What is a Do Not Hospitalize (DNH) order?
A Do Not Hospitalize (DNH) order is a medical directive that instructs healthcare providers not to transfer a patient to a hospital for treatment. This order is typically put in place for patients who have chronic or terminal illnesses and wish to receive care in a non-hospital setting, such as a nursing home or hospice facility. The DNH order is intended to honor the patient’s wishes and provide them with comfort-focused care in their preferred environment.
Who can request a Do Not Hospitalize (DNH) order?
A Do Not Hospitalize (DNH) order can be requested by the patient themselves, their designated healthcare proxy, or their legal guardian. In some cases, a healthcare provider may also recommend a DNH order based on the patient’s medical condition and preferences. It is important for the patient and their healthcare team to have open and honest discussions about the patient’s goals of care and treatment preferences before implementing a DNH order.
When is a Do Not Hospitalize (DNH) order appropriate?
A Do Not Hospitalize (DNH) order is appropriate for patients who have chronic or terminal illnesses and wish to avoid unnecessary hospitalizations. This may include patients who are in the advanced stages of diseases such as cancer, dementia, or heart failure, and who prefer to receive care in a non-hospital setting. Patients who have a high risk of complications or adverse events from hospitalization may also benefit from a DNH order.
How is a Do Not Hospitalize (DNH) order different from a Do Not Resuscitate (DNR) order?
A Do Not Hospitalize (DNH) order and a Do Not Resuscitate (DNR) order are both medical directives that outline a patient’s treatment preferences, but they serve different purposes. A DNR order instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest, while a DNH order specifies that the patient should not be transferred to a hospital for treatment. While a DNR order focuses on end-of-life care decisions, a DNH order is more about the patient’s overall care preferences and quality of life.
What are the benefits of having a Do Not Hospitalize (DNH) order in place?
Having a Do Not Hospitalize (DNH) order in place can provide several benefits for patients with chronic or terminal illnesses. Firstly, it allows patients to receive care in a familiar and comfortable environment, such as their own home or a hospice facility, which can improve their quality of life. Additionally, a DNH order can help prevent unnecessary hospitalizations, which can be stressful, disruptive, and costly for patients and their families. By honoring the patient’s wishes and focusing on comfort care, a DNH order can help improve the patient’s overall well-being and satisfaction with their care.
How can a Do Not Hospitalize (DNH) order be revoked or changed?
A Do Not Hospitalize (DNH) order can be revoked or changed at any time by the patient or their designated healthcare proxy. If the patient’s medical condition changes or if their treatment preferences evolve, they can discuss their wishes with their healthcare team and update their DNH order accordingly. It is important for patients to communicate openly with their healthcare providers and loved ones about their care preferences and goals to ensure that their wishes are respected and followed. Additionally, healthcare providers should regularly review and reassess the patient’s DNH order to ensure that it aligns with their current medical status and preferences.