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Tissue donation rises as nurses focus on bereavement support

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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.

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Readers' comments (2)

  • This report is badly informed and contradictory. Bereavement support should be entirely for consoling those grieving and should not be manipulated for third party benefits "to make sure staff include donation in end-of-life care" when people are most vulnerable. The lead bereavement and donor co-orcinator at the Royal Bolton Hospital includes the threat of legislation to impose presumed consent if organ donation rates do not increase.
    She confuses the obtaining of corneas and tissues (which can be usefully taken from cadavers) with multi-organ donations which are taken from living bodies. These are patients who are still respiring (with assisted ventilation), have spontaneous heartbeat pulse and circulation, are digesting metabolising and excreting, are warm and pink and require paralysis and anaesthesia to control responses to surgery.
    Those consenting to organ removal "after my death" may have a very different concept of death. This is never explained on donor cards or registry, but may explain the 40-50% refusal rates by relatives present at the bedside.
    Whatever the need for organ transplantation, it should not be at the expense of obscuring truth.

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  • firstly can i say how i disagree with dr david hill but still we are all entitled to our own opinion. i am an employee at the royal bolton hospital and have attended organ donation course on more than 1 occasion.on these courses i have had a huge insight learning about how important organ donation is,how it saves lives and also enhances quality of life.i think its a great thing that bereavement and organ donation team are now combined .the bereavement team at bolton do a great job are extremely sensitive when approaching relatives regarding the subject around organ donation as well as providing one to one support with the bereaved.despite your views more organs have been retrieved therefore more lives have been saved and people haven't died in vain what is so wrong with that.from where i am standing its a fantastic thing to be able to give the gift of life to someone out there who could be your mother,father,son or daughter etc.i feel so strongly about organ donation that myself and my husband have recently registered on the organ donation register you never know someone close to me may need an organ at some time in their lives.we are all happy to take but are we generous enough to give.

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