Get Mc 3834 (10/95)--front Vanderbilt University Medical Center Code Status Progress Note (insert In

The MC 3834 (10/95) form is an essential document used by Vanderbilt University Medical Center to outline a patient's code status. This guide provides clear, step-by-step instructions for completing the form accurately and effectively.

Follow the steps to complete the code status progress note effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Review the code status section at the top of the form. Choose one option that applies to the patient: 'Do not resuscitate', 'Do not intubate', or 'Limited cardiopulmonary resuscitation'. Ensure you check the appropriate boxes relevant to the patient's wishes.
3. In the next section, document the patient's diagnosis clearly in the space provided. Ensure that it is legible and reflects the current condition accurately.
4. Provide a detailed prognosis along with the basis for that prognosis. This is crucial to understanding the patient's health status and future assessments.
5. Indicate the patient’s decision-making capacity by marking either 'Present', 'Absent', or 'Variable'. This is important for understanding the patient's ability to make informed decisions about their care.
6. If the patient’s decision-making capacity is absent or variable, explain the reasons in the designated area to provide further clarity.
7. Select the reasons for the Do Not Resuscitate (DNR), Do Not Intubate (DNI), or Limited Cardiopulmonary Resuscitation (LCPR) order. Check all that apply and, if necessary, specify additional details.
8. Document who has been involved in discussions about the code status. Check all relevant parties including family, nursing staff, and consulting physicians.
9. Identify who performed the discussion of code status. This includes selecting all applicable roles such as the patient, attending physician, or nursing staff.
10. Detail any treatments goals and explain them in the designated section to align care goals properly with the patient's wishes.
11. Provide a summary statement or any additional comments to clarify the patient's situation and care preferences.
12. Finally, ensure that the attending physician completes their signature, along with the date and time of the completion. This is vital for the document's validity.
13. Once completed, you can save changes, download the form, print it, or share it as needed.

Complete the code status progress note online to ensure clarity and compliance with patient wishes.