North Valley Hospital
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Advance Directives Policy


Advance Directives Policy (Medical & Mental Health)


This policy is to provide an atmosphere of respect and caring and to ensure that each patient's ability and right to participate in medical and mental health decision making is maximized. Additionally, the purpose of this policy is to assure compliance with the Patient Self Determination Act (PSDA) in such a manner as to expand the patient, personnel, and community knowledge base regarding Advance Directives and the process by which patient participation in medical decision-making is carried out at North Valley Hospital. WAC 246-320-141(i)


It is the policy of North Valley Hospital to respect and encourage patient self-determination. Patients will be encouraged and assisted to be active participants in the decision making process regarding their care through education, inquiry, and assistance as requested. Patients will be encouraged to communicate their desires in regard to advance directives to their patient representative, to allow for guidance health care providers in following the patient's wishes should the patient become incapacitated, rendering them unable to make decisions.


An inquiry will be made by authorized staff members as to whether or not the patient has completed an Advance Directive. North Valley Hospital will not discriminate against any individual based on whether or not the individual has executed an Advanced Directive.

A request of the patient or patient representative to provide a copy of the Advance Directive for medical record entry will be made.

As part of the admission process the patient or patient representative will be provided with access to information outlining the individual's rights for make decisions concerning medical care. The information includes:

  • The right to accept or refuse medical or surgical treatment, even if the treatment is life-sustaining.

  • Information concerning the PSDA; and how to formulate Advance Directives or POLST (Physician Ordered Life Sustaining Treatment).

  • Patient Rights and Responsibilities.

  • Information regarding the PSDA/Advance Directives and the Mental Health Care Directive will be provided to the patient upon admission to North Valley Hospital.

Authorized personnel will document in the medical record whether the patient has completed an Advance Directive or that information concerning Advance Directives has been given to the patient/patient representative.

The provider or the nursing staff will have the responsibility to review any existing advance directive with the patient/patient's representative to validate its current status.

In the event the patient/patient representative indicates that the previous advance directive does not accurately reflect the patient's wishes, a revised advanced directive should be drafted, per patient request.

To the extent that the patient/patient representative requests additional information or further explanation regarding the PSDA or Advance Directives, referrals will be made to nursing or the patient's primary provider for follow-up interaction with patient and significant others, as appropriate.

There will be availability to discuss patient rights issues as needed. All requests from patients/patient's representative, hospital personnel and/or medical staff members to convene an Ethics Committee (See policy) process will be honored.

It is recommended that follow-up education and interaction with the patient/patient's representative be documented in the medical record by the individual designated to interact with the patient/patient's representative regarding their concerns surrounding Advance Directives.

In order to ensure that an opportunity for patient participation in medical decision-making is maximized, and that care provided is consistent with patient values and directives; educational information about advance directives will be provided periodically to staff.