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Patient/Family Refusal of Treatment-Policy

How does this agency's policy influence the professional nursing role?

Mercy San Juan Medical Center

Patient/Family Refusal of Treatment


To outline the process for handling patient/family refusal of scheduled treatments

The attending physician will be notified if a scheduled treatment is refused.
a. Physician may indicate, "Patient may refuse" when prescribing the treatment. In such cases, do not notify the at tending physician if patient refuses the treatment
b. PRN (as needed) medications
c. Medications held in accordance with parameters prescribed by the physician.
d. Medications self-managed by the patient (eg: Insulin pump)

1. Attempt to understand the reason why the patient/family is refusing the prescribed treatment.
Provide additional education or information about the treatment..
2. The staff member providing the scheduled treatment will notify the attending physician the
treatment was refused. Exception: If a laboratoryor radiology test is refused, laboratory
personnel will notify the nurse caring for the patient. The nurse will then notify the physician.
The staff member will contact the attending physician within a time frame that is reasonable for the treatment refused unless the licensed practitioner has, in their clinical judgment, deemed the situation to be urgent.
i. The attending physician is defined as the physician who ordered the treatment being refused. If the ordering physician is not available, notify the physician on-call for the ordering physician
ii. The physician of record for the day (the physician providing/supervising care) will be contacted if the ordering physician and on-call physician are not available. If the physician of record for the day is unavailable,
additional calls will follow the Chain of Command (Division Chief, Department Chairman, Chief of Staff).
iii. The staff member may refer to the attached script to guide their conversation with the physician. (see attachment 1)
3. Document medication refusal on the Medication Ad
ministration Record.
4. The staff member will complete the ad hoc "Refusal of Care" form in the electronic record and forward the completed form to the appropriate physician. (see attachment 2 for screen shot of the form)

1. Patient refers to the patient able to make his/her medical decisions
2. Family refers to the decision maker or legal representative for the patient

Solution Preview

This agency's policy influences the professional nursing role, due to the fact that it makes the nurse an instrumental healthcare practitioner in analyzing a situation in which a patient is refusing medical care, in order to ascertain the best methodology by which to help to address this problem effectively. The individual that is referred to in first observing that the patient is refusing their medication is referred to as the staff member that is providing the treatment within ...

Solution Summary

The expert examines patient and family refusal of treatment policies.