CPR.
• Nursing Home Admissions: A frail elderly patient enters a nursing home with a completed POLST form, ensuring staff are aware of their end-of-life care preferences from the outset.
• Hospital Transfers: A patient is transferred from a hospital to hospice care, bringing their POLST form to ensure their treatment preferences are respected in the new setting.