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Free Do Not Resuscitate Order File

File Details

Fact Name Details
Definition An Arkansas Do Not Resuscitate (DNR) Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
Governing Law The DNR Order in Arkansas is governed by Arkansas Code Annotated § 20-13-220.
Eligibility Any adult can complete a DNR Order, provided they have the capacity to make medical decisions.
Signature Requirement The DNR Order must be signed by the patient or their legal representative and a physician.
Validity The DNR Order remains valid until revoked by the patient or their representative, or until the patient’s death.

Key takeaways

Filling out the Arkansas Do Not Resuscitate Order (DNR) form is an important step for individuals who wish to communicate their preferences regarding medical treatment in emergency situations. Here are key takeaways to consider:

  • The DNR form must be completed and signed by a qualified healthcare provider.
  • It is essential to discuss your wishes with family members and healthcare professionals to ensure understanding and support.
  • The form should be easily accessible, such as kept in a visible location or included in a medical file.
  • Once the DNR is signed, it remains in effect until it is revoked or updated by the individual.
  • Patients can request a copy of the DNR form for their records, ensuring that their wishes are documented.

Detailed Steps for Using Arkansas Do Not Resuscitate Order

Completing the Arkansas Do Not Resuscitate Order form is a straightforward process. This form allows individuals to communicate their wishes regarding resuscitation in a medical emergency. Follow the steps below to ensure the form is filled out correctly.

  1. Obtain the Arkansas Do Not Resuscitate Order form. You can find it online or request a copy from your healthcare provider.
  2. Fill in your full name at the top of the form. Make sure to include any relevant identification details, such as your date of birth.
  3. Designate a healthcare agent if you wish. This person will be responsible for making decisions on your behalf if you cannot do so.
  4. Clearly indicate your wishes regarding resuscitation. This usually involves checking a box or writing a statement.
  5. Sign and date the form at the bottom. Your signature confirms that you understand and agree with the contents of the form.
  6. Have the form witnessed. You will need at least one witness who is not your healthcare agent or related to you.
  7. Make copies of the completed form. Keep one for your records and provide copies to your healthcare provider and your designated agent.

Once you have completed the form, it’s important to discuss your wishes with your healthcare provider and loved ones. This ensures everyone is aware of your preferences and can act accordingly in an emergency.

Common mistakes

Completing the Arkansas Do Not Resuscitate (DNR) Order form is a critical task that requires careful attention. However, many individuals make common mistakes that can lead to confusion or unintended consequences. Understanding these pitfalls can help ensure that the form accurately reflects a person's wishes.

One frequent mistake is failing to include all necessary signatures. The DNR form must be signed by the patient or their legal representative, as well as a physician. Omitting any of these signatures can render the document invalid. It is essential to double-check that all required parties have signed before submitting the form.

Another common error involves not clearly indicating the patient's wishes. The form should explicitly state the desire for no resuscitation in a straightforward manner. Ambiguous language or unclear instructions can lead to misinterpretation by medical personnel. Clarity is crucial to avoid any confusion during critical moments.

People often overlook the importance of dating the form. A DNR Order must be current to be valid. If the form is not dated, healthcare providers may question its validity. Therefore, always ensure that the date is clearly marked when the form is completed.

Some individuals mistakenly assume that a verbal DNR order is sufficient. In Arkansas, a written DNR Order is required to be legally recognized. Relying on verbal instructions can lead to misunderstandings and may not be honored by medical staff.

Another mistake is neglecting to review the form periodically. A person's health status or preferences may change over time. Regularly revisiting the DNR Order ensures that it remains aligned with the individual's current wishes and medical circumstances.

In some cases, individuals fail to provide copies of the completed DNR form to relevant parties. It is essential to distribute copies to family members, healthcare providers, and any facilities where the patient may receive care. This ensures that everyone involved is aware of the patient's wishes.

Additionally, people may not understand the implications of a DNR Order. It is vital to discuss the decision with healthcare professionals to fully grasp the consequences. Without this understanding, individuals might make choices that do not reflect their true desires.

Another mistake involves using outdated forms. Laws and regulations can change, and using an old version of the DNR form may lead to complications. Always obtain the most current version of the form to ensure compliance with state laws.

Lastly, some individuals may fail to communicate their wishes to loved ones. A DNR Order is not just a legal document; it is also a personal decision that should be discussed openly with family members. Failing to have these conversations can lead to conflict or confusion at critical moments.

Arkansas Do Not Resuscitate Order Sample

Arkansas Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is a legal document in accordance with Arkansas state law, specifically addressing the wishes of a patient regarding resuscitation efforts in the event of a cardiac or respiratory arrest.

Please complete the information below to ensure clarity and compliance with your wishes.

Patient Information:

  • Name: ________________________________________
  • Date of Birth: _________________________________
  • Address: ______________________________________

Healthcare Provider Information:

  • Physician Name: _________________________________
  • Physician Phone Number: _________________________

Patient's Wishes:

The patient wishes to refrain from any resuscitation efforts, including CPR, intubation, or other advanced life-support measures in the event of a cardiac or respiratory arrest.

Signature:

  • Patient Signature: _______________________________ Date: ______________
  • Witness Signature: ______________________________ Date: ______________

This document should be kept in a place where it can be easily accessed by healthcare providers and family members. It is recommended to provide copies to your healthcare provider and any family members involved in your care.

For any changes to this order, a new document must be executed and signed in compliance with Arkansas law.