16 Del. Admin. Code § 4304-2.0

Current through Register Vol. 28, No. 7, January 1, 2025

Section 4304-2.0 - Form Description

2.1 The DMOST form, including instructions for completion and plain language explanation, is published in these regulations. The DHSS documents in these regulations may not be altered.

2.1.1 The patient's identification block has the patient's name (last, first, middle), patient's address of record, patient's phone number, patient's gender, patient's date of birth, and last four digits of the patient's social security number.

2.1.2 The Scope of Treatment sections are Blocks A to D.

2.1.2.1 Section A contains the goals of care. This section is for the patient to draft a goal statement relative to their current treatment plan. This section does not constitute a medical order.

2.1.2.2 Section B contains Cardiopulmonary Resuscitation decision (when the patient has no pulse and/or is not breathing). This section constitutes a medical order.

2.1.2.3 Section C contains Medical Interventions (when patient is breathing and/or has a pulse). This section has four categories to be answered. This section constitutes a medical order.

2.1.2.3.1 Treatment of symptoms only/Comfort Measures Only. Use any medications, including pain medication, by any route, positioning, wound care, and other measures to keep clean, warm, dry, and comfortable. Use of oxygen, oral suctioning and manual treatment of airway obstruction as needed for comfort. Use antibiotics only to promote comfort. Transfer if comfort needs cannot be met in current location.

2.1.2.3.2 Limited Treatment. Includes care described above, and use appropriate medical treatment such as antibiotics and IV fluids, and cardiac monitoring as indicated. Do not use intubation or mechanical ventilations. May use non-invasive airway support that does not require the introduction of instruments into the body [e.g. CPAP, BIPAP] however if clearing the airway with manual techniques is unsuccessful, direct laryngoscopy and the use of Magill Forceps may be used. Generally avoid intensive care and transfer to hospital if ordered for medical interventions or if ordered because comfort needs cannot be met in current location.

2.1.2.3.3 Full Treatment. Includes care described above, and use all appropriate medical and surgical interventions, including intubation, advanced airway interventions, mechanical ventilation, and cardioversion, in an intensive care setting if indicated to support life. Transfer to a hospital, if indicated, including intensive care.

2.1.2.3.4 Other orders. Provide the care stated.

2.1.2.4 Section D contains the blocks to determine the desire for the artificially administered fluids and nutrition.

2.1.2.5 Section E contains information as to whom the DMOST form was discussed with and it contains a signature block where the patient, if they have decision-making capacity, can prohibit an authorized representative from voiding the DMOST form and executing a new DMOST form that changes the treatment choices if the patient loses decision-making capacity.

2.1.3 The Signature. Section F contains the signature areas for the patient/authorized representative/parent and the health care practitioner. To be valid the form must have both required signatures.

16 Del. Admin. Code § 4304-2.0

19 DE Reg. 922(4/1/2016)
21 DE Reg. 233( 9/1/2017) (Final)