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Homepage Attorney-Approved Do Not Resuscitate Order Template Valid Do Not Resuscitate Order Form for Ohio
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In Ohio, the Do Not Resuscitate (DNR) Order form serves as a critical document for individuals who wish to express their preferences regarding medical treatment in the event of a cardiac or respiratory arrest. This legally binding form allows patients to communicate their desire to forgo resuscitation efforts, ensuring that their wishes are respected by healthcare providers. It is essential for individuals to complete the form accurately, as it must be signed by both the patient and a physician to be valid. The DNR Order must be readily accessible, often displayed prominently in the patient's medical records or on their person, to guide emergency responders in urgent situations. Understanding the implications of this form is vital, as it not only reflects personal values and medical wishes but also facilitates discussions among family members and healthcare professionals about end-of-life care. By taking this step, individuals can maintain control over their medical decisions, providing peace of mind for themselves and their loved ones.

Common mistakes

  1. Failing to provide all required personal information. Individuals often overlook sections that require details such as full name, date of birth, and medical record number.

  2. Not signing the form. A common mistake is submitting the Do Not Resuscitate Order without the necessary signatures from the patient or their legal representative.

  3. Inaccurate completion of the physician's information. Some people neglect to include the physician's name, contact information, or license number, which can render the document invalid.

  4. Using outdated forms. Individuals may use older versions of the Do Not Resuscitate Order, which may not comply with current regulations.

  5. Not discussing the order with healthcare providers. Failing to communicate the existence of the Do Not Resuscitate Order to medical staff can lead to confusion during emergencies.

  6. Ignoring state-specific guidelines. Each state has its own requirements for Do Not Resuscitate Orders. Some people do not familiarize themselves with Ohio's specific rules.

  7. Forgetting to update the form. Life circumstances change, and individuals often forget to revise their Do Not Resuscitate Order to reflect new wishes or changes in health status.

  8. Not providing copies to relevant parties. After completing the form, it is essential to distribute copies to healthcare providers, family members, and emergency contacts. Failing to do so can lead to unintended resuscitation.

Example - Ohio Do Not Resuscitate Order Form

Ohio Do Not Resuscitate Order

This Do Not Resuscitate Order (DNR) is designed to express the wishes of the individual named below regarding resuscitation in the event of a medical emergency. It complies with Ohio state laws related to advance directives and DNR orders.

Patient Information:

  • Name: ____________________________
  • Date of Birth: ____________________________
  • Address: ____________________________
  • Phone Number: ____________________________

Healthcare Representative Information:

  • Name: ____________________________
  • Relationship to Patient: ____________________________
  • Address: ____________________________
  • Phone Number: ____________________________

Order Statement:

I, the undersigned, declare that I do not wish to receive cardiopulmonary resuscitation (CPR) in the event my heart stops or I stop breathing. I understand that this decision may result in my death.

Signature of Patient or Healthcare Representative:

____________________________ (Signature)

____________________________ (Date)

Witnesses:

  1. ____________________________ (Witness 1 Signature)
  2. ____________________________ (Date)
  3. ____________________________ (Witness 2 Signature)
  4. ____________________________ (Date)

This document becomes effective immediately upon signature and should be placed in the patient’s medical records and easily accessible to medical personnel when needed.

More About Ohio Do Not Resuscitate Order

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

A Do Not Resuscitate Order is a medical order that tells healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a person's heart stops beating or if they stop breathing. In Ohio, this order is used to respect the wishes of individuals who do not want to undergo resuscitation efforts in the event of a medical emergency.

Who can request a DNR Order?

In Ohio, a DNR Order can be requested by a patient who is at least 18 years old and has the capacity to make their own healthcare decisions. Additionally, a legal guardian or a person with durable power of attorney for healthcare can also request a DNR on behalf of an individual who is unable to make decisions for themselves.

How is a DNR Order created in Ohio?

A DNR Order must be completed using the official Ohio DNR form. This form needs to be signed by the patient or their authorized representative and a physician. It is important to ensure that the form is filled out correctly and that all required signatures are obtained to make it valid.

Where should the DNR Order be kept?

The completed DNR Order should be kept in a place that is easily accessible to emergency medical personnel. It is advisable for individuals to carry a copy of the DNR Order with them at all times, especially when traveling or going to healthcare facilities. Additionally, a copy should be provided to family members and healthcare providers.

Can a DNR Order be revoked?

Yes, a DNR Order can be revoked at any time by the patient or their authorized representative. To revoke the order, the individual simply needs to destroy the existing DNR form or inform their healthcare provider of the decision to cancel it. It is important to communicate this change clearly to avoid any confusion during a medical emergency.

What happens if a DNR Order is not available during a medical emergency?

If a DNR Order is not available when emergency medical services arrive, healthcare providers are required to perform CPR and other life-saving measures. It is crucial to ensure that the DNR Order is easily accessible to avoid unwanted resuscitation efforts.

Are there any limitations to a DNR Order?

A DNR Order specifically addresses resuscitation efforts in the event of cardiac arrest or respiratory failure. It does not affect other medical treatments or interventions. Patients can still receive comprehensive medical care, including medications, comfort measures, and other supportive treatments, even with a DNR Order in place.

Key takeaways

Understanding the Ohio Do Not Resuscitate (DNR) Order form is essential for individuals who wish to make their healthcare preferences clear. Here are some key takeaways to consider:

  • The DNR form allows individuals to refuse resuscitation efforts in the event of a medical emergency.
  • It is crucial to have the DNR form signed by a licensed physician to ensure it is legally valid.
  • Make sure to discuss your wishes with family members and healthcare providers to avoid confusion during critical moments.
  • Keep the DNR form in a visible place, such as on the refrigerator or with other important medical documents.
  • Review and update the DNR order regularly, especially if there are changes in health status or personal preferences.

File Details

Fact Name Description
Definition An Ohio Do Not Resuscitate (DNR) Order is a legal document that allows a person to refuse resuscitation efforts in the event of a medical emergency.
Governing Law The Ohio DNR Order is governed by Ohio Revised Code § 2133.21 to § 2133.28.
Eligibility Any adult with a terminal condition or a medical condition that limits their ability to survive can complete a DNR Order.
Signature Requirements The DNR Order must be signed by the patient or their legal representative, along with a physician's signature.
Validity The DNR Order is valid in all healthcare settings in Ohio once properly executed.
Revocation A DNR Order can be revoked at any time by the patient or their legal representative, verbally or in writing.
Emergency Services Emergency medical personnel must honor a valid DNR Order and refrain from resuscitation efforts when presented.

Dos and Don'ts

When filling out the Ohio Do Not Resuscitate Order form, it's important to follow certain guidelines to ensure the document is completed correctly. Here are five things you should and shouldn't do:

  • Do ensure that the form is signed by the patient or their legal representative.
  • Do provide accurate medical information to avoid any confusion in emergencies.
  • Do keep a copy of the completed form for your records.
  • Don't leave any sections blank; fill out all required fields.
  • Don't forget to inform your healthcare providers about the existence of the form.

Following these guidelines will help ensure that the Do Not Resuscitate Order is respected and properly implemented when needed.