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Implementing minimum notification criteria for organ donation in an acute hospital's critical care units
1Donor Transplant Co-ordinator - North West Region, Specialist Nurse - Donor Care. Greg.Bleakley@nhsbt.nhs.uk
Aims And Objectives:
To increase the number of donated organs through an effective donor identification and referral scheme in a large acute hospital's critical care units.
Background:
The barrier to successful organ transplantation is a serious shortage of donated organs. In January 2008, the Department of Health officially endorsed all 14 recommendations presented by the Organ Donation Taskforce. Recommendation 5 from the Taskforce is that minimum notification criteria for potential organ donation should be introduced on a UK-wide basis.
Design:
A hospital policy entitled Required Referral was implemented into a large hospital trust consisting of four critical care units. Support from the trust board was sought and it was agreed that the policy would be implemented as a 'pilot policy' in the first instance, then a formal review after a 6-month period. A rolling education programme was instituted to incorporate 170 clinical staff to ensure the policy was activated with the following criteria: If the plan is to perform brain stem death tests on a patient or a clinical decision is made to withdraw treatment, the on-call donor transplant co-ordinator is contacted for an assessment of suitability.
Results:
A significant increase in potential donor referrals and a 200% increase in donated organs has been achieved with the policy in place. A retrospective audit for the 6-month period prior to the policy launch had shown four referrals from the pilot sites. The following 12 months as the policy was implemented revealed an impressive 121 referrals to the transplant co-ordinator. This has resulted in nine successful multi-organ donors.
Conclusion:
The required referral scheme has clearly shown an impressive increase in donation activity within the trust. Donation has been embraced as a normal part of end of life care.
Insights
Implementing a required referral scheme significantly increased organ donor referrals and achieved a 200% rise in donated organs. This policy integrated organ donation into end-of-life care protocols within critical care units.
Area of Science:
- Medical Science
- Transplantation Medicine
- Critical Care Medicine
Background:
- The critical shortage of donated organs presents a significant barrier to successful organ transplantation worldwide.
- The UK Department of Health endorsed recommendations for organ donation, including establishing minimum notification criteria for potential donors.
- Effective donor identification and referral schemes are crucial for increasing organ availability.
Purpose of the Study:
- To evaluate the impact of a 'Required Referral' policy on organ donor identification and referral rates.
- To increase the number of donated organs from critical care units within a large acute hospital trust.
- To integrate organ donation as a routine aspect of end-of-life care.
Main Methods:
- Implementation of a 'Required Referral' policy across four critical care units in a large hospital trust.
- A 6-month pilot phase followed by a formal review period.
- Mandatory contact with the on-call donor transplant coordinator for patients undergoing brain stem death testing or treatment withdrawal.
Main Results:
- A substantial increase in potential donor referrals, from four in the 6 months prior to the policy to 121 in the subsequent 12 months.
- A 200% increase in the number of donated organs.
- Nine successful multi-organ donors were identified through the scheme.
Conclusions:
- The 'Required Referral' scheme effectively boosted organ donation activity within the hospital trust.
- The policy facilitated the integration of organ donation into standard end-of-life care practices.
- This approach demonstrates a successful strategy for increasing organ donor referrals and subsequent organ procurement.
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