Free  Do Not Resuscitate Order Template for Ohio Make My Do Not Resuscitate Order Online

Free Do Not Resuscitate Order Template for Ohio

The Ohio Do Not Resuscitate Order form is a legal document that allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. This form ensures that healthcare providers honor a patient's decision to forgo life-sustaining treatment. Understanding its purpose and proper usage is essential for both patients and caregivers.

Form Sample

Ohio Do Not Resuscitate Order Template

This Do Not Resuscitate (DNR) Order is completed in accordance with Ohio Revised Code Sections 2133.21 to 2133.26.

The purpose of this order is to ensure that the patient’s wishes regarding resuscitation are respected and followed in the event of a medical emergency. This DNR order applies to any health care provider in the state of Ohio.

Patient Information:

  • Name: _________________
  • Date of Birth: _________________
  • Address: _________________

Health Care Professional Information:

  • Physician Name: _________________
  • License Number: _________________
  • Address: _________________
  • Contact Number: _________________

Patient’s Wishes: The patient, having discussed their condition and options with their healthcare provider, wishes to refuse resuscitation as follows:

  • No chest compressions
  • No artificial ventilations
  • No advanced cardiac life support (ACLS)

This order is effective immediately and shall remain in effect until revoked or modified by the patient or authorized representative.

Designation of Health Care Representative:

  • Name: _________________
  • Relationship to Patient: _________________
  • Contact Number: _________________

Signatures:

Patient Signature: _______________________ Date: _____________

Health Care Provider Signature: _______________________ Date: _____________

This Do Not Resuscitate Order is valid in any health care setting in Ohio, including hospitals, emergency medical services, and home health care.

Misconceptions

Understanding the Ohio Do Not Resuscitate (DNR) Order form is crucial for making informed healthcare decisions. Here are ten common misconceptions about the DNR form, along with clarifications to help you navigate this important topic.

  1. A DNR means that no medical care will be provided.

    This is not true. A DNR specifically addresses resuscitation efforts during a cardiac or respiratory arrest. Other medical treatments and care continue as needed.

  2. Only terminally ill patients need a DNR.

    A DNR can be appropriate for anyone who wishes to forgo resuscitation efforts, regardless of their health status. It’s a personal choice.

  3. A DNR is only valid in a hospital setting.

    The Ohio DNR Order is valid in all healthcare settings, including hospitals, nursing homes, and even at home, as long as it is properly completed.

  4. Family members can make a DNR decision on behalf of a patient.

    While family members can discuss and recommend a DNR, only the patient or their legally appointed representative can sign the DNR form.

  5. A DNR is permanent and cannot be changed.

    This is incorrect. A DNR can be revoked or modified at any time by the patient or their representative, as long as they communicate their wishes clearly.

  6. Having a DNR means you are giving up on life.

    A DNR is a personal choice reflecting a desire for a specific type of care during a medical emergency. It does not signify a lack of hope or will to live.

  7. All healthcare providers will respect a DNR order.

    While most providers will honor a valid DNR, it’s essential to ensure that the order is communicated clearly to all members of the healthcare team.

  8. A DNR is the same as a living will.

    These are different documents. A living will outlines a person's wishes regarding medical treatment in general, while a DNR specifically addresses resuscitation efforts.

  9. You need a lawyer to create a DNR.

    No legal representation is necessary to complete a DNR form. It can be filled out by the patient or their representative with the appropriate information.

  10. A DNR is only for older adults.

    Anyone, regardless of age, can have a DNR if they choose. The decision is based on individual values and preferences, not age alone.

By addressing these misconceptions, individuals can make more informed decisions about their healthcare preferences and ensure their wishes are respected.

Key takeaways

Filling out and using the Ohio Do Not Resuscitate (DNR) Order form is an important decision that requires careful consideration. Here are some key takeaways to keep in mind:

  1. Understand the Purpose: The DNR Order is designed to communicate your wishes regarding resuscitation efforts in the event of a medical emergency. It ensures that healthcare providers respect your preferences.
  2. Eligibility: To complete a DNR Order in Ohio, you must be an adult or an emancipated minor. A physician must also sign the order to validate it.
  3. Discuss with Healthcare Providers: Before filling out the form, it is crucial to have a conversation with your healthcare provider. They can help clarify the implications of a DNR and guide you through the process.
  4. Keep Copies Accessible: After completing the DNR Order, make several copies. Share these with your healthcare provider, family members, and anyone else involved in your care.
  5. Review Regularly: Your health status and preferences may change over time. It is wise to review your DNR Order periodically to ensure it still aligns with your wishes.
  6. Legal Considerations: While the DNR Order is a legal document, it is important to understand that it only applies in specific situations, typically in cases of cardiac arrest or respiratory failure.

By keeping these points in mind, you can make informed decisions about your healthcare preferences and ensure that your wishes are honored.

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