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Division of Pulmonary and Critical Care Medicine
Tuesday, December 15, 2009
Best practices in nursing lead to outstanding organ donation rate
Two nurses at Massachusetts General Hospital dress a man in his culture’s ceremonial wear and prepare him for his moment of passing. He has a grave prognosis, but his family has decided to offer life to others by donating his organs. It is a remarkable scene and just one example of how nurses at the Mass General Transplant Center support patients and families during difficult times.
“There is an art to this type of work,” says Tara Tehan, RN, nursing director of the Neuroscience Intensive Care Unit. “That art involves carefully letting families know that everything possible has been done to deliver the best possible care to their loved ones. And when a patient has a grave prognosis, the art is how we support them through the donation process.”
Every day 77 people in the United States receive lifesaving organ transplants thanks to selfless decisions made by donors and families. This year the Department of Health and Human Services has awarded the Transplant Center a Medal of Honor for its outstanding achievements in organ donation, including a donation rate of 75 percent or more eligible donors. Read about Transplant Center awards and recognitions
Mass General’s nurses are at the heart of this award, and they follow best practices when working with donors and their families. The Department of Health and Human Services evaluated hospitals on these best practices, including conversion rate (how many families approached said “yes” to donation), timely referral to the organ bank and process when caring for patients.
“When we know someone has a grave prognosis, the best practice is to conduct a timely referral to the organ bank, meaning nurses make a request to the organ bank to review the patient’s situation,” continues Mary Guanci, RN, clinical nurse specialist in the Neuroscience Intensive Care Unit. “Then the organ bank tells us whether the patient is eligible for donation. A timely referral allows us to partner with the organ bank and plan for a possible organ donation approach.”
Nurses at Mass General’s Neuroscience Intensive Care Unit also have a unique approach when caring for patients. A collaborative group applies the “Take 5” approach, which involves discussing the best way to meet with a family and provide them with information regarding organ donation. Together, a physician, nurse, social worker, chaplain and member of the New England Organ Bank help families make educated decisions during a difficult time. Nurses at Mass General were among the first in the nation to apply the “Take 5” approach. Learn more about the Transplant Center
“We support families whether they choose donation or not. However, we see the families who choose donation express a belief that donation provides a comfort that something good came out of something tragic,” affirms Guanci.
Mass General was also one of the first hospitals in the region to perform organ donation after cardiac death. These procedures are particularly sensitive because families must make the difficult decision to withdraw medical support prior to making the decision to donate. Tehan says that Mass General’s nurses are skilled when supporting these families. Their goal is to make sure families understand the extent of the injury and prognosis, and are able to cope with deep emotions. “Sometimes it’s just making sure they have their physical needs met, such as sleep and food,” says Tehan.
Mass General’s nurses are leading the way in developing and following best practices for organ donation. They teach other clinicians how to apply these techniques, and even developed a training video called Conversations Regarding End of Life and Donation, which has circulated across the nation. Watch Conversations Regarding End of Life and Donation
When nurses successfully guide families through organ donation, it opens the door for others who are awaiting transplant. This is exactly why nurses at Mass General are proud of their work - they have an ability to give life to others in need. “This is a testament to the skill and hard work of our nurses. They take a lot of pride in their skill, practice and compassion,” says Tehan.
Learn about the New England Organ Bank and how to sign up to be a donor
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