Printable Do Not Resuscitate Order Document for the State of Texas

Texas Do Not Resuscitate Order - Usage Guidelines

A Texas Do Not Resuscitate (DNR) Order is a crucial document for individuals who wish to express their preference not to receive certain life-sustaining treatments in the event of a cardiac or respiratory arrest. This document ensures that the patient's wishes are respected by healthcare providers. Understanding how to accurately complete this form is important for the patient, or the patient's legally authorized representative, to ensure that the instructions are clear and legally recognized. The following steps outline how to fill out the DNR Order form in Texas.

1. Obtain the correct form. Make sure you are using the most recent version of the Texas DNR Order form. This can usually be obtained from a healthcare provider or from the Texas Department of State Health Services website.
2. Gather required information. Before filling out the form, gather all necessary information including the patient's full legal name, date of birth, and specific medical orders regarding the DNR request.
3. Read the form carefully. Make sure to read through the entire form to understand all the sections and what is required in each.
4. Enter patient details. Fill in the patient's information section with the appropriate details such as the patient's name, date of birth, and address.
5. Review medical interventions. There may be sections outlining specific medical interventions that can be declined. Discuss these with the patient (if possible) and healthcare providers to make informed decisions.
6. Signatures. The form must be signed by the patient or the patient’s legally authorized representative. If the patient is unable to sign, a witness or the patient's legal guardian, power of attorney, or surrogate may be required to sign on the patient's behalf.
7. Physician’s signature. A crucial step in the process is obtaining the signature of a licensed physician. This certifies that the physician has discussed the DNR order with the patient or the patient’s representative and agrees with the patient's decision.
8. Witness section. Some versions of the form require a witness signature. If so, have an adult witness sign the form, attesting that the patient (or representative) and physician signatures were willingly provided.
9. Keep the DNR accessible. Once the form is filled out and signed, make multiple copies. Keep the original in a place where it can be easily found in an emergency. Inform family members and caregivers of its location. It is also advisable to inform your primary care physician and provide them with a copy.

Accurately completing and properly storing the Texas DNR Order ensures that the patient's wishes are clearly communicated and can be followed by healthcare professionals in critical situations. It is a key component of healthcare planning, empowering individuals to make decisions that align with their values and preferences regarding end-of-life care.

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

A Do Not Resuscitate Order (DNR) in Texas is a medical order that tells healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. It is used by individuals who do not want to receive CPR in these situations due to the quality of life concerns or terminal illness.

Who can request a DNR order in Texas?

In Texas, a DNR order can be requested by the patient if they are competent and able to make their own healthcare decisions. If the patient is not capable of making such decisions, a legal guardian, healthcare proxy, or someone holding medical power of attorney for the patient can request the DNR on their behalf.

How can one obtain a DNR order in Texas?

To obtain a DNR order in Texas, a discussion with a healthcare provider is necessary. The healthcare provider must agree that a DNR is appropriate based on the patient's health status and care preferences. The request must then be documented in the patient's medical records and a formal DNR order must be filled out, signed, and dated by the physician.

Is the Texas DNR order applicable outside of hospital settings?

Yes, in Texas, the DNR order is applicable both in hospital settings and in non-hospital settings, such as the patient's home, hospice, or any long-term care facility. It is important for patients and their families to inform caregivers and first responders of the DNR order's existence and location.

Can a DNR order be revoked?

Yes, a DNR order can be revoked at any time by the patient or their designated legal representative. This can be done by expressing the desire to revoke the order verbally or in writing to the healthcare provider. Additionally, physically destroying the DNR document itself is a way to revoke the order.

What should one do with the DNR order once it is signed?

Once a DNR order is signed, it should be kept in a place where it is easily accessible to healthcare providers and first responders, such as in the patient's medical records, at the bedside if at home, or with other important medical documents. Copies should also be provided to any healthcare proxies or legal representatives, and the patient's primary physician should have a copy included in the medical records.

