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V. Armstrong, M. Renaud

Jour Nursing Home Res 2015;1:41-46

Objectives: The objective of this study was to evaluate the effect of Physician Order for Scope of Treatment (POST) orders on interdisciplinary staff caregiver satisfaction, hospital admissions and hospice enrollment. POST is a program that provides a vehicle for clear communication of an individual’s desires for EOLC care in a physician order to be honored across the continuum of care. The effect of POST orders on staff caregiver satisfaction, hospital admissions and hospice enrollment has not been published. Design: This study used a quasi-experimental pre-test/post-test design for a single group of participants to measure staff caregiver satisfaction change. Retrospective chart reviews for data collection for comparison to historical data for change of hospice enrollment and hospital admission. Setting: The study was conducted in nine nursing homes in Southeastern Virginia from August 1, 2013 to December 31, 2013. Participants: Participants were the interdisciplinary staff caregivers who cared for residents with POST orders. Intervention: Implementation of POST orders. Measurements: Pre and post POST order surveys that were completed by staff and retrospective chart reviews for evidence of hospice enrollment and hospital admission. Results: There was no demonstrated change in staff caregiver satisfaction (p=0.05). 86 charts with POST orders were reviewed. Hospice enrollment for residents with POST orders was 16.2% compared to 2.10% in 2013 and 1.68% in 2012 of nursing home residents without POST orders. Hospital admissions were 0% as compared to 2012 and 2013 hospital admission rates of 4.8% and 6.2% respectively. Conclusion: POST orders did not change staff caregiver satisfaction with EOLC, however there were significant changes in the rate of hospital admissions and utilization of hospice services. These results may provide basis for further examination and possibly dedication of resources for further development of Advance Care Planning Facilitator training. The ability to identify and communicate individual wishes for EOLC beneficially impacts the patient, family, caregivers and society; continued efforts in this arena are imperative.

V. Armstrong ; M. Renaud (2015): POST Orders-What’s the Impact on Staff, Hospital Admissions and Hospice?. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2015.8


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