The Impact of a Comprehensive, Hospital-Focused Intervention to Increase Organ Donation

1997 ◽  
Vol 7 (1) ◽  
pp. 6-13 ◽  
Author(s):  
Carol L Beasley ◽  
Carie Lynn Capossela ◽  
Lori E Brigham ◽  
Susan Gunderson ◽  
Phyllis Weber ◽  
...  

In this article the results of a 2-year intervention designed to increase rates of organ donation while improving services to bereaved families of potential donors are described. The project focused on improving key elements of the organ donation process. The intervention was implemented in 50 hospitals within the service areas of three organ procurement organizations. Results show an increase in identification, referral, and asking rates. The overall donation rate increased significantly, from 33% to 43%. However, consent rates remained unchanged. Future efforts should focus on improving the request process by systematically incorporating practices that are associated with higher consent rates. This should enable hospital and organ procurement organization staff to appropriately and effectively offer families the option of organ donation; further increases in organ donation should follow.

2017 ◽  
Vol 25 (8) ◽  
pp. 1041-1050
Author(s):  
Marcelo José dos Santos ◽  
Lydia Feito

Background: The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. Objective: This study aims to analyze the family interview process with a focus on principlist bioethics. Method: This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: “Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family to donate or not.” For the treatment of qualitative data, we chose the method of content analysis and categorical thematic analysis. Participants: The study involved 18 nurses who worked in three municipal organ procurement organizations in São Paulo, Brazil, and who conducted family interviews for organ donation. Ethical considerations: The data were collected after approval of the study by the Research Ethics Committee of the School of Nursing of the University of São Paulo. Results: The results were classified into four categories and three subcategories. The categories are the principles adopted by principlist bioethics. Discussion: The principles of autonomy, beneficence, non-maleficence, and justice permeate the family interview and reveal their importance in the organs and tissues donation process for transplantation. Conclusion: The analysis of family interviews for the donation of organs and tissues for transplantation with a focus on principlist bioethics indicates that the process involves many ethical considerations. The elucidation of these aspects contributes to the discussion, training, and improvement of professionals, whether nurses or not, who work in organ procurement organizations and can improve the curriculum of existing training programs for transplant coordinators who pursue ethics in donation and transplantation as their foundation.


1996 ◽  
Vol 6 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Mark T Gravel ◽  
Penelope Szeman

Although transplantation centers directly benefit from organ and tissue donation, they continue to yield low organ and tissue referral and donation rates. Our medical center and organ procurement organization developed a model to increase referral and donation rates. This model, called the Transplant Center Development Model, facilitates the donation process, specializes staff education, and promotes administrative involvement. After it was was implemented at our medical center in 1991, the referral and donation rates from 1988 to 1990 were compared with those from 1991 to 1993. The results showed that after implementation of the model, the organ referral mean increased 47%; the organ donation mean, 50%; and the tissue donation mean, 117%. These findings suggest that this model may be a valuable tool in transplant center development.


2018 ◽  
Vol 43 (7) ◽  
pp. 1-2
Author(s):  
Jozef Zalot ◽  

This guide was developed in collaboration with LifeCenter Organ Donor Network (Cincinnati, OH) to offer chaplains a framework for the best possible course of action when they provide spiritual care to family members of patients who are potential vital organ donors. Some organ procurement organizations (OPOs) may want to control the donation process. They are thus hesitant to invite in—let alone collaborate with—any “outsiders” who they believe might undermine the likelihood of procuring vital organs. So how should a chaplain respond when ministering to potential vital organ donors and their families? Should they speak with family members about donation? What should they say? Do OPOs want chaplains to speak with family members? Should there be limits to these conversations? This can be a touchy area, because vital organ donation necessarily entails the death of the patient. This makes the relationship between chaplains and OPOs sometimes strained.