How does a DNR order affect other medical treatments?

A DNR order specifically addresses the use of CPR in the case of cardiac or respiratory arrest and does not impact the provision of other medical treatments or care. Patients with a DNR order can still receive medications, surgeries, or other procedures that they and their healthcare providers deem necessary for their health and comfort.

Is there a difference between a DNR and an advance directive in Texas?

Yes, there is a significant difference between a DNR and an advance directive in Texas. An advance directive is a broader document that can outline the patient's wishes regarding a variety of medical treatments and life-sustaining measures, including but not limited to CPR. A DNR, on the other hand, specifically addresses the issue of cardiopulmonary resuscitation.

Are healthcare providers required to follow a DNR order?

In Texas, healthcare providers are legally obligated to follow a valid DNR order. Failure to comply with the patient's wishes as outlined in a DNR could result in legal consequences for the healthcare provider or facility. This is why clear communication and proper documentation of the DNR order are crucial.

1. Not using the patient's full legal name. It's essential that the name on the DNR order matches exactly with the name on the patient's identification and medical records to prevent any confusion during critical moments.

2. Failure to date the form. The date gives the health care providers and emergency personnel a reference point to know the form is current and valid. Without a date, the directive's applicability can be questioned.

3. Incorrectly signed documents. Whether it's the patient, the legal guardian, or an authorized representative, the signature must comply with Texas law. A common mistake is not having the required witnesses or notarization, depending on the circumstances under which the DNR order is signed.

4. Not specifying clear patient wishes. Although the form itself is designed to communicate a clear decision, filling it out inaccurately or incompletely can lead to misinterpretation of the patient's wishes. Details are crucial.

5. Forgetting to distribute copies of the DNR order. After completing the form, copies should be given to the patient, the patient’s family, the primary care physician, and any healthcare facilities the patient frequents. Failure to distribute the form properly can result in medical professionals not being aware of the patient's wishes.

Understanding and avoiding these mistakes can ensure that a patient's wishes are respected and that medical professionals have clear, legally compliant instructions to follow.

In the journey through life's final chapters, preparation involves more than just conversations; it requires specific documentation to ensure one's wishes are respected. Among these critical documents, the Texas Do Not Resuscitate (DNR) Order form is significant but often is one part of a broader ensemble of legal documents designed to communicate an individual's preferences regarding end-of-life care and other important decisions. The compilation of these documents ensures that an individual's healthcare and personal affairs are managed according to their wishes, especially during times when they may not be able to communicate these preferences themselves. Below is a concise description of several forms and documents that are frequently used in conjunction with the Texas DNR form, each playing a vital role in the comprehensive planning for end-of-life care and beyond.

• Medical Power of Attorney: This legal document allows an individual to designate another person, known as an agent, to make healthcare decisions on their behalf if they are incapacitated or otherwise unable to make decisions for themselves. It's instrumental in ensuring that someone trusted can oversee the implementation of healthcare preferences, including decisions related to the DNR order.
• Directive to Physicians and Family or Surrogates (Living Will): This document complements the DNR by providing detailed instructions regarding the types of life-sustaining treatment an individual wishes or does not wish to receive in the event they are diagnosed with a terminal or irreversible condition. It's a key document for pre-determining one’s end-of-life care.
• Declaration for Mental Health Treatment: This form allows individuals to make decisions about their mental health treatment in advance, in case they become unable to make these decisions for themselves. It specifies which treatments they would accept or refuse and can include preferences regarding hospitalization, medications, and electroconvulsive therapy.
• HIPAA Release Form: Essential for the seamless sharing of medical information, this document authorizes healthcare providers to disclose an individual's health information to designated persons or entities. It ensures that those making decisions or managing the individual’s healthcare have access to necessary medical records.
• Out-of-Hospital Do Not Resuscitate (OOH-DNR) Order: Specific to Texas, this legal document complements the in-hospital DNR by directing emergency medical personnel not to perform CPR or other life-sustaining treatments if the individual's heart stops or if they stop breathing when outside of a hospital setting. It’s crucial for ensuring one's DNR preferences are honored in all settings.
• Last Will and Testament: Although primarily focused on after-death affairs, this document is crucial for outlining how an individual’s property and personal affairs should be handled posthumously. Having a Last Will and Testament in place ensures that an individual’s assets are distributed according to their wishes, alleviating potential familial disputes during a vulnerable time.

