A Panel Discussion The Donation and Transplantation Symposium October 15, 2013
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Transcript of A Panel Discussion The Donation and Transplantation Symposium October 15, 2013
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A Panel DiscussionThe Donation and Transplantation Symposium
October 15, 2013
Presenters:Amy Durrant, OneLegacy Ambassador & Donor WifeRobert Coppel, Family Care Specialist, OneLegacy
Melanie Crowley, Clinical Manager Trauma Service,Northridge Hospital Medical Center
Moderator: Bryan Stewart, Vice President of Communications, OneLegacy
Donor Designation, Your Families and You
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Kevin Durrant
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Donor Designation
Robert CoppelFamily Care Specialist
OneLegacy
Working with Families in Conflict
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Advance Health Care Directive Form
“You have the right to give instructions
about your own health care.”
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(2.1) END-OF-LIFE DECISIONS: I direct my health care providers and others involved in my care to provide, withhold, or withdraw treatment in accordance with the choice I have marked below: a) Choice Not To Prolong: I do not want my life
to be prolonged if the likely risks and burdens of treatment would outweigh the expected benefits…b) Choice To Prolong: I want my life to be prolonged as long as possible within the limits of generally accepted medical treatment standards.
Upon my death (mark applicable box): I give any needed organs, tissues, or parts
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Melanie Crowley, RN, MSN, CENClinical Manager, Trauma Service
Northridge Hospital Medical Center
Donor Designation
Protecting the Decision:A Case Study
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• Admit 12/14 @ 00:46
• 20yr Female admitted s/p MVA
• Only ID is Credit Card in pocket
• GCS 3 on arrival / Severe Traumatic Brain Injury
• Referred to OneLegacy @ 08:34
• Family onsite +8hrs post ICU admit
• Registered Donor
Day 1• Day 2: CT Scan
shows herniation
• Day 3: EEG ordered, Na 119
• Family first voices objection to donation
• Day 4: First BD Note written 12/17 @ 19:10
• Pt too unstable for CBF/apnea test
Day 2-4• Second BD Note
written 12/18 @ 09:39
• Family refuses to meet with OneLegacy FCS
• Nursing staff voices discomfort with starting case against family’s wishes
• 19:00 Administrator On Duty (AOD) contacted
Day 5Case Overview
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Overarching GoalStrive to meet the needs of
the
What happens when theseCONFLICT?
PatientFamilyStaff
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Law & Policy Must Guide Practice
CA State Health & Safety CodeSection 7150.35 (a):
“…Absent an express, contrary indication by the donor,
a person other than the donor is barred from making, amending or revoking an anatomical
gift of a donor’s body or part if the donor made an anatomical gift…”
Anatomical gift that does not revoke before death is irrevocable
No permission from the donor’s family is warranted
The family does not have the power, right or authority to consent to, amend or revoke
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?Law & Policy Must Guide Practice
Northridge Hospital Policy
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Northridge Hospital Policy
Law & Policy Must Guide Practice
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Utilize Your Resources
Follow your chain of command:• AOD• Unit Director• VP Medical Affairs• Bioethics• Legal Counsel• OneLegacy Hospital Liaison
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Perception = RealityAddress Misconceptionsof Family & Staff
• Validate patient’s Donor Registry status (Document of Gift)
• Donor Registry Status cannot be overridden• Donation honors the patient’s wishes!
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Next Steps
• 12/18 @ 24:00 (+14hrs post BD declaration) Charge RN & OneLegacy FCS meet with family in hospital lobby
• Additional family support provided by Social Work, Nursing Staff, OneLegacy Staff
• 12/19 @ 12:00 Family completes Med/Soc History
• Family provided with memory box, handprints, Aftercare Support Services
Day 5 Post Admit
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Case Outcome4 Organs Recovered & Transplanted:• Left Kidney – 17yr Male• Right Kidney & Pancreas – 49yr
Male• Liver – 61yr Male
Tissues Recovered for Transplant:• Corneas• Bone
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A Panel DiscussionThe Donation and Transplantation Symposium
October 15, 2013
Presenters:Amy Durrant, OneLegacy Ambassador & Donor WifeRobert Coppel, Family Care Specialist, OneLegacy
Melanie Crowley, Clinical Manager Trauma Service,Northridge Hospital Medical Center
Moderator: Bryan Stewart, Vice President of Communications, OneLegacy
Donor Designation, Your Families and You