A pioneering service that provides hospital staff with 24-hour access to a bereavement and donation officer has helped to dramatically increase the number of tissue donations at a Lancashire trust.
The nurse-led service at the Royal Bolton Hospital was introduced in 2005 as part of a package of measures to help address the low rates of organ and tissue donation.
This included combining the hospital’s bereavement and donation services, setting up a corneal retrieval service, and employing four extra nurses to offer round-the-clock support to hospital staff and families of the deceased.
Tissue donation rates, such as corneas, had been relatively low at the hospital, ranging from just six in 2002 to 37 in 2005. However, following implementation of the new service, this figure leapt to 234 by 2007.
The trust looks set to achieve even greater success in tissue donation, with every ward at the hospital recording at least one tissue donor over the last 12 months. Latest figures also show 108 cornea donations already between April and early August this year.
Additionally, a trigger system introduced in 2007 – which automatically refers all potential organ donors to the regional transplant donor coordinators – resulted in 31 referrals and nine successful multi-organ donations by the end of 2008.
The team have also made amendments to the end-of-life care pathway for dying patients to make sure staff include donation in end-of-life care, and they also provide training for all hospital staff, including monthly teaching sessions.
‘The aim of the service is to change the culture around donation, and to make it a normal part of end-of-life care,’ said Fiona Murphy, lead bereavement and donor coordinator at the Royal Bolton Hospital.
‘All choices around death and dying have to be made in a timely manner, and it is vital that patients and families have clear, concise information to be able to make informed decisions,’ she added.
‘It is about giving control to families in an uncontrollable situation, and providing the same high level of care for patients and their families regardless of whether or not they donate,’ Ms Murphy told Nursing Times.
Organ donation rates in the UK are among the lowest in Europe. In 2006, the government established the Organ Donation Task Force to help identify obstacles to organ donation and plug the gap between supply and demand.
Last year, the taskforce published a set of recommendations to help meet a target of increasing organ donation in the UK by 50% over five years, including encouraging hospital trusts to develop local initiatives.
However, if organ donation rates do not increase, the government is considering changing the law on organ donation to one of ‘presumed consent’, where it will be assumed that organs and tissues can be used unless people ‘opt out’.
‘Providing everybody with the information they need to make an informed choice about donation is a real alternative to presumed consent,’ said Ms Murphy. ‘It may not work in all settings, but it has really worked for us in Bolton,’ she added.