Utilisation of an embedded specialist nurse and collaborative care pathway increases potential organ donor referrals in the emergency department

OBJECTIVE: To review the impact of an embedded specialist nurse in organ donation (SN:OD) and the utilisation of a collaborative care pathway on potential solid organ donor referrals in an emergency department (ED) over a 24-month period. METHODS: A retrospective cohort study of adult patient deaths within the department, (n=311) during a 24-month period. Referral rates to the organ donation team (ODT) were compared before and after the introduction of a SN:OD and collaborative care pathway. RESULTS: Referrals to the ODT significantly increased from three of 151 eligible patients (2%) to 26 of 160 patients (16%; χ(2) test p<0.0001) following the introduction of a SN:OD into the trust. The number of patients proceeding to organ donation increased from none to two (Fisher's exact test p=1.0). CONCLUSIONS: The presence of an embedded SN:OD in the ED and the adoption of a collaborative care pathway to establish clinical triggers for referral to the ODT have significantly increased the rate of referral of adult potential organ donors to organ donation services.