Free Arkansas Do Not Resuscitate Order Template Open My Document

Free Arkansas Do Not Resuscitate Order Template

A Do Not Resuscitate (DNR) Order form in Arkansas is a legal document that allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. By completing this form, patients can ensure that their preferences are respected by healthcare providers. Understanding the DNR process is essential for anyone considering end-of-life care options.

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In Arkansas, the Do Not Resuscitate (DNR) Order form serves as a crucial document for individuals wishing to express their preferences regarding medical treatment in the event of a life-threatening situation. This form allows patients to communicate their desire not to receive cardiopulmonary resuscitation (CPR) or other resuscitative measures if their heart stops or they stop breathing. It is important for individuals to understand that a DNR order is not a decision to forgo all medical care; rather, it specifically addresses the use of life-saving interventions. The form must be completed and signed by a licensed physician, ensuring that the patient's wishes are documented and respected. Additionally, it should be readily accessible to medical personnel, often by displaying the DNR order prominently in the patient’s medical records or on their person. Understanding the implications of this order is essential for patients and their families, as it can facilitate difficult conversations about end-of-life care while ensuring that personal wishes are honored in critical moments.

Essential Queries on Arkansas Do Not Resuscitate Order

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

A Do Not Resuscitate Order is a legal document that allows a person to refuse resuscitation efforts in case of a medical emergency. In Arkansas, this order is typically used by individuals with serious health conditions who do not wish to receive cardiopulmonary resuscitation (CPR) or other life-saving measures if their heart stops or they stop breathing.

Who can request a DNR Order in Arkansas?

In Arkansas, a DNR Order can be requested by the patient themselves if they are an adult and mentally competent. If the patient is unable to make this decision, a legally authorized representative, such as a family member or a healthcare proxy, can request the order on their behalf. It’s important to ensure that the representative has the authority to make healthcare decisions.

How do I obtain a DNR Order form in Arkansas?

You can obtain a DNR Order form from various sources, including:

  • Your healthcare provider or hospital
  • The Arkansas Department of Health website
  • Local health departments or clinics

Once you have the form, it should be filled out carefully, ensuring all required information is included. After completion, it must be signed by the patient and a physician.

What should I do with my DNR Order after it is completed?

After completing the DNR Order, it’s crucial to keep the document in an accessible place. You should provide copies to your healthcare providers, family members, and anyone involved in your care. It’s also advisable to keep a copy in your medical records. This ensures that your wishes are known and respected in an emergency situation.

Can I change or revoke my DNR Order?

Yes, you can change or revoke your DNR Order at any time. If you decide to do so, it’s important to inform your healthcare providers and family members of your decision. To revoke the order, you can simply destroy the original document and any copies. You may also want to fill out a new DNR Order form if you wish to make changes.

Arkansas Do Not Resuscitate Order Example

Arkansas Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is created in accordance with the laws of the State of Arkansas. Its purpose is to ensure the individual's wishes regarding resuscitation efforts are respected in medical emergencies.

Patient Information:

  • Full Name: ____________________________________________________
  • Date of Birth: _________________________________________________
  • Address: _______________________________________________________
  • Phone Number: ________________________________________________

Physician Information:

  • Physician’s Name: ______________________________________________
  • Office Address: _______________________________________________
  • Phone Number: ________________________________________________

Patient’s Wishes:

The patient, named above, has made a conscious decision regarding their medical care. Specifically:

  • This individual does not wish to receive cardiopulmonary resuscitation (CPR) or any advanced cardiac life support (ACLS) in the event of cardiac arrest.
  • The patient understands the implications of this decision and has discussed it with their physician.

The following statements confirm the patient's consent:

  • This order is effective immediately upon the signing of the patient and physician.
  • This order shall remain in effect until revoked by the patient or changed by a physician.

Signatures:

  • Patient Signature: ____________________________________________
  • Date: ________________________________________________________
  • Physician Signature: __________________________________________
  • Date: ________________________________________________________

In the event this order is presented in a medical setting, please ensure healthcare providers have a copy for their records.

Some Other Arkansas Templates

Dos and Don'ts

When filling out the Arkansas Do Not Resuscitate (DNR) Order form, it’s crucial to approach the process thoughtfully. Here are five important dos and don'ts to keep in mind:

  • Do ensure that you fully understand what a DNR order entails. It is a legal document indicating that you do not wish to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
  • Don't fill out the form without consulting with your healthcare provider. They can provide valuable insights into your health status and the implications of a DNR order.
  • Do discuss your wishes with family members or loved ones. Open communication helps ensure that everyone understands your preferences regarding end-of-life care.
  • Don't assume that a verbal agreement is sufficient. The DNR order must be documented and signed to be legally binding.
  • Do keep a copy of the completed form in a safe place and share it with your healthcare provider and family. This ensures that your wishes are known and can be honored when necessary.

Common mistakes

  1. Inaccurate Personal Information: Individuals may fail to provide complete or correct personal details, such as their full name, date of birth, or address. This can lead to confusion and potential issues in the future.

  2. Missing Signatures: The form requires signatures from both the patient and a witness. Omitting either signature renders the document invalid.

  3. Not Including a Date: Failing to date the form can create ambiguity regarding when the order was established. This is crucial for ensuring that the wishes are honored at the appropriate time.

  4. Not Discussing with Healthcare Providers: Some individuals neglect to discuss their decision with their healthcare team. This can lead to misunderstandings about the patient's wishes and the implications of the order.

  5. Ambiguous Language: Using vague terms or phrases can result in misinterpretation of the patient's wishes. Clear and specific language is essential for accurate understanding.

  6. Not Informing Family Members: Failing to inform family members about the existence of the Do Not Resuscitate Order can lead to conflict and confusion during critical moments.

  7. Neglecting to Review the Order: Individuals may overlook the importance of periodically reviewing the order to ensure it still reflects their current wishes. Changes in health status or personal beliefs may necessitate updates.

PDF Data

Fact Name Description
Governing Law The Arkansas Do Not Resuscitate (DNR) Order is governed by Arkansas Code Annotated § 20-13-2201 et seq.
Purpose This form allows individuals to express their wishes regarding resuscitation efforts in case of a medical emergency.
Eligibility Any adult or emancipated minor can complete a DNR order in Arkansas.
Signature Requirement The DNR order must be signed by the patient or their legally authorized representative.
Healthcare Provider Signature A healthcare provider must also sign the DNR order to validate it.
Form Availability The DNR order form is available online through the Arkansas Department of Health.
Revocation Patients have the right to revoke a DNR order at any time, verbally or in writing.
Emergency Medical Services Emergency medical personnel must honor the DNR order if it is properly completed and signed.
Storage of DNR Order It is recommended to keep the DNR order in a visible location, such as on the refrigerator or with medical records.