Organ donation: what can we learn from North America?

The aim of this qualitative case study was to investigate how organ donation is promoted and managed in North America aimed specifically at patients and relatives. A 4-week study to Boston and Baltimore in America was undertaken to observe and learn how organ donation is promoted and managed within a critical care environment. The study tour was undertaken specifically to examine the policy and procedures that enhance the procurement of organ donation in specific centres in the USA. The study tour wanted to examine and gain a better understanding of the issues, policies and procedures used by these centres when seeking permission for organ donation. Data were collected by a variety of methods involving observation, unstructured informal interviews, examinations of policies and procedures and a daily diary was maintained. A thematic analysis method was used to analyse the qualitative data collected. Four areas were identified as potential areas for learning. Approaching relatives of potential donors for consent, at a time of intense emotional crisis, is a challenge that involves all nurses working in critical areas. Nurses are identified as a key component in the process of organ donation; research highlights that approaching relatives can be problematic and stressful for nursing staff. The British government should consider required request legislation that ensures all hospitals refer potential donors to the Regional Transplant Center. In-house coordinators could be appointed and protocols developed for referrals of potential donors. It is also suggested that the approach for consent is decoupled and designated requesters approach relatives.