Download - DCD Approach Process: Maximizing the Gift Jamie Kothapalli, RN BSN Wisconsin Donor Network
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DCD Approach Process: Maximizing the Gift
Jamie Kothapalli, RN BSN
Wisconsin Donor Network
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Background
• In early 2013, WIDN started evaluating DCD donors for the potential for BD to maximize the gift and improve recipient outcomes.
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2013 DCD Approach Data
• 33 instances where family was asked to wait for BD
• 6 families did not want to wait - DCD donors• 27 families waited, time range 5-75 hours
• 13 of these patients progressed to BD (average wait time 24 hours)
• 14 instances where family was not asked to wait
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2014 DCD Approach Data
• 22 instances where family was asked to wait for BD
• 2 families did not want to wait - DCD donors– 37/C/M- 3 small children, family emotionally drained– 35/C/M- wife was DOA family wanted dual funeral
• 20 families waited, time range 5-67 hours• 18 of these patients progressed to BD (average wait
time 21 hours)
• 11 instances where family was not asked to wait
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Two Year Success
• 2013• 82% of families willing to wait for BD
• 48% of donors progressed to BD
• 2014• 91% of families willing to wait for BD
• 90% of donors progressed to BD
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DCD Pre-Approach Process
• Huddle with Attending MD• Determine potential for DCD donation• Determine potential for progression to BD
– Discussion surrounding likelihood to progress and timing of progression
– Pre-approach discussion
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Family Discussion• Focus of discussion is on BD donation• Talking points:
– Recipient Outcomes– Maximize the gift
• DCD donation only discussed in some situations
• Establish a plan with the family– How long they are comfortable waiting– Drive family support/future discussions
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Donor Designation
Donor Designation No Donor Designation0
2
4
6
8
10
12
14
16
20132014
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92 Lives Saved!
• 10 Hearts• 8 Lungs• 21 Livers• 47 Kidneys• 5 Pancreata• 1 Intestine
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Highlights
• Skill of Family Services Coordinator
• Support of Attending Physician– Effective huddle to determine likelihood for BD
• Family’s willingness to optimize the gift