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During my education experience at Sentara College of Health Sciences (SCOHS), I have learned two curricular concepts that will help me promote organ and tissue donation as a Registered Nurse. Both of these concepts have prepared me to take on a leadership role once I have transitioned into my professional practice.

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The first concept I will apply is effective time management. Though we have only recently studied it in our Leadership course, we have been practicing and implementing it into our role as a nursing student since the first day of the program. Time management is essential for the nurse when referring patients to the OPO. I will concentrate on planning and scheduling tasks appropriately to ensure all donors are considered and promptly reported.

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The second concept I will apply is initiating and managing change by becoming a change agent. Organizational change is essential or adaptation, and creative change is mandatory for growth. I will initiate change on my unit developing a set of guidelines at which nurses follow to promote organ donation within our facility.  Nurses will be challenged to report referrals within 1 hour of cardiac death and attend two organ donation education sessions a year.

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Once I have transitioned to my professional practice and have taken on a leadership role, I will be responsible for setting goals, determining priorities, managing time, and implementing change. SCOHS has helped me develop effective time management skills and the confidence required to become a change agent. These learned skills and concepts will serve as my foundation as a leader.

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In the health care field, there is a lack of education regarding the nurse's role in organ and tissue donation (OTD). Nurses do not realize they are responsible for identifying possible organ and tissue donors and referring them to their facilities designated Organ Procurement Organization (OPO).
Another issue that occurs withing the nursing population involves negative personal feelings towards OTD, preventing the nurse from promoting and advocating for donation.

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The nurse should emphasize the most critical element in organ and tissue donation to all coworker and community members alike; expressed consent.

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Advocate for organ and tissue donation education within the nursing school curriculum.

Attend learning sessions that represent all aspects of the organ donation community. These are frequently held in large hospitals and they can help staff learn how to rapidly improve donation rates.

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Why & how do these affect the community? 

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Why & how do these affect the community? 

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With brain death, early identification of a possible organ donor is paramount in maintaining organ viability. With cardiac death, time is of the essence because procurement must be complete within 24 hours of death for tissue to be variable for transplant. When nurses do not understand their role in early identification and immediate referral distribution, donors are missed, declined, or timed out.
The attitudes of health care employees, especially that of nurses, are important because they are the ones who often guide the community behavior and perspective on health care concerns (Bener, El-Shoubaki, & Al-Maslamani, 2008).
Both of these concerns have a direct correlation with how many donors are procured each year. This can increase or decrease the amount of available organs and tissue for transplantation.

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Refer all potential donors to local OPO in a timely manner

Be familiar with the hospital’s
criteria for clinical triggers, and call the OPO promptly.
• Get to know your OPO team members by ntroducing yourself to OPO coordinators when they are evaluating a potential donor in
your unit. Be a part of their team.

Ask the OPO to share information and resources to implement changes in your unit.
• Become a donor “champion”, speak with your colleagues
about the importance of supporting organ donation.

Sign a donor card
or join a registry, and tell your family about your decision
to donate.

(Tamburri, 2006)

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When are others affected by these issues? 

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When are others affected by these issues? 

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This particular problem affects others every single day. Per United Network for Organ Sharing (UNOS), one donor can save 8 lives (UNOS, 2018).

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The majority of nurses express positive attitudes towards both end-of-life care and organ donation, but there is ambiguity as to whether referring patients and families, to the OPO, for these services is within nursing scope of practice (Crymble, Fabian, Etheredge, & Gaylard, 2017). This is a troubling discovery because involving the OPO is extremely time sensitive and imperative for donation to occur.

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The nurses role and participation in organ donation:

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The nurses role and participation in organ donation:

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Provide the public with accurate and objective information concerning donation

Early identification of possible donors

Work closely with the healthcare facility, the organ procurement organization and/or the tissue banks,to seek consideration for donation

Provide clinical expertise, emotional support, and objective and accurate information to families who are considering organ and tissue donation

Maintain adequate care of possible donor to ensure the viability of the organs and tissue

Advocate for patients and families in the informed choice process, recognizing and respecting their personal, ethical, cultural and religious beliefs

Advocate and reinforce the nurse and patients individual rights supported in the American Nurses Association (ANA) Code of Ethics for Nurses (ANA, 2001).

(NYSNA, 2010)

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Nurse's have exhibited concerns about their lack of knowledge of organ donation and transplantation and suggest implementing organ & tissue donation lessons it into the nursing school curriculum (McGlade & Pierscionek, 2013).

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In 2007, researchers conducted face to face interviews with 253 nurses to assess their knowledge level and personal feelings regarding OTD. The result showed there is a significant need for better understanding of organ and tissue donation within the health care field(Bener, El-Shoubaki, & Al-Maslamani, 2008). Please refer to the next shelf for results.

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Why the nurse's involvement is so important?  

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Why the nurse's involvement is so important?  

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Without the nurses involvement, identification of donors does not occur, organ maintenance and viability suffer, and cardiac deaths go unreported to the OPO. All of these result in less or no available organs &tissue grafts for transplant recipients.

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Everyone in need of an organ for life saving measures or a tissue graft for health improving purposes.

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Only 12% knew that someone who died of cardiac arrest is able to donate.

Only 20.6% knew that the hospitals involvement in donation is monitored according to the state and federal laws.

Only 15.4% knew that people who are brain dead are legally dead.

Though 71.5% knew that brain dead persons are eligible for organ donation, only 15.7% knew it was the RNs responsibility to report the possible organ donor to their hospital's designated organ procurement organization.

62.8% were concerned that designating oneself as an organ donor would lead to insufficient medical care.

41.5% had personal conflicts or moral objections to organ donation when considering themselves. However 79.8& supported organ donation when it pertained to others.

(Bener, El-Shoubaki, & Al-Maslamani, 2008).

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Late identification of possible organ donors due to insufficient staff-patient ratios

Valuable nursing time required for OPO referral and screening

Myths: Fear one will not receive lie saving measures if designated as an organ donor

Religious beliefs

Uncertainties about financial responsibilities for choosing to donate

Fear of body mutilation and funeral home interference