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What Is the Patient Self-Determination Act

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What is the Patient Self-Determination Act (PSDA)

This amendment to the Omnibus Budget Reconciliation Act of 1990 required that health care provider to provide adult individuals, at the time of inpatient admission or enrolment, certain information about his or hers rights under state laws governing advance directives. This act also included the following rights for the patients: 1) He or she can participate in and direct his or hers health care decisions; 2) He or she may refuse treatment relating to medical procedures, treatment of ailments or surgical procedure; 3) He or she has the option to prepare an advance directive or provide one to the healthcare system; 4) Information on the provider's policies that govern the utilization of these rights. Discriminating against patients whom do not want an advance directive was included in the act. The PSDA further requires institutions to document patient information and provide ongoing community education on advance directives (Scension Concepts, 2009) .

Effect of the Patient Self-Determination Act on health care delivery

The effect that PSDA has on the quality of care delivered has put the patient in control of his or hers life concerning advance directives. Patients may direct certain procedures to be executed depending on a given circumstance. Nurses and doctors who are the primary caregivers of patients should be familiar with the state law govern advance directive. This will allow the nurse or doctor proper legal coverage if an advance directive needs to be executed (Nursing World, 1991) .

Record management and PSDA

Record management has become a critical piece of ensuring that advance directives are carried out correct. If the directive is not recorded in the Patient Health Information (PHI) record it will not be executed. It is critical that upon admitted as an inpatient or outpatient that he or she is informed of his or hers options so it may be recorded and reviewed by the individual.


Nursing World. (1991, November 18). Position Statement: Nursing and the Patient Self-Determination Acts - 11/18/91. Retrieved from

Scension Concepts. (2009, Fall). Patient



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