EFFECTIVENESS OF NURSING EDUCATION IN TIMELY ORGAN REFERRAL: A SMALL INTERVENTION, AN IMPRESSIVE OUTCOME
Chest
; 162(4):A1458, 2022.
Article
in English
| EMBASE | ID: covidwho-2060819
ABSTRACT
SESSION TITLE Quality Improvement SESSION TYPE Original Investigations PRESENTED ON 10/17/22 130 pm - 230 pm PURPOSE:
Organ transplant is the ultimate necessity in managing many end-stage organ pathologies. As per the health resource and service administration, 17 people die every day while waiting for an organ transplant. In the year 2020, 169 million Americans registered as organ donors, but due to the limitations of organ donation such as cause of death and condition of the organ at the time of death, only about 3 in 1000 people die in such a way that their organs are in an optimum condition for transplantation 1. The role of nurses in organ donation is critical in both acute and critical care settings 2. Educating nurses on certain aspects of organ donation, such as approaching the families and counseling regarding moral and legal considerations, will acclererate the process of organs retrieval from the interested donors. We hypothesized that in addition to Best Practice Alert (BPA) on Electronic Medical Record (EMR), educating nurses can optimize organ donation by timely referring the organs for transplantation.METHODS:
ICU-wide nursing education sessions were conducted elucidating that when a ventilated patient qualifies for Life Gift notification and a BPA does not pop up in EMR, Nurses should immediately call the Houston Methodist organ donation service, Life Gift within one hour of the following two triggers 1) Loss of one or more brainstem reflex(es), 2) Glasgow Coma Scale (GCS) ≤ 5. Nurses were also educated to start a timely discussion with the family proposing Life Gift prior to discussing the withdrawal of life-sustaining treatments, popularly known as terminal extubation. The data for timely organ referral from the preceding six months (January 2021 to June 2021) was compared to the four months (July 2021 to October 2021) following the nursing education sessions.RESULTS:
The total number of timely referrals in the pre- and post-education period were n=23/33 Vs. n=29/31. The overall timely referral of the organ for transplantation increased from 69.2% to 95%. Out of four months post-education, two months record the compliance of 100%. Our chi-square statistic was 5.969 with a p-value of 0.01456. We performed Yates continuity correction due to small sample size and to compensate for deviations from the theoretical (smooth) probability distribution. Our chi-square statistic with Yates correction was 4.506, and the p-value was 0.034 (Significant at p < 0.05). Our study was limited by the small sample size, high nursing turnover due to the COVID-19 pandemic, and logistic restrictions due to the pandemic.CONCLUSIONS:
The overall referring time for organs improved after nursing education sessions, including targeted triggers. CLINICAL IMPLICATIONS Nursing education plays a crucial role in organ donation programs. Further studies are needed to better understand the issues that nurses face and develop new strategies that can be implemented to improve the organ and tissue referrals for organ donation. DISCLOSURES No relevant relationships by Muhammad Mohsin Abid No relevant relationships by Sana Jogezai No relevant relationships by Iqbal Ratnani No relevant relationships by Salim Surani No relevant relationships by Muhammad Hassan Virk
adult; brain stem; conference abstract; controlled study; coronavirus disease 2019; counseling; drug withdrawal; education; electronic medical record; extubation; female; Glasgow coma scale; human; human tissue; information retrieval; intensive care; life sustaining treatment; major clinical study; male; Methodist; morality; nurse; nursing education; organ donor; pandemic; patient referral; probability; reflex; sample size; surgery; theoretical study; transplantation; turnover rate; ventilated patient; Yates continuity correction
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Experimental Studies
/
Prognostic study
Language:
English
Journal:
Chest
Year:
2022
Document Type:
Article
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