Release from the West Virginia Center for End-of-Life Care:
MORGANTOWN, W.Va. – A new law that authorizes nurse practitioners to sign medical orders for end-of-life care is already having a significant impact on ensuring patients’ end-of-life treatment wishes are respected.
Since the passage of House Bill 4334, which became effective in June, nurse practitioners have submitted 14 percent of all the Physician Orders for Scope of Treatment (POST) forms sent to the West Virginia e-Directive Registry, according to Dr. Alvin H. Moss, director of the West Virginia Center for End-of-Life Care.
“This percentage is higher than other states such as Oregon, where nurse practitioners have been submitting POST forms to their state’s registry for the past 15 years,” Dr. Moss said. “It is a testament to the commitment of advanced practice registered nurses in West Virginia to serving and caring for their seriously ill patients.”
A study published this month in the Journal of Palliative Medicine by Oregon Health & Science University researchers examined the impact of allowing advanced practice registered nurses to complete POST forms. POST forms are recommended for seriously ill patients, those for whom their primary health care provider would not be surprised if they died within the next year. Most patients complete a POST form with a health care professional in the last two months of life.
The six-year Oregon study concluded that about 11 percent of the POST forms submitted between 2010 and 2015 in that state were completed by an advanced practice registered nurse. Nurse practitioners have been authorized to enter forms in the Oregon Registry since 2001.
“We have known for some time the vital role advanced practice registered nurses can play in their patients’ lives, especially in the rural areas of West Virginia,” Dr. Moss said. “By the state legislature granting nurse practitioners ‘this signatory authority,’ they are able to have advance care planning conversations and implement them with the completion of POST forms for their patients who are near the end of life.”
West Virginia is one of 16 states that allow advanced practice registered nurses (APRNs) to sign POST forms.
“As a faculty member at West Virginia University School of Nursing who educates nurse practitioner students, I am gratified with APRNs’ rapid assumption of this role,”” said Lori Constantine, DNP, APRN, FNP-BC. “It is extremely important to conduct these patient-centered conversations while patients are still well enough to have them so that we can know and respect their wishes for treatment at the end of life. Because of their relationships with their patients in which they serve as their primary care providers, APRNs are in an excellent position to advise their patients about their options knowing their patients’ values and preferences. HB 4334 has been a real improvement to patient care in West Virginia.”
Dr. Moss said that evidence promotes POST programs as a critical part of end-of-life care, and West Virginians should be proud that our state is a national leader in this important effort.
“We encourage all people over 18 to complete advance directives and submit them to the e-Directive Registry,” he said. “What this research shows is that people who are dealing with a potential end-of-life illness also should talk to their health care professional about filling out a POST form.”
The West Virginia Center for End-of-Life Care provides guidance to health care professionals and the general public about the importance of advance directives such as Living Wills and Medical Powers of Attorney and medical orders including West Virginia’s POST form. The center also maintains the e-Directive Registry, a secure database where medical professionals can access patients’ forms in a medical emergency to respect their wishes.
The West Virginia Center for End-of-Life Care receives funding from the West Virginia Department of Health and Human Resources. For more information, call 1-877-209-8086 or visit www.wvendoflife.org.
For more information, contact: Alvin Moss, director, 877-209-8086
