Finding, understanding, and acting on CPR orders: a communication analysis of POLST forms across 51 jurisdictions
- 1College of Public Health, University of Georgia, Athens, GA, United States
- 2Spelman College, Atlanta, GA, United States
- 3Georgia Department of Public Health, Epidemiology Division, Atlanta, GA, United States
Abstract
This descriptive communication analysis examines the cardiopulmonary resuscitation (CPR) section of physician/portable orders for life-sustaining treatment (POLST) forms across 51 U.S. Jurisdictions. It focuses on the printable version as encountered by a responder who must locate the CPR order, interpret the physiologic condition that activates it, and determine the authorized response. Printable POLST delivers medical orders on a single 8.5 by 11 inch page. Within this limited space, jurisdictions communicate these orders with slightly different strategies. This study applies a find-understand-act framework to characterize these tasks. Find assesses the visual characteristics of the CPR decision box. Understand examines the relationship between the physiologic trigger, the affirmative or negative treatment choice, and any interpretive burden created by cross-references or adjacent instructions. Act examines language directing response to CPR choice. The prominence of the CPR box and its textual density are two distinct characteristics. Forms anchored the CPR decision to a common physiologic state. However, trigger wording was not linguistically uniform. A yes-CPR response directed initiation of resuscitative actions. A no-CPR response was dominated by instructions not to initiate resuscitation. This option contained few words describing clinical care after a no CPR decision was implemented. This action-language gap is a communication boundary requiring further study. It also presents a challenge to the concept of portable medical orders. Our findings do not rank forms or establish a preferred design; rather, they describe how POLST forms make a time-sensitive CPR decision visible, interpretable, and actionable.
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BibTeX
@article{miles2026finding,
title = {{Finding, understanding, and acting on CPR orders: a communication analysis of POLST forms across 51 jurisdictions}},
author = {Toni P. Miles and Sydney Catron and Michenzi Brown and Antionette Lavender and Rana Bayakly},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1979970},
url = {https://doi.org/10.3389/fpubh.2026.1979970},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Finding, understanding, and acting on CPR orders: a communication analysis of POLST forms across 51 jurisdictions
AU - Toni P. Miles
AU - Sydney Catron
AU - Michenzi Brown
AU - Antionette Lavender
AU - Rana Bayakly
PY - 2026
DA - 2026/10/23
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1979970
UR - https://doi.org/10.3389/fpubh.2026.1979970
AB - This descriptive communication analysis examines the cardiopulmonary resuscitation (CPR) section of physician/portable orders for life-sustaining treatment (POLST) forms across 51 U.S. Jurisdictions. It focuses on the printable version as encountered by a responder who must locate the CPR order, interpret the physiologic condition that activates it, and determine the authorized response. Printable POLST delivers medical orders on a single 8.5 by 11 inch page. Within this limited space, jurisdictions communicate these orders with slightly different strategies. This study applies a find-understand-act framework to characterize these tasks. Find assesses the visual characteristics of the CPR decision box. Understand examines the relationship between the physiologic trigger, the affirmative or negative treatment choice, and any interpretive burden created by cross-references or adjacent instructions. Act examines language directing response to CPR choice. The prominence of the CPR box and its textual density are two distinct characteristics. Forms anchored the CPR decision to a common physiologic state. However, trigger wording was not linguistically uniform. A yes-CPR response directed initiation of resuscitative actions. A no-CPR response was dominated by instructions not to initiate resuscitation. This option contained few words describing clinical care after a no CPR decision was implemented. This action-language gap is a communication boundary requiring further study. It also presents a challenge to the concept of portable medical orders. Our findings do not rank forms or establish a preferred design; rather, they describe how POLST forms make a time-sensitive CPR decision visible, interpretable, and actionable.
SN - 2296-2565
ER -