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Board Policy 5162.1 - Do Not Resuscitate Orders

Board Policy 5162.1 - Do Not Resuscitate Orders

I. POLICY STATEMENT

The Board of Education of Prince George’s County (Board) recognizes students with life threatening health problems may attend Prince George’s County Public Schools (PGCPS) with valid Maryland Medical Orders for Life-Sustaining Treatment (MOLST) “Do Not Resuscitate orders.” The Board also recognizes that parents/guardians have the right to make decisions regarding health care measures for their children. To that end, implementation of the MOLST form in the school setting must be individually evaluated and addressed on a case-by-case basis.

II. PURPOSE

The purpose of this policy is to provide direction for the school system’s response to a MOLST form.

III. DEFINITIONS

  1. Do not resuscitate (DNR)’ – Means cardiopulmonary resuscitation (CPR) and other invasive medical procedures are not to be administered in the event of a life-threatening medical episode with an individual.
  2. Maryland Medical Orders for Life Sustaining Treatment (MOLST) – A form that includes medical orders for Emergency Medical Services (EMS) and other medical personnel regarding cardiopulmonary resuscitation and other life sustaining treatment options for a specific student. The form must be completed accurately and legibly, signed and dated by the physician, nurse practitioner (NP), or physician assistant (PA).
  3. School-based health professional – A nurse practitioner (“NP”), registered nurse (“RN”), or licensed practical nurse (“LPN”) who delivers care in a PGCPS setting.

IV. STANDARDS

  1. Schools shall accept and honor a MOLST form (DNR Order) that has been signed by a student’s treating physician, nurse practitioner or physician assistant. The MOLST form must be the State-approved form found in the Code of Maryland Regulations (COMAR) (10.01.21.03).
  2. The school-based health professional shall review the order.
  3. Upon receipt of a signed MOLST form, the designated school RN shall arrange a conference with the parent/guardian and appropriate school to outline expectations and procedures to follow. The plan must be memorialized in writing and placed in the student’s electronic health record along with a copy of the MOLST form.
  4. A specific list of who is to be informed of the MOLST form must be included in the written plan. The designated school RN is responsible for ensuring that all staff who are identified on the list, including transportation personnel, are informed of the order, receive a copy of the plan and are trained to follow the plan.
  5. A school transportation protocol should be developed which provides provisions for communication.
  6. Schools are to inform the Area Office and the Office of School Health that the school has received a MOLST form (DNR order).
  7. Student confidentiality must be maintained.
  8. The original or copy of the MOLST form shall be readily available and accompany the student at all times while in school so that it can be retrieved and given to Emergency Medical Services providers.
  9. If a student experiences cardiac or respiratory arrest while at school, the staff shall call 911 and ensure that the MOLST form accompanies the student.
  10. The principal/designee shall secure the assistance of the PGCPS crisis intervention team as soon as possible if the student dies in school or on the way to/from school. The crisis intervention team will provide assistance to the school administration, staff, and students to maximize healthy responses to the situation and facilitate returning the school to normal.
  11. The DNR order may be revoked at any time by the parent/guardian in writing.

V. IMPLEMENTATION RESPONSIBILITIES

The Chief Executive Officer is authorized to develop an administrative procedure consistent with this policy.

VI. REFERENCES

  1. Legal
    COMAR 10.01.21
    COMAR 13A.05.05.08-09
  2. Other Board Policies and Administrative Procedures
    Administrative Procedure 5162.1 (Maryland Medical Orders for Life-Sustaining Treatment (MOLST) (Formerly Known as Do Not Resuscitate)
  3. Relevant Data Sources
    79 Md. Op. Att’y Gen. 244 (1994)
    Maryland State School Health Services Guideline – Model Policy – Management of Do Not Resuscitate Orders in Maryland Schools (January 2006)
  4. Other

VII. HISTORY

Policy Adopted
8/24/95

Policy Amended
5/16/03

Policy Reviewed-No Revisions Required
11/9/04

Policy Reviewed-No Revisions Required
10/11/05

Policy Amended
4/29/10

Policy Amended
05/11/23

About This Policy

Updated May 11, 2023

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