Intensive critical care nurses' with limited experience: Experiences of caring for an organ donor during the donation process

Background: Critical care nurses play an important role in the organ donation process, and their attitudes towards it and willingness to register as an organ donor are related to various factors, including empathy. Objective: This study aims to compare the attitudes of nurses in Intensive Care Unit (ICU), Emergency Department (ED), and Dialysis Unit (DU) towards organ donation and its relationship with empathy. Methods: This descriptive study with cross-sectional design that was conducted in 2019 in hospitals affiliated to Qazvin University of Medical Sciences in Qazvin, Iran on 222 nurses from the three critical care units who were selected by stratified random sampling method. Data collection tools were Chakradhar’s Organ Donation Questionnaire (ODQ) and Davis’s Interpersonal Reactivity Index (IRI), completed by nurses were completed. Data were analyzed by descriptive and analytical tests. Findings: The mean ODQ score was higher in DU and ICU nurses than in ED nurses (P=0.23), where the nurses of ICU-General had the highest score (51±6.07) and the nurses of ED-Trauma had the lowest score. The highest and lowest IRI scores were related to DU and ICU-General nurses, respectively. The total IRI score (r=0.13, P=0.04) and its dimensions of perspective taking ( r=0.152, P=0.02) and fantasy (r=0.14, P=0.03) had a positive correlation with the nurses’ attitudes. Conclusion: Critical care nurses have greater than the average score in ODQ. There is a significant relationship between empathy and their attitudes towards organ donation. Their empathy with patients has a significant effect on increasing their attitudes towards accepting organ donation. Therefore, it is necessary to implement educational interventions for changing the critical care nurses’ attitudes in order to increase their empathy.

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Readiness of critical care physicians and nurses to handle requests for organ donation

American Journal of Critical Care ◽

10.4037/ajcc1998.7.1.4 ◽

1998 ◽

Vol 7 (1) ◽

pp. 4-12 ◽

Cited By ~ 75

Author(s):

MJ Evanisko ◽

CL Beasley ◽

LE Brigham ◽

C Capossela ◽

GR Cosgrove ◽

...

Keyword(s):

Critical Care ◽

Brain Death ◽

Organ Donation ◽

The United States ◽

Critical Care Nurses ◽

Care Staff ◽

Factual Knowledge ◽

Donation Process ◽

Nurses And Physicians ◽

Effective Procedures

BACKGROUND: Critical care nurses and physicians usually care for those patients whose condition progresses to brain death and are also often responsible for requesting organ donation from the family of a brain-dead patient. We hypothesized that staff support, knowledge, and training levels would be significantly associated with organ donation rates. OBJECTIVE: To assess the readiness of critical care staff to successfully handle requests for organ donation. METHODS: A total of 1061 critical care staff from 28 hospitals in four separate regions of the United States completed a questionnaire that assessed (1) factual knowledge about organ donation, (2) understanding of brain death, (3) previous training in procedures for requesting donations, and (4) comfort levels with the donation process. RESULTS: Staff training in effective procedures for requesting organ donations was significantly correlated with hospitals' donation rates. Less than a third of respondents, however, had received training in explaining brain death to and requesting organ donation from a grieving family. In hospitals with high rates of organ donation, 52.9% of staff had received training; in hospitals with low rates of organ donation, 23.5% of staff had received training. Levels of factual knowledge about organ donation and brain death were unexpectedly low but were not significantly related to hospitals' rates of organ donation. CONCLUSIONS: Training of critical care nurses and physicians in effective procedures for requesting organ donation is significantly associated with higher rates of organ donation, yet two thirds of critical care staff report no relevant training. Consequently, critical care staff cannot be considered ready to effectively handle requests for organ donation.

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Families Experiencing a Traumatic Accident: Implications and Nursing Management

AACN Advanced Critical Care ◽

10.4037/15597768-1990-3007 ◽

1990 ◽

Vol 1 (3) ◽

pp. 522-534 ◽

Cited By ~ 2

Author(s):

Sandra R. Schlump-Urquhart

Keyword(s):

Critical Care ◽

Traumatic Event ◽

Critical Care Nurses ◽

Psychosocial Assessment ◽

Nursing Interventions ◽

Dysfunctional Families ◽

Psychosocial Needs ◽

Nursing Management ◽

Emotional Needs ◽

Limited Experience

Families experiencing a traumatic accident experience significant psychosocial disruption. The traumatic event is sudden and unexpected. Families have no opportunity to prepare themselves emotionally, have limited experience with such catastrophic events, and are overwhelmed by the magnitude of the patient’s injuries. Critical care nurses have an important role in the psychosocial assessment, support, and management of these families. Many critical care nurses are uncomfortable interacting with families with significant psychosocial/emotional needs due to a lack of understanding of their needs, lack of knowledge of how to manage their needs, lack of confidence in communicating with families, and generalized discomfort and awkwardness when confronted with grief and bereavement issues. This article presents important information for critical care nurses to help them understand and manage families psychosocial needs and to feel more confident interacting with these families. Information presented includes (1) impact of the traumatic event, (2) emotional responses, (3) assessment of psychosocial needs, and (4) nursing interventions for the care and management of these families. Special considerations impacting on families’ psychosocial needs, including dysfunctional families, ineffective coping mechanisms, suicide, and the patient’s death, are presented

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How nurses shift from care of a brain-injured patient to maintenance of a brain-dead organ donor

