CAPC Palliative Care Discussion Forum
Leadership and Team Dynamics
Here at Baptist Health South Florida we do not use DNR but we have 4 levels of End-of-Life Care. The 1st three levels are withholding of life prolonging treatments and the 4th level is Comfort Measures which usually includes withdrawing of life prolonging treatments. We have one policy that covers all levels and withholding and withdrawing life-prolonging interventions. We consider AICD a life-prolonging intervention so we have included in this policy a section called: "Deactivation of Cardiac Rhythm Management Device for Comfort Measures". This outlines the process which includes a standing order sheet where the physician must sign after discussing with the patient or the patient's legal decision-maker, whether to deactivate all or partial therapies of the cardiac rhythm management device.I will be happy to share that with you if you wish.
Rose Allen
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Re:AICD
I am very interested in seeing your policy on the four levels of EOL care. Please email a copy to frainone@ourdes.com.
Thank you.
Does anyone else think it might be useful to have a section on CAPC to share this kind of information?
Francine
Would you please share with me your policies regarding the four levels of EOL care including your AICD deactivation policy? We have implemented an End Of Life orderset which is basically for the level 4 care as you indicated. We included the deactivation of the AICD into this set. I am intrigued with the other three levels as they could provide guidance earlier into the care for those physicians who are somewhat reluctant to consult our service. Thanks!
Mary Merdan, NP Palliative Care
mermar@rhahealthcare.org
Too would appreciate a copy of the 4 levels of End-of-Life care & policy as well as the "Deactivation of Cardiac Rhythm Management Device for Comfort Measures". My email address is: marj.trumpy@monroeclinic.org.
I agree with the previous writer about a Forum posting policies, etc.
Thank you in advance, Rose.
Go to:
http://www.capc.org/tools-for-palliative-care-programs/clinical-tools/
Copy and paste the above link into your browser's address bar to download the following documents located under the section entitled, "Templated Order Forms:"
1. Levels of End-of-Life Care (Baptist Hospital of Miami)
2. Documentation of Physician Examination: Withdrawal of Life Sustaining Procedures for Incapacitated Patients (Baptist Hospital of Miami)
3. Clarification of End of Life Care Orders Prior to Anesthesia, Surgical, or Other Procedures (Baptist Hospital of Miami)
4. Deactivation of Cardiac Device (Baptist Hospital of Miami)
5. Levels of End-of-Life Care Policy (Baptist Hospital of Miami)
Thank you,
Forum Administrator