MOLST Checklist
MOLST Checklist
General Items
- Educate staff on the importance and use of the MOLST form
- Ensure compliance with state regulations regarding MOLST forms
- Provide resources for patients and families about MOLST options
Patient Identification
- Verify patient identity with two identifiers
- Confirm the patient's current health status and prognosis
- Assess patient decision-making capacity
MOLST Form Completion
- Ensure the MOLST form is completed by a qualified medical professional
- Discuss treatment options with the patient and/or surrogate decision-maker
- Document patient's preferences clearly in the MOLST form
MOLST Form Review
- Review the MOLST form with the patient and family members
- Ensure all sections of the form are filled out correctly
- Check for signatures of the patient or surrogate and the physician
Implementation and Communication
- Ensure copies of the MOLST form are provided to the patient and family
- Distribute copies to all relevant healthcare providers
- Post the MOLST form in the patient's medical record
Regular Review and Update
- Schedule regular reviews of the MOLST form as patient's condition changes
- Update the MOLST form as necessary with the patient’s consent
- Communicate any changes to all healthcare providers involved
Generated from Panda Checklist
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