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Poor Outcomes From CPR and Ventilator Use in COVID-19 May Alter POLST Choices

The decision to initiate CPR has become more difficult.  We know that CPR substantially increases the risk of aerosolized SARS-CoV-2 and its transmission to health care workers (HCW) in the area of CPR.  For this reason, AMDA and other societies have given guidance on ways to reduce the risk, but these added risk reducing measures may delay initiation of CPR.  

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Should You Be Concerned About the “Integrity” of Your Facility’s POLST Forms?

In 2008, I attended the UCLA LMG (Leadership and Management in Geriatrics) course that has continued under the leadership of CALTCM.  I was paired with a nursing professor at Sacramento State who was quite helpful as a mentor for my project which was the implementation of the new POLST Form in Sonoma County.  I teamed with Susan Keller, who energetically partnered with many people and provided detailed trainings in many settings of care. Sadly, despite our efforts, I still find POLST forms initiated by frontline SNF admitting nurses that don’t have choices congruent with the ones I find on my assessments.  In addition, many of the forms fail to record basic information like care contacts, presence of AHCDs/DPOAs, and who assisted with completion of the form.  

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