American Journal of Critical Care ◽

10.4037/ajcc2001.10.5.306 ◽

2001 ◽

Vol 10 (5) ◽

pp. 306-312 ◽

Cited By ~ 21

Author(s):

L Day

Keyword(s):

Critical Care ◽

Organ Procurement ◽

Injured Patient ◽

Organ Donor ◽

Critical Care Nurses ◽

Organ Donors ◽

Early Referral ◽

Brain Injured Patient ◽

Brain Injured ◽

Brain Dead

BACKGROUND: The responsibility of obtaining organs for transplantation rests partly on critical care nurses. How nurses balance care of critically ill, brain-injured patients with the professional responsibility to procure organs is a question of ethical and clinical importance. OBJECTIVES: To describe the experiences of critical care nurses in making the shift from caring for a brain-injured patient identified as a potential organ donor to maintaining a brain-dead body. METHODS: An interpretive, phenomenological design was used. In 2 trauma centers, 9 critical care nurses were interviewed, and 2 of the 9 nurses were observed. RESULTS: Identification of potential organ donors is made under conditions of prognostic ambiguity. The transition from brain injury to brain death is a period of instability in which the critical care team must decide quickly whether to resuscitate a patient in order to procure organs. After a patient is brain dead, critical care nurses' relationship with and responsibility toward the patient change. CONCLUSIONS: The process of identifying potential organ donors and holding open the tentative possibility of organ procurement illustrates the practical difficulties of early referral of potential donors to organ procurement organizations. Early referral to an organ procurement organization implies a commitment to organ procurement that some nurses may hesitate to make because such a commitment changes their relationship with a brain-injured patient.

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The view from the front line – issues faced by critical care nurses throughout the donation process

Australian Critical Care ◽

10.1016/s1036-7314(99)70525-4 ◽

1999 ◽

Vol 12 (1) ◽

pp. 36

Author(s):

S. Oliver ◽

J. Gillott

Keyword(s):

Critical Care ◽

Critical Care Nurses ◽

Front Line ◽

Donation Process

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Organ donation and the rural critical care nurse

American Journal of Critical Care ◽

10.4037/ajcc1994.3.6.473 ◽

1994 ◽

Vol 3 (6) ◽

pp. 473-475 ◽

Cited By ~ 10

Author(s):

LK McCoy ◽

SK Bell

Keyword(s):

Critical Care ◽

Organ Donation ◽

Positive Attitude ◽

Organ Procurement ◽

Medical Center ◽

Organ Donor ◽

Critical Care Nurses ◽

Urban Setting ◽

Organ Donors ◽

Knowledge And Attitudes

BACKGROUND. Less than 20% of people who meet the criteria for organ donors are estimated to donate organs. OBJECTIVE. To examine the knowledge and attitudes of rural critical care nurses regarding organ donation. METHODS. Forty-six critical care nurses from a southwestern medical center provided data for this study. Self-reported knowledge and attitudes were measured using the Organ Donor Attitude Questionnaire and compared with respondents' demographic characteristics. RESULTS. Knowledge scores were found to be average (74% correct). Attitude scores reflected a strongly positive attitude toward organ donation. Increased knowledge of organ donation was not found to be related to a positive attitude. However, both attitude and knowledge were found to be positively correlated with previous experience in caring for either organ donors or recipients. Results were compared with data collected in an urban setting and found to be similar. CONCLUSIONS. Results of this study indicate that exposure to patients affected by organ procurement increased knowledge and improved attitudes of the nurses who provided care. Increased knowledge and positive attitude are important when providing support to families and caring for potential donors. These factors could increase the supply of donors for transplants, which is a goal of the organ procurement process.

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Adverse Events Reporting System as Experienced by Critical-Care Nurses in KwaZulu-Natal, South Africa

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/2456 ◽

2018 ◽

Vol 20 (1) ◽

Author(s):

Thusile Mabel Gqaleni ◽

Busisiwe Rosemary Bhengu

Keyword(s):

South Africa ◽

Critical Care ◽

Adverse Events ◽

Patient Care ◽

Family Involvement ◽

Reporting System ◽

Legal Framework ◽

Critical Care Nurses ◽

Kwazulu Natal ◽

Life Threatening

Critically ill patients admitted to critical-care units (CCUs) might have life-threatening or potentially life-threatening problems. Adverse events (AEs) occur frequently in CCUs, resulting in compromised quality of patient care. This study explores the experiences of critical-care nurses (CCNs) in relation to how the reported AEs were analysed and handled in CCUs. The study was conducted in the CCUs of five purposively selected hospitals in KwaZulu-Natal, South Africa. A descriptive qualitative design was used to obtain data through in-depth interviews from a purposive sample of five unit managers working in the CCUs to provide a deeper meaning of their experiences. This study was a part of a bigger study using a mixed-methods approach. The recorded qualitative data were analysed using Tesch’s content analysis. The main categories of information that emerged during the data analysis were (i) the existence of an AE reporting system, (ii) the occurrence of AEs, (iii) the promotion of and barriers to AE reporting, and (iv) the handling of AEs. The findings demonstrated that there were major gaps that affected the maximum utilisation of the reporting system. In addition, even though the system existed in other institutions, it was not utilised at all, hence affecting quality patient care. The following are recommended: (1) a non-punitive and non-confrontational system should be promoted, and (2) an organisational culture should be encouraged where support structures are formed within institutions, which consist of a legal framework, patient and family involvement, effective AE feedback, and education and training of staff.

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