Living wills and advance directives are important components of patients' medical records, which all too often do not indicate the appropriate palliative care measures the patient desires. A review of the current literature indicates that approximately 85% to 95% of the population does not have adequate advance directives or palliative care measures written in their medical record. Furthermore, these orders may not follow the patient when he or she is transferred to other facilities for intermittent care. Unwanted tracheal intubations can be both costly to the facility and distressing to the patient and family members. By instituting a change in policy, organizations can ensure that patients' wishes for end-of-life care are met appropriately. In addition, nurses should advocate for a centralized database at the political level.
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