Section 70. Issuance of a Durable DNR Order

Part IV. Implementation Procedures

A. A Durable DNR Order may be issued to a patient by a physician, with whom the patient has established a bona fide physician/patient relationship, as defined by the Board of Medicine in their current guidelines, only with the consent of the patient or, if the patient is a minor or is otherwise incapable of making an informed decision regarding consent for such an order, upon the request of and with the consent of the person authorized to consent on the patient's behalf.

B. The use of the authorized Durable DNR Order Form is encouraged to provide uniformity throughout the health care continuum.

C. The authorized Durable DNR Order can be honored by qualified health care personnel in any setting.

D. Qualified health care personnel are authorized to honor only a Durable DNR Order on an authorized form or Alternate DNR jewelry, except as provided in 12VAC5-66-60 of these regulations.

E. Prior to issuing a Durable DNR Order, the physician shall explain to the patient or the person authorized to consent on the patient's behalf, the alternatives available for response in the event of cardiac or respiratory arrest. If the option of a Durable DNR Order is agreed upon, the physician shall have the following responsibilities:

1. Explain the circumstances under which qualified health care personnel may follow a Durable DNR Order.

2. Explain how to and who may revoke the Durable DNR Order.

3. Document the patient's full legal name.

4. Document the execution date of the Durable DNR Order.

5. Obtain the signature of the patient or the person authorized to consent on the patient's behalf on all three forms: the patient's copy, medical record copy, and the copy used for obtaining Alternate DNR jewelry.

6. Make sure that the issuing physician's name is clearly printed and the form is signed.

7. Record the contact telephone number for the issuing physician.

8. Issue the original Durable DNR Order Form, and the patient and Alternate DNR jewelry copies to the patient and maintain the medical record copy in the patient's medical file.

F. The person to whom a Durable DNR Order applies or the person authorized to consent on the patient's behalf must present the following information to the approved vendor in order to purchase and be issued an approved Alternate Durable DNR necklace or bracelet. The necklace or bracelet must contain the following information:

1. The following words: Do Not Resuscitate;

2. The patient's full legal name;

3. The physician's name and phone number; and

4. The Virginia Durable DNR issuance date.

Historical Notes

Derived from Volume 18, Issue 12, eff. March 27, 2002, amended, Virginia Register Volume 27, Issue 21, eff. July 20, 2011.

Statutory Authority

§§ 32.1-12 and 32.1-111.4 of the Code of Virginia.