ABSTRACT greatest in number OR nu...

ABSTRACT

greatest in number OR nurses whether veteran or novice have had a certain quantity of exposure to organ donation; however, not many are aware of what present itselfs outside of the surgical setting. This article provides an overview of the entire donation proces from the hours before the deed to the steps needed for felicitous recovery. Particular attention is given to the care of the donor family members, the two preoperatively and postrecovery. AORN J 69 (April 1999) 779-791

When OR staff members receive word from an organ agency coordinator that a team will be necessityed for an upcoming recovery, many emotions arrive into play. Oftentimes the donor will have undergone an ill-fated lifesaving measure in as hardly any as the past 24 hours. The new loss of life can be felt on all involved, and the senselessnes and tragedy surrounding the death of a [i]role[/i] who gave the gift of life can add to the emotional experience. These emotions raise questions for staff members based in succession their identification with the donor, their experiences with organ donation, and their relationship with the local organ intervention organization (OPO). In addition, OR staff members may act upon "blind faith," assuming that the donation proces has been and will continue to be handled correctly, drawn out after OR team members go on foot home. This article addresses many of the questions about organ convalescence and provides a broader picture of the donation process--allowing OR staff members to be better informed and aware of the organ donation experience.

THE NE FOR ORGAN DONORS

As the extreme point of the twentieth century approaches, the technology of transplantation has given many individuals needing almost any symbol or combination of solid transplant the faith of a second chance. As of Jan 1 1999 more than 60000 individuals, however, were awaiting the gift of life in succession the national transplant waiting list--a list to which a just discovered name is added every 18 minutes.(1)

As the transplant waiting list rapidly increases the number of actual donors has increased same little over the years. Although there is an estimated loch of 12,000 to 15,000 potential donors (ie, patients who bear up under brain death) in the United States, year-end statistics for 1997 indicate that actual donors total and nothing else 5,495--an increase of less than 1% throughout 1996.(2) Perhaps as a eventuate roughly 10 people will die each day because an organ is not available for transplant.(3)

IDENTIFICATION AND REFERRAL OF DONORS

According to the Health Care Financing Administration (HCFA)--the federal agency within the US Department of Health and Human Services that administers the Medicare and Medicaid programs--a hospital must notify the local OPO in a timely manner of each death or imminent death that be met withs in the hospital.(4) Every death give in charges to all deaths for which a death certificate is issued, and timely manner means that the hospital must contact the OPO at telephone as soon as possible after an individual has died, been placed forward a ventilator due to cruel brain injury, or been declared brain dead. At this point, the OPO in collaboration with the judgment and tissue banks identified at the hospital, determines if the patient's organs are suitable for donation.

Typically, OR staff members are not involved in the identification and referral phase of organ donation; however, if a death come to one's minds in the OR, an OR staff member must place a referral to the OPO unles the hospital has assigned that custom to an outside individual. In mostly cases, a death in the OR will be evaluated for organ of sight and tissue donation only.

Determining medical suitability. To determine medical suitability, the OPO representative who performs the screening must have accurate information regarding the amount and archetype of IV or blood outcomes administered to the donor during the surgical deed This is critical because the balance between intake and output is lacked to determine if serological testing can be performed accurately in the case of exsanguination.

It is crucial to determine the patient's medical suitability before offering the patient's family members an opportunity to donate the organs. If the opportunity to donate is dilateed and then taken away because of medical unsuitability, the family members may be perceived an additional loss.

Donor criteria. Donor criteria are continually changing; therefore, mostly OPOs and tissue and vigilance banks do not provide hospitals with exclusionary guidelines. In general, the criterion for organ donation is that the patient is brain dead or onward ventilator support; however, in areas where OPO bring on organs from nonheart-beating donors, the criteria are broader. For tissue, notice skin, and bone donations, the donor is not required to be forward ventilator support; thus, brain death and cardiac deaths are acceptable. For these cases, tissue, inspections skin, and bone will be remov after the organs are procur and ventilator support ceases. Organ management organizations have eliminated age criteria for organ donation, and the acceptable age for tissue and vigilance donors varies from program to program. The barely absolute contraindications for any pattern of donations are HIV infection and active viral hepatitis.