Together, these documents form a comprehensive legal framework protecting an individual's healthcare and personal preferences. When complemented by the Texas DNR Order, they ensure that an individual's end-of-life wishes are fully understood and respected by family, healthcare providers, and legal representatives, thus providing peace of mind for all involved. It's advisable for anyone considering a DNR to consult with healthcare and legal professionals to ensure that all documents are correctly executed and reflect their most current wishes.

• Living Will: Much like the Do Not Resuscitate (DNR) order, a living will is a document that outlines a person’s preferences regarding end-of-life medical care. It activates only when the individual cannot communicate their health care decisions due to incapacity. While a DNR specifically addresses the use of CPR, a living will can cover a broader range of medical treatments and interventions.

• Medical Power of Attorney (POA): A medical POA is a legal instrument that grants another individual the authority to make health care decisions on someone’s behalf should they become unable to do so. Although its scope is broader, the intent to respect the patient’s health care wishes aligns with the principle behind a DNR order.

• Advance Health Care Directive: An advance health care directive merges the concepts of a living will and medical POA. It provides instructions for medical treatment and appoints a health care proxy. The directive can include DNR preferences, illustrating its comprehensive approach to end-of-life planning.

• Physician Orders for Life-Sustaining Treatment (POLST): Similar to a DNR, a POLST form is a medical order that outlines a patient's preferences for end-of-life treatment, including resuscitation efforts. The POLST is more detailed, applying to various interventions beyond CPR and is intended for seriously ill or frail patients.

• Hippocratic Oath: While not a legal document, the Hippocratic Oath is a moral commitment made by medical professionals to do no harm. A DNR order represents a specific clinical application of this principle, acknowledging when the avoidance of aggressive treatment is in the patient's best interest.

• Health Insurance Portability and Accountability Act (HIPAA) Authorization: A HIPAA authorization form allows for the sharing of an individual’s health information with specified people. While its purpose is different, it shares the characteristic of being a legal tool that respects the patient's wishes regarding their personal health information, much like a DNR respects their choices about medical treatment.

• Emergency Medical Services (EMS) Protocols: These protocols guide first responders in various medical situations, including when to administer or withhold CPR. EMS protocols consider the existence of DNR orders, making them functionally similar in the context of emergency medical care.

• Last Will and Testament: A last will and testament is a legal document that expresses an individual’s wishes regarding the distribution of their property after death. Though it deals with assets rather than medical care, both this document and a DNR order share the fundamental purpose of honoring an individual's preferences after they can no longer communicate.

Filling out the Texas Do Not Resuscitate (DNR) Order form requires attention to detail and a clear understanding of the patient's wishes. To ensure the form is completed correctly and legally, here are some dos and don'ts:

• Do ensure that the patient or their legally authorized representative is the one making the decision to agree to a DNR order.
• Do have a detailed conversation with a healthcare provider to fully understand what a DNR order means and how it affects emergency medical care.
• Do verify that the patient's full legal name and other identifying information are filled out accurately on the form.
• Do ensure that the form is signed and dated by the authorized person, which could be the patient, a legally authorized representative, or a surrogate decision-maker as permitted under Texas law.
• Do seek notarization if required, as some states or healthcare facilities may require a notarized DNR order to consider it valid.
• Don't fill out the form without the patient's consent if they are mentally capable and of legal age to make their own medical decisions.
• Don't leave any required fields blank, as incomplete forms may not be legally binding or recognized by healthcare providers.
• Don't use unclear language or abbreviations that could be misinterpreted when specifying additional orders related to the patient's end-of-life care.
• Don't forget to distribute copies of the completed and signed DNR order to relevant parties, including the patient’s primary care provider, family members, and healthcare agents.
• Don't ignore reviewing and updating the DNR order as needed, especially if the patient’s health status or wishes change.

