Valid Do Not Resuscitate Order Template for Hawaii

A Do Not Resuscitate (DNR) Order is a legal document that allows individuals to express their wishes regarding medical treatment in the event of a life-threatening situation. In Hawaii, this form specifically instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if the individual’s heart stops or if they stop breathing. Understanding the implications of this order is essential for anyone considering their end-of-life care options.

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The Hawaii Do Not Resuscitate Order (DNR) form serves as a crucial document for individuals wishing to express their preferences regarding life-sustaining treatments in the event of a medical emergency. This form allows patients to communicate their desire not to receive cardiopulmonary resuscitation (CPR) or other resuscitative measures if their heart stops beating or they stop breathing. It is essential for the DNR to be completed in accordance with state regulations, ensuring that it is properly signed by both the patient and a physician. The form is designed to be easily accessible and should be kept in a prominent location, such as on the refrigerator or in a medical file, so that emergency responders can quickly identify it. Understanding the implications of a DNR order is vital; it is not a decision made lightly, as it reflects deeply held beliefs about end-of-life care. Additionally, the DNR form must be reviewed periodically to ensure it aligns with the patient's current wishes and medical condition. In Hawaii, this form is recognized by healthcare providers and first responders, making it an important tool for respecting patient autonomy and ensuring that medical care aligns with individual values.

Hawaii Do Not Resuscitate Order Sample

Hawaii Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is in accordance with Hawaii state law, specifically Act 37, which allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency.

Patient Information

Patient Name: ________________________________
Date of Birth: ________________________________
Address: ________________________________

Healthcare Decisions

This order should be followed in all healthcare settings. If the patient experiences a medical emergency, the following is requested:

Do not perform cardiopulmonary resuscitation (CPR).
Do not use electronic defibrillation.
Do not employ any measures intended to restart the heart or breathing.

Patient's Wishes

This DNR order reflects the patient’s wishes regarding resuscitation. The patient has made this decision based on a clear understanding of their medical condition and prognosis.

Signature and Date

Patient or Legal Representative Signature: ________________________________
Date: ________________________________

Witness Information

Witness Name: ________________________________
Witness Signature: ________________________________
Date: ________________________________

It is recommended that copies of this DNR order be provided to healthcare providers, family members, and stored where it can be easily accessed.

This document serves as an important expression of the patient’s healthcare preferences. Take time to discuss its contents with medical professionals and ensure everyone involved understands its significance.

Popular Do Not Resuscitate Order State Forms

Dnr Paperwork - In some cases, a physician's signature is required to validate the DNR order.

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What Is Dnr Mean - Helps align medical care with the patient’s values and desires at the end of life.

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Key takeaways

When filling out and using the Hawaii Do Not Resuscitate (DNR) Order form, keep these key takeaways in mind:

The DNR form must be completed and signed by a licensed physician.
It is essential to discuss your wishes with family members and healthcare providers before completing the form.
The form should clearly state your desire for no resuscitation efforts in the event of cardiac or respiratory arrest.
Ensure that the form is easily accessible to emergency medical personnel and healthcare providers.
Keep a copy of the DNR order in your medical records and provide copies to your family.
The DNR order remains valid unless revoked or modified by the patient or their legal representative.
Review the DNR order regularly to ensure it still reflects your wishes.
Be aware that the DNR order applies only to resuscitation efforts and does not affect other medical treatments.
Consider discussing your decision with a healthcare professional for guidance and support.
Understand that the DNR form is legally recognized in Hawaii and must be honored by healthcare providers.