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The Medical Orders for Scope of Treatment (MOST) form is a document to record individual current GoC [8] specific to person wishes, choices and preferences for healthcare and guide decision-making in the event of a change of condition that requires decision-making about intervention [9, 10].
The MOST form needs to be completed by both the patient and his/her doctor, advanced practice nurse or physician assistant. The MOST form is a doctor's order regarding end-of-life care.
The primary differences between the MOLST form and a DNR are: MOLST covers a variety of end-of-life treatments. A DNR only gives instructions about CPR. The MOLST form can also be used in a community setting where the DNR is intended to be used as a directive in a hospital setting.
MOST is a medical order and must be reviewed and signed by a licensed physician (MD/DO), physician assistant, or nurse practitioner to be valid. Be sure to document the basis for the order in the progress notes of the medical record. Mode of communication (e.g., in person, by telephone, etc.) also should be documented.
The MOST or POLST, like the DNR, indicates if they do or don't want CPR, but it also specifies what type of life-prolonging medical interventions they'd want on top of comfort care, if any; under what circumstances they would want to be moved to a hospital and whether they want a feeding tube and if so, for how long.