Advance Directives and Patient Consent Flashcards

Which of the following best describes the PAR's responsibility regarding advance directives in their facility's documentation system?

Answer: The PAR scans or flags the existence of an advance directive in the patient's record and alerts the clinical team

The PAR is responsible for ensuring the presence of an advance directive is documented in the patient's record and that clinical staff are notified, not for creating or interpreting them.

What is a healthcare proxy?

Answer: A person legally designated to make healthcare decisions on behalf of an incapacitated patient

A healthcare proxy (also called a healthcare agent or surrogate) is an individual designated by the patient through a durable power of attorney for healthcare to make medical decisions when the patient cannot.

Under HIPAA, who may access a patient's advance directive documents stored in the medical record?

Answer: Authorized healthcare providers involved in the patient's care and individuals with proper authorization

HIPAA protects advance directives as part of the patient's protected health information (PHI); access is limited to treating providers and those with proper patient authorization.

A patient with a guardianship order has been admitted. Who makes healthcare decisions for this patient?

Answer: The court-appointed guardian, within the scope defined by the guardianship order

A court-appointed guardian has the legal authority to make decisions on behalf of an incapacitated patient, within the scope specified by the court's guardianship order.

A patient's existing advance directive on file conflicts with what their healthcare proxy now requests. What is the appropriate first step for the PAR or care team?

Answer: Escalate the conflict to the attending physician and potentially the hospital ethics committee for resolution

Conflicts between advance directives and proxy decisions require clinical and ethical review; the attending physician should be notified and the ethics committee may need to be involved to resolve the disagreement.

Which of the following is NOT typically included in a hospital's required advance directive education for incoming patients?

Answer: Instructions on how to file a claim with their insurance for advance directive preparation costs

PSDA requires hospitals to educate patients about their right to make decisions and to create advance directives, including relevant state law — insurance billing for creating the document is not part of the required education.

What is the purpose of a Five Wishes document?

Answer: A consumer-friendly advance directive that addresses medical, personal, emotional, and spiritual end-of-life wishes

Five Wishes is a widely used advance directive document that addresses who should make care decisions, what medical treatment is desired, comfort preferences, personal treatment wishes, and what the patient wants loved ones to know — meeting legal requirements in most US states.