2005 ◽  
Vol 15 (2) ◽  
pp. 124-128 ◽  
Author(s):  
Christian C. Essman ◽  
Daniel J. Lebovitz

Purpose Increasing healthcare professionals' knowledge about organ and tissue donation; the national mandates regarding referral compliance; and the effect on donors, donor families, and transplant recipients is a challenging task. Physicians not routinely involved in organ donation or transplantation are some of the most difficult professionals for organ procurement organizations to access. A course for medical students was developed to initiate the transfer of information, comfort, and familiarity with the organ and tissue donation process. Methods Discussions with a local medical school revealed that little organized education on organ and tissue donation existed. An elective course was developed consisting of 2-hour lectures, once a week for 6 weeks. Topics included an overview of tissue and organ donation, history and significance of the current crisis, determination of brain death and its role in organ donation, tissue donation, pretransplant and posttransplant processes, ethical issues, and the donor family and recipient experience. Results A thorough course proposal was presented to the medical school's Chairman of Surgery and Chairman of Transplantation. The proposal was approved for first- and second-year medical students. Conclusion Offering medical students a unique and comprehensive course may attract curious students who could become future champions for donation. This type of educational approach may significantly influence future interactions between physicians and organ procurement organizations. If more organ procurement organizations implement this type of program, the medical students' knowledge of donation will not only affect and benefit the local organ procurement organization's service area but other procurement organizations throughout the country as well.


Author(s):  
Lissi Hansen ◽  
Lauren F. Dunn

This chapter examines the organ donation process from the time the bedside nurse recognizes that a patient should be referred for organ donation until organ procurement has been completed. It also discusses when to speak with families about organ donation, how to address family concerns, the clinical triggers for organ donation, differences between brain death donation and donation after circulatory death (DCD), and palliative care for patients who are candidates for DCD. State and federal regulations related to prospective donors and safeguarding standards that are in place for organ procurement organizations (OPO) and hospitals are also included.


2005 ◽  
Vol 15 (4) ◽  
pp. 379-384 ◽  
Author(s):  
Robert A. Metzger ◽  
Gloria J. Taylor ◽  
Lin J. McGaw ◽  
Francis L. Delmonico ◽  
Jeffrey M. Prottas ◽  
...  

Purpose To gain consensus on aspects of the process of gaining consent for organ donation that should be mainstream daily practice. Methods A 3-day consensus conference of transplant professionals that provided a forum for research and innovative ideas about gaining consent for organ donation. Four work groups were assembled to address issues of gaining consent from organ and tissue donors: (1) demystifying first-person consent (donor authorization): is it a matter of law?, (2) recovery coordinators: getting from green to great, (3) maximizing the process: old views and new, and (4) donor family support: mother or smother? Results Participants reached a consensus about major consent-related practices, identified areas of practice variance, and defined topics in need of further research. Conclusions The conference participants agreed that (1) the primary role of the organ procurement organization is to recover organs for transplantation from deceased donors and to facilitate distribution of those organs to the appropriate recipients; (2) early referral of potential donors from the hospital to the organ procurement organization is desirable; (3) a score less than 5 on the Glasgow Coma Scale should initiate end-of-life discussions with family members; a procurement coordinator from the organ procurement organization who is physically housed within the hospital is the most successful model for accommodating early referral of potential donors and optimizing family support practices; and (3) a decedent's right to donate should take precedence in the donation process and such designation by the donor before death is irrevocable and does not require the consent or concurrence of any person after the donor's death.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Manik Razdan ◽  
Howard B. Degenholtz ◽  
Jeremy M. Kahn ◽  
Julia Driessen

Background. This study examines the effect of breakdown in the organ donation process on the availability of transplantable organs. A process breakdown is defined as a deviation from the organ donation protocol that may jeopardize organ recovery.Methods. A retrospective analysis of donation-eligible decedents was conducted using data from an independent organ procurement organization. Adjusted effect of process breakdown on organs transplanted from an eligible decedent was examined using multivariable zero-inflated Poisson regression.Results. An eligible decedent is four times more likely to become an organ donor when there is no process breakdown (adjusted OR: 4.01; 95% CI: 1.6838, 9.6414;P<0.01) even after controlling for the decedent’s age, gender, race, and whether or not a decedent had joined the state donor registry. However once the eligible decedent becomes a donor, whether or not there was a process breakdown does not affect the number of transplantable organs yielded. Overall, for every process breakdown occurring in the care of an eligible decedent, one less organ is available for transplant. Decedent’s age is a strong predictor of likelihood of donation and the number of organs transplanted from a donor.Conclusion. Eliminating breakdowns in the donation process can potentially increase the number of organs available for transplant but some organs will still be lost.


2021 ◽  
pp. 152692482110028
Author(s):  
Janice Jene Hudgins ◽  
Allison Jo Boyer ◽  
Kristen Danielle Orr ◽  
Clint Allen Hostetler ◽  
Jeffrey Paul Orlowski ◽  
...  

