Family and Staff Responses to a Scripted Introduction to Tissue Donation for Hospice Inpatients on Admission

Purpose To implement and evaluate a change in practice regarding the timing of introducing donation for inpatient hospice staff and families whereby scripted information about tissue/organ donation was given by the nurse upon admission as part of the normal admission process and then repeated at the time of death per usual protocol. Methods Data were collected from staff for 6 months (January to June 2006). The hospice staff agreed to complete a donor services comment log at the admission and at the death of each patient to relay any concerns with the change in practice rather than just writing down complaints as was the previous practice. Data were supplemented with staff input during regular meetings. Donation rates were compiled as usual for 6 months and compared with the preceding 6 months. Results Data were analyzed from the written interactions. Trends identified were limited by the small sample size. The results confirmed that both nursing staff and potential donor families supported the change in practice. No families or staff called the organ procurement organization with complaints during the 6-month period. Corneal donations increased from 2 to 7, a 250% increment for the 6-month period. Conclusion The assumption that discussing donation when hospice patients are admitted will lead to a decrease in donation is not supported by the results of this study. The findings suggest the need for a methodologically rigorous, theoretically driven examination of hospice donor families' reactions to the introduction of donation at admission and the subsequent decrease in stress and increase in donation rates.