1. Out of Hospital Do Not Resuscitate (DNR) Declaration and Order. Indiana law allows a qualified person to say they do not want CPR given if the heart or lungs stop working in a location that is not a hospital. A physician must certify that the patient has a terminal condition or that resuscitation would likely be unsuccessful. This order may override other advance directives. Prior to completing, the patient should understand about various life-sustaining procedures and what they can and cannot do.

Resources:

CPR or No CPR: What you should know - The Optimistic Project
Indiana Out of Hospital Do Not Resuscitate Declaration and Order Form

1. Indiana Physician Orders for Scope of Treatment (POST). The Indiana POST is a physician order for treatment determined by a patient’s goals and the treatment options available to the patient. Orders are based on the individual’s current health situation. In consultation with the patient and/or the patient’s legal healthcare representative, a physician will write orders that reflect patient wishes with regards to cardiopulmonary resuscitation (CPR), medical interventions (comfort measures, limited additional interventions, or full treatment), antibiotics, and artificially administered nutrition. Prior to completing, the patient should understand about various life-sustaining procedures and comfort care and what they can and cannot do.

It is recommended that completed POST forms be printed on Astrobright’s Pulsar Pink 65lb paper for inclusion in patient files and records.

Five features make the POST useful:

1. Recognizable, standardized form;
2. Addresses not only code status, but a variety of other treatment categories;
3. Allows patients to determine their healthcare plan;
4. Converts treatment preferences into immediately actionable medical orders;
5. Transfers across treatment settings with the patient, including pre-hospital.

To be eligible for a POST, a person must have at least one of the following:

1. An advanced chronic progressive illness.
2. An advanced chronic progressive frailty.
3. A condition caused by injury, disease, or illness from which, to a reasonable degree of medical certainty there can be no recovery, and death will occur within a short period without the provision of life-prolonging procedures.
4. A medical condition that, if the person were to suffer cardiac or pulmonary failure, resuscitation would be unsuccessful or within a short period the person would experience repeated cardiac or pulmonary failure resulting in death.

Indiana POST Resources:
The Indiana POST Program
The Indiana POST for Healthcare Providers
Using the Indiana POST Form: Guidance for Healthcare Professionals
Indiana POST information for healthcare professionals
Indiana POST information for patients
The Indiana POST Program – FAQ’s
Indiana POST and Advance Directives EMS Study Guide
Indiana Physician Orders for Scope of Treatment (POST) Form

Other Resources:

National Physician Orders for Life Sustaining Treatment (POLST) Program
Comparison: Living Will/Out of Hospital Do Not Resuscitate Order/Physician Orders for Scope of Treatment.

The Optimistic Project – Treatment Decision Aids

CPR or No CPR: What you should know
Tube Feeding: What you should know
Help with Breathing: What you should know
Antibiotics: What you should know
A Guide to Comfort Care for Patients and Families