The COVID-19 pandemic has been well-documented to have a variable impact on individual communities and health care systems. We describe the experience of a single organ procurement organization (OPO), located in an area without a large cluster of cases during the initial phase of the COVID-19 pandemic. A review of community health data describing the impact of COVID-19 nationally and in Oklahoma was conducted. Additionally, a retrospective review of available OPO data from March 2019-May 2020 was performed. While the amount of donor referrals received and organs recovered by the OPO remained stable in the initial months of the pandemic, the observed organs transplanted vs. expected organs transplanted (O:E) decreased to the lowest number in the 15-month period and organs transplanted decreased as well. Fewer organs from Oklahoma donors were accepted for transplant despite staff spending more time allocating organs.


Neurology ◽  
2021 ◽  
Vol 96 (10) ◽  
pp. e1453-e1461
Author(s):  
Panayiotis N. Varelas ◽  
Mohammed Rehman ◽  
Chandan Mehta ◽  
Lisa Louchart ◽  
Lonni Schultz ◽  
...  

ObjectiveTo fill the evidence gap on the value of a single brain death (SBD) or dual brain death (DBD) examination by providing data on irreversibility of brain function, organ donation consent, and transplantation.MethodsTwelve-year tertiary hospital and organ procurement organization data on brain death (BD) were combined and outcomes, including consent rate for organ donation and organs recovered and transplanted after SBD and DBD, were compared after multiple adjustments for covariates.ResultsA total of 266 patients were declared BD, 122 after SBD and 144 after DBD. Time from event to BD declaration was longer by an average of 20.9 hours after DBD (p = 0.003). Seventy-five (73%) families of patients with SBD and 86 (72%) with DBD consented for organ donation (p = 0.79). The number of BD examinations was not a predictor for consent. No patient regained brain function during the periods following BD. Patients with SBD were more likely to have at least 1 lung transplanted (p = 0.031). The number of organs transplanted was associated with the number of examinations (β coefficient [95% confidence interval] −0.5 [−0.97 to −0.02]; p = 0.044), along with age (for 5-year increase, −0.36 [−0.43 to −0.29]; p < 0.001) and PaO2 level (for 10 mm Hg increase, 0.026 [0.008–0.044]; p = 0.005) and decreased as the elapsed time to BD declaration increased (p = 0.019).ConclusionsA single neurologic examination to determine BD is sufficient in patients with nonanoxic catastrophic brain injuries. A second examination is without additional yield in this group and its delay reduces the number of organs transplanted.


2015 ◽  
Vol 4 (3) ◽  
pp. 1
Author(s):  
Charles Calhoun Reed ◽  
Elma I Fonseca ◽  
Regina I Reed ◽  
Stacy Foremski ◽  
Sara L Gill

Objective: Various types of organ donation memorials, to include tree planting, rose garden memorials, candle lighting, donor memorial wall events are conducted throughout the year primarily by organ procurement organizations (OPOs). Although the benefits of such events have not been explored there has been continued interest by hospital staff and administrators to host such events. The purpose of this grounded theory pilot study was to describe the process of healing that a hospital-based organ donation memorial ceremony creates at the individual level and organ donation awareness and advocacy at the community level.Methods: The researchers interviewed nine organ donor family members who were invited to attend a hospital-based organ donation memorial ceremony at one Level I Trauma Center located in South Texas.Results: A 4-stage social process, “makes the hole in the heart smaller”, was identified from the qualitative interview data. Participants journeyed through a four stage process to make the hole in their hearts smaller. The four stages are: choosing to attend, being able to connect, keeping the memory alive and knowing something good came from it. As participants moved between stages their meaning for attendance changed. Families shifted from personal grieving and needing support to supporting other donor families and in the process became advocates for organ donation.Conclusions: The findings from this study validate the benefits of hospital-based organ donation memorial ceremonies. Families reported these ceremonies support their decision to donate, while also providing a means of continued emotional support throughout their grief process. The memorial event provides a safe venue for organ donor families to connect and share with others who have had a similar experience, while acknowledging their loved ones gift of life. Hospital-based organ donation memorial ceremonies and the permanent memorial structure increase awareness of organ donation for the community of donor families, hospital visitors and hospital staff.


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