ORGAN DONATION…And what it means for the RN

A Few Stats

Currently, the number of names on the UNOS National Organ Transplant Waiting List exceeds 110,000.

Nationally, 18 people die each day awaiting a transplant. A new name is added to the list every 13 minutes.

One donor can save up to 8 lives and improve the lives of up to 50 others

Transplantable Organs

Transplantable Tissues

Critical Care Implications

Nearly 70% of the 13,500 patients experiencing brain death (annually and nationwide) are suitable candidates for organ and tissue transplantation

In almost 90% of instances, only patients experiencing brain death may donate organs

The Bottom Line

January – November 2005: Organ transplantations totaled 19,621 while 91,000 remained on the waiting list

2002: Of the 14,000 potential donors, only 6,671 became actual donors

Only 2 organ procurements have taken place at MMC in the last decade

Shortage Culprits

Knowledge and attitudes of health professionals

Processes for donor IdentificationTiming of request for organ donationRefusal of family members to Consent to

donationCultural considerations

Saving Lives Takes Many Forms

Sooooo……

How can the role of the Registered Nurse help to

alleviate the organ transplant shortage?

Educate: Yourself And Your Colleagues

Become knowledgeable about organ donation, procurement, and hospital policy and procedure

Initiate conversation about and advocate for EBP on your unit

Update or edit policy and procedureInitiate in-service training for your unit

with the local Organ Procurement Organization (OPO)

Be Gracefully Assertive, not aggressive

Assess, Assess, Assess! Then…

ICP

GCS

Posturing

Prognosis

Inoperable?

Do not consider: age, tox screen, disease history, ethnicity, socioeconomic status

ACT!!!

ER and ICU nurses are in a prime position

Suspect a good candidate for donorship?

Contact your local OPO or donor network ASAP

Let them take the reigns and continue highest standard of care for your patient

Keep Assessing!!!!!!!!!

Brain stem functions are absent when there is no response to the following:◦Pupillary light reflex (PERRLA)◦Corneal reflex (cotton swab)◦Oculocephalic (dolls eyes)◦Oculovestibular (cold caloric test)◦Oropharyngeal (gag and cough)◦Respiratory (may require apnea test)

Change in Baseline? REPORT IMMEDIATELY

Ethical Considerations

Autonomy- respect family decisionmaking

Beneficence-patient is still a whole person

Maleficence-no place for negligence

Veracity-family deserves only truth (within the RN scope of practice)

Justice- Standards of Care are upheld

After Consent to Donorship

Who is your primary patient now?

Debrief yourself

Be a change agent: “after-action” review◦Focus on systems◦Discuss process and outcomes

Know you helped to save and improve human lives

Resources

Earle, B. (2012). Determination of brain death. Sutter Health Memorial Medical Center Interdisciplinary Policy and Procedure Manual

California Transplant Donor Network. (2013). Current data and basics in California. Retrieved from http://www.ctdn.org/current-data-basics-in-ca.html

New York State Nurses Association (NYSNA). (2004). Role of the registered professional nurse in organ and tissue donation. Retrieved from http://www.nysna.org/practice/positions/position10_04.htm

Tamburri, L. (2006). The role of critical care nurses in the organ donation breakthrough collaborative. Critical Care Nurse, 26, 20-23 retrieved from http://ccn.aacnjournals.org/content/26/2/20.full.pdf+html