Appropriately completing the Texas DNR Order form is crucial for it to be respected by healthcare professionals and to ensure that the patient's wishes are honored. It's important always to consult with qualified healthcare providers when having discussions about DNR orders or any advance directives.

When it comes to understanding the Do Not Resuscitate (DNR) Order form in Texas, misconceptions abound, often leading to confusion and distress among patients and their families. It's crucial to dispel these myths to make informed healthcare decisions. Here are six common misconceptions about the Texas Do Not Resuscitate Order form:

• All patients can decide for themselves if they want a DNR order. It's often misunderstood that any patient can request a DNR order regardless of their medical condition. In reality, the ability to consent is determined by the patient's capacity to understand the implications of the order. If a patient is unable to make informed decisions, their legal representative or a close family member may be consulted.

• A DNR order is applied across all medical situations. Many believe that a DNR order means no medical interventions will be made under any circumstances. However, this order specifically applies to not performing cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. Other life-sustaining treatments can still be provided unless otherwise stated in an advance directive.

• DNR orders are permanent and cannot be revoked. Another common misconception is that once a DNR order is in place, it is irreversible. Patients or their legally authorized representatives have the right to revoke a DNR order at any time to ensure that their current wishes are respected.

• Only the elderly or terminally ill can have a DNR order. Many assume that DNR orders are solely for the elderly or those with terminal illnesses. In truth, patients with various health conditions and prognoses may consider a DNR order based on their values, preferences, and discussions with healthcare providers.

• A verbal DNR order is sufficient for emergency responders. While verbal directives during hospitalization can be significant, emergency medical personnel require a formally documented DNR order to act accordingly outside of hospital settings. Texas law requires a specific form to be completed and signed by both a physician and the patient or their representative.

• Hospital DNR orders automatically transfer to other settings. A widespread misconception is that a DNR order in a hospital will automatically apply in other care settings, such as at home or in a nursing facility. Each setting requires documentation according to its regulations and procedures, emphasizing the need to ensure that DNR preferences are clearly communicated and documented across all care environments.

The Texas Do Not Resuscitate Order (DNR) form is an important document for individuals wishing to decline certain life-sustaining treatments. Understanding how to properly fill out and use this form is crucial for ensuring your wishes are respected. Here are five key takeaways to consider:

• To initiate a DNR order in Texas, the form must be completed accurately. This includes providing personal identification details along with the signatures of the individual (or their legally authorized representative) and the physician. The physician's signature confirms the medical understanding and agreement with the DNR order.
• The form should be easily accessible to healthcare providers. Once completed, the DNR order should be placed in a location where it can be quickly found by emergency personnel or medical staff, such as with other important medical documents or in a visible spot if at home.
• Communication with family members and healthcare providers about the decision to have a DNR order is vital. This ensures everyone understands the individual’s wishes, reducing confusion or conflicts during a medical emergency.
• The DNR order is specifically applicable in situations where resuscitative efforts could be initiated. This includes not only cardiac arrest but also respiratory arrest. Therefore, the decision to have a DNR order should be made with clear consideration of its implications on emergency medical treatments.
• The Texas DNR order can be revoked at any time by the individual or their legally authorized representative. This revocation can be done verbally or by destroying the DNR order form. However, it is crucial to communicate this revocation to the healthcare providers and remove any copies of the previously signed form from accessible places.

Understanding these key aspects of the Texas Do Not Resuscitate Order form can empower individuals to make informed decisions about their end-of-life care. It ensures that their wishes regarding resuscitation are clearly documented and respected by medical personnel, family, and caregivers.