The Nurse’s Role in the Organ Donation Process

Presented By:

Shannon MilanekChristie Rigney

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A Case Study….

35 year old Greg Jones is on his way home from work when he is involved in a high speed head on collision.

Paramedics arrive and find Mr. Jones unconscious and unresponsive to verbal and painful stimuli.

Mr. Jones is intubated in an attempt to stabilize him and transported to the nearest Level One Trauma Center.

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Arriving at The ER….. The top notch trauma team

receives report from EMS and springs into action.

Numerous X-rays are obtained to evaluate injury.

CT of head and abdomen is completed.

Mr. Jones is stabilized and transferred to the Surgical Trauma Intensive Care Unit for care.

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STICU Clinical Evaluation Glasgow Coma Scale – 3

Mr. Jones is unresponsive to painful stimuli

No cough or gag response

Blood Pressure 80/40

CT shows brain herniation

Family informed of prognosis

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What Does the Nurse Do?

•Regardless of age or diagnosis, refer intubated patients with a cerebral injury and meeting clinical trigger criteria to the organ procurement organization designated by your facility.

•Do not mention donation to Mr. Jones’s family. If the family mentions donation, provide information and support.

•The organ procurement agency will screen Mr. Jones and review the chart to determine medical suitability for donation.

•Familiarize yourself with and follow your facility’s protocol.

•Continue to provide quality care to Mr. Jones and his family.

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When Should I call the Donor Referral Hotline?

Organ Donation Clinical TriggersYour patient is intubated and shows evidence of the following:

•Coma•Stroke

•Hypoxia•Brain Tumor

•Cerebral Injury•Near-Drowning

•Cerebral Edema•Cerebral Hemorrhage

ANDTwo or more of the following criteria are met:

•No cough or gag•Unresponsive or posturing

•No spontaneous respiration •No pupillary or corneal reflex

•Discussion of DNR or withdrawal of support•Glasgow Coma Scale Rating of less than 5 without sedation

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Does Mr. Jones Meet Criteria?

The Nurse calls the referral line, which is staffed by the Organ Procurement Agency in that state.

The Medical Screener on the referral line conducts a preliminary screening of Mr. Jones.

The Medical Screener contacts a Transplant Coordinator and relays the referral information obtained from the hospital.

The Transplant Coordinator calls or arrives at the hospital to to obtain additional information about Mr. Jones.

YES!

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What is an OPO?

Organ Procurement Organization. Each state has one or more depending on population.

A not-for-profit organization responsible for identification and care of organ donors, organ retrieval, organ preservation, transportation, and data follow up regarding organ donors.

OPO staff work with donor families, and educate medical staff and the general public about organ donation.

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Ok! My job is over now….

Not so fast! The nurse must still:

Monitor Vital Signs Monitor Intake and Output Administer and manage medication administration to

maintain perfusion and blood glucose levels Manage ventilator to maintain ABG’s Obtain labs to monitor kidney, liver and pancreas function Work with the transplant coordinator to obtain significant

medical and social history Coordinate with local physicians for any special procedures

that may be required by the OPO Offer support and coordinate resources for Mr. Jones family

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How many nurses does it take….

Emergency Room NurseSTICU Nurse

Transplant CoordinatorOperating Room Nurse for Organ Procurement

Organ Placement NurseFlight Nurse (in some situations)

Operating Room Nurse for Transplant RecipientICU Nurse for Transplant Recipient

Medical Surgical NurseHome Health Nurse

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So, why should you bother???

Mandated by Federal Law to refer any patient who meets criteria to the states Organ Procurement Organization

Opportunity to be involved with making the best of a tragic situation

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Mr. Jones saved many lives… Heart: A 58 year

old man lived to see his first grandchild born.

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Mr. Jones saved many lives…. Lungs: An 13 year

old girl with cystic fibrosis will breathe easier.

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Mr. Jones saved many lives…. Kidney: A 40 year

old mother of two will have many more years with her children.

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Just so you know…. The average organ donor saves 8 lives by

donating organs. Heart, Lungs, Liver, Kidneys, Pancreas,

Small Intestine

Quality of life for many recipients can be improved by organ and tissue donation

Eyes, Corneas, Skin, Bone, Heart Valves, Tendons and Veins

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Did You Pay Attention?????

The Nurse should always ask if the patient is an organ donor before beginning any type of treatment.

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FALSE

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Did You Pay Attention?????

The Nurse must possess good assessment skills when determining if a patient could be a potential organ

donor.

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TRUE

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Did You Pay Attention?????

The Nurse’s only role in the organ donation process is to make the

referral to the Organ Procurement Organization

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FALSE

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Did You Pay Attention?????

The Nurse should always follow the facility’s protocol for organ donation

referral

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TRUE

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