How to Obtain a Minnesota Do Not Resuscitate Form

In Minnesota, a Do Not Resuscitate (DNR) form is a medical order that guides emergency responders and healthcare providers about handling life-sustaining measures. It is essential for individuals who want to outline preferences regarding CPR and other resuscitation efforts. This article explains how to obtain a Minnesota DNR form, what it includes, and practical steps to ensure it is honored across care settings.

What Is A Minnesota DNR Form

The Minnesota DNR form is a medical order issued by a licensed clinician that directs healthcare professionals not to perform cardiopulmonary resuscitation (CPR) or other life-sustaining interventions in the event of cardiac or respiratory arrest. The order is designed to be actionable in medical settings and should accompany a patient’s medical records. In Minnesota, DNR decisions are integrated with broader advance care planning, including POLST (Physician Orders for Life-Sustaining Treatment) options for seriously ill patients.

Who Can Request One

A DNR order can be requested by a patient who has decision-making capacity, or by a legally authorized surrogate if the patient lacks capacity. A clinician—such as a physician, advanced practice clinician, or nurse—must assess the patient’s goals of care, discuss risks and benefits, and determine whether a DNR order aligns with the patient’s wishes and medical circumstances. Nursing home residents, hospital inpatients, and individuals in home-based care can all request or have a DNR order placed as part of their care plan.

Steps To Obtain The Minnesota DNR Form

Follow these steps to obtain an enforceable Minnesota DNR form:

• Discuss With a Clinician: Have an open conversation about goals of care, prognosis, and the specific preferences regarding resuscitation and other life-sustaining treatments.
• Evaluate Alternatives: Consider POLST or other advance directives that address preferred levels of treatment in different situations.
• Complete The Medical Order: When appropriate, the clinician documents the DNR decision on the state-approved form or equivalent medical order. The form must clearly indicate the do-not-resuscitate status and the patient’s or surrogate’s consent.
• Signatures And Dates: Ensure the form contains the signature, title, and contact information of the authorizing clinician, along with the patient’s or surrogate’s signature and date.
• Distribute Copies: Provide copies to the patient, designated healthcare agents, primary care provider, and develop a plan to share the order with all care settings (hospitals, EMS, nursing facilities, home health, and pharmacies).

Where To Access The Form

Access is available through several reliable channels in Minnesota:

• Healthcare Providers: Hospitals, clinics, and primary care offices can supply the official DNR form and assist with completion.
• State Resources: Minnesota Department of Health (MDH) and state health portals offer information and approved forms or links to electronic medical orders.
• Hospice And Palliative Care Programs: These programs routinely guide patients through DNR decisions and provide the necessary forms.
• EMS And Home Health Agencies: Some EMS agencies and home health services require a valid DNR order to honor resuscitation preferences outside hospital walls.

What Information The Form Typically Includes

A Minnesota DNR form should clearly communicate the patient’s resuscitation preferences and be easy for health professionals to interpret in an emergency. Common elements include:

• The patient’s name, date of birth, and contact information.
• The explicit do-not-resuscitate directive for CPR and defibrillation, and any exceptions (e.g., during certain procedures).
• The authorizing clinician’s name, professional designation, and contact details.
• Dates of authorization and any revocation instructions if applicable.
• Information about whether the order is part of a broader POLST or advance directive.
• Signatures of the patient or surrogate and the clinician, with dates.

Carrying And Recognizing The DNR Across Care Settings

To ensure the DNR order is honored in all care settings, consider these practices:

• Carry Copies: Keep a physical copy in the patient’s wallet or cardholder and ensure it is accessible to emergency responders and facilities.
• Share Digitally: If the facility uses electronic health records (EHRs), ensure the DNR order is properly uploaded and flagged for rapid access.
• Inform Key Contacts: Notify primary care physicians, hospice providers, and family members about the DNR status and its location.
• EMS Preparedness: Confirm EMS agencies in the patient’s area recognize Minnesota DNR orders and understand how to verify the order during emergencies.

Legal Considerations And Revocation

A Minnesota DNR form is a medical order that can be revoked or amended by the patient if capacity is present, or by a legally authorized surrogate as appropriate. Documentation of revocation should be clear and communicated to all involved care providers. In cases of cognitive decline or changing health status, periodic reviews with a clinician are recommended to ensure the DNR aligns with current wishes and medical realities.

POLST As An Alternative Or Complement

For individuals with serious, life-limiting illness, the POLST program provides portable orders that specify desired levels of medical intervention across multiple scenarios. In Minnesota, POLST forms often complement DNR orders by detailing resuscitation preferences as well as decisions about intubation, mechanical ventilation, and artificial nutrition. Discussing POLST with a clinician can create a cohesive plan that travels with the patient across care settings.

Practical Tips To Ensure The Form Is Honored

• Review Regularly: Revisit preferences during major health changes or annual care planning.
• Keep It Clear: Use plain language to minimize misinterpretation in an urgent situation.
• Educate Caregivers: Ensure family members and caregivers understand the DNR and respect it in daily care.
• Clarify Data Sharing: Confirm who can access the form in emergencies and how updates are shared.

Obtaining and maintaining a Minnesota DNR form is a proactive step in aligning medical care with personal values. By engaging with a clinician, understanding the interface with POLST, and ensuring proper documentation and accessibility, individuals can ensure their resuscitation preferences are respected across settings.