Purpose | Principles | How to Care for a Patient in Pain | Nutrition
Nausea and Vomiting | Constipation | Anxiety and Depression | Dyspnea
Fatigue | End-of-Life Decision-Making | Community Resources
How to Refer Patients | Communication | Links and References
Setting and Implementing Goals for Care
-
Identify patient and family preferences
-
Consider an evidence-based prognosis
-
Uses the goals for care to develop a management plan
| Goal |
Use |
Code Level |
| Life prolongation |
All measures including ICU procedures without exception |
Code I |
| Maintenance of physical function, cognitive function |
All medically indicated procedures physical appropriate to an individual's needs |
Code I or
Code II |
| Palliation |
Relief of symptoms, substitution of medical treatment for surgery where possible |
Code II |
| Comfort |
Focus on symptom management |
Code III |
Missouri Baptist Medical Center Inpatient Code Level Definitions
Code I -- All appropriate diagnostic tests, therapeutic measures and nursing care, including resuscitation.
Code II -- All appropriate diagnostic tests, therapeutic measures and nursing care without resuscitative measures; no CPR, defibrillation, intubation, ventilation. Consider limiting other measures.
Code III -- Comfort measures only. No diagnostic or therapeutic measures are given except aggressive pain and symptom management. Implementation of Code III order set.
Communicating Patient's Wishes -- Advance Directives
Three documents are available to assert a person's choice for health-care treatment, especially when a person lacks the capacity to make his or her own health-care decisions. Consult a social worker for questions or assistance regarding advance directives.
Living Will -- General statement concerning withholding and withdrawing medical treatment when a person is diagnosed as terminally ill.
Health-Care Directive -- A more specific statement of choices about withholding and withdrawing medical treatments such as CPR, ventilation, surgery, antibiotics, and artificial nutrition and hydration.
Durable Power of Attorney for Health Care -- Designation of an agent who will make health-care decisions if the person is incapacitated and unable to make his or her own decisions.
Cancer Education & Information Center | 3015 N. Ballas Road | St. Louis, Missouri 63131 USA | 314.996.5800