1 Medical Orders for Scope of Treatment:

The Medical Orders for Scope of Treatment (MOST) document is a standardized form that patients can use to designate treatment preferences which can be used as medical orders across healthcare facilities. The form must be completed by both the patient (or his or her authorized representative) and the physician, nurse practitioner or physician assistant. The MOST form includes care preferences in regards to cardio-pulmonary resuscitation, antibiotics, intravenous fluids, and feeding tubes, including scope of care (full care, limited care, comfort measures only). These types of care preferences may be of particular use in nursing home settings. Studies have shown that the patients ’ preferences are more likely to be honored with use of similar forms. 1,2 Despite generally high support of the MOST form by health professionals, there has been some concern regarding time, complexity, literacy level, and need for annual update. Nursing homes in NC are thought to have excellent compliance with documenting advanced care directives, but the type of process used by most nursing homes in NC is widely varied. In addition, we have no knowledge of the use of the MOST form in North Carolina, how it i