Call to organ donation center post pt death

[LogCabinMom]

Hi there -

I'm questioning a policy my hospital has and am wondering what other hospitals do. I have not encountered this at other hospitals mainly because they've been larger, and have had "death coordinators" to do this, so I wasn't directly involved.

At this hospital, though, it is required that we call the organ bank within 1 hr of all deaths and go through a very time-intensive question and answer process about the pt and their diagnosis, how they died, etc, sometimes involving the MD. The last 2 I've been involved in have taken about 45min, after which they have denied the pt. We call for ALL patients, not just those with an organ donation card. In fact, our policy even states:

"The opportunity for organ, eye and/or tissue donation should not be discussed with next of kin without NEOB involvement. NEOB must screen a patient for medical suitability prior to next of kin being offered the option for donation."

I find this really weird. First question is, where is HIPAA in this? Next, if I think as a patient's family, what if I am totally against organ donation and yet the nurse is giving all this personal information to the organ bank about my loved one - what if the organ bank says, yes, they would like this person's organs/tissue? Am I, as the RN, supposed to go into that deceased patient's room and try to convince the family that they should donate?

What do other facilities do?

Thanks!

[Guest343211]

I've called NEOB twice and I was only on the phone for a couple of minutes.

Experiences will vary, as was mentioned by the responder and others. I certainly am not going to put another patient in jeopardy by being on the phone with one of these folks for 45 minutes. The process should be streamlined, period.

[Guest343211]

If people are too pushy about this kind of thing, and I am for organ donation, family members need to have their lawyers on speed dial.

There is no easy way to deal with this, but common sense is a good place to start.

[Morainey, BSN, RN]

I think the first time was my first patient death, ever, and the patient had died from metastatic cancer. As soon as I told them that they were like oh ok thank you for your time! The second time I forget the specifics but they weren't interested then either. I'm sure if the person was a potential donor they'd have all kinds of questions.

[Elvish, BSN, DNP, RN, NP]

The ones I have had to call about are always extreme prematurity deaths....never takes long, and they're obviously not candidates for donation. I'm talking 17, 18-weekers born alive and live for a few minutes/hours.

[Esme12, ASN, BSN, RN]

I've called NEOB twice and I was only on the phone for a couple of minutes.

It really depends and if they got a new coordinator on the phone they don't go straight to the point or they go to the point and keep going. It is always helpful to have your facility have a worksheet so you can have all the information available and streamlined.

[monkeybug]

The ones I have had to call about are always extreme prematurity deaths....never takes long, and they're obviously not candidates for donation. I'm talking 17, 18-weekers born alive and live for a few minutes/hours.

We had to call for those, and also for IUFDs. Those were always interesting. "No, I don't know when the patient died, but he was born today." It was never more than a few minutes, but very weird when I first started doing it. I like the idea that it's taken out of the nurses' hands. You don't have to hope that a nurse is persuasive, approves of donation, has a good relationship with the family, etc.

[umcRN, BSN, RN]

Yes. We always call. Even in the NICU with the 23-24 week preemies (who are never candidates).

[KelRN215, BSN, RN]

This is an interesting thread for me... when I worked in the hospital, it was ALWAYS the attending MD who made the call. They called the ME and then they called the Organ Bank. The vast majority of our deaths were from cancer so the patients never qualified to be organ donors.

[Overwhelmed1026]

One of my Nursing school classmates works for the organ procurement center. She has weeks where she is on call to do the cornea harvesting, then other weeks were it is her job to approach the families. She really enjoys the harvesting, not so much the approaching loved ones. I have a badge for the organ procurement line with all the criteria that outlines a call to them.

[anotherone, BSN, RN]

Hmm, I didn't know anything about these calls. i guess where I work the doctors do this. No nurse that I work with has ever made a call of this type on my unit.

[klone, MSN, RN]

It does not violate HIPAA. I have made these calls countless times. In my experience, call takes no more than 7-8 minutes provided that you have the appropriate information gathered before calling: patient demographics (including SS#), past medical history, and a timeline of the interventions leading to up to the patient's death.

How does that NOT violate HIPAA? Next of kin has not given permission to disclose patient's PHI to a third party (yet). Are they exempt from HIPAA under federal law?

[morte, LPN, LVN]

I imagine it is written in there somewhere. As i said in my first comment, HIPAA just makes it easier for the persons you DON'T want to have access, to have access....

How does that NOT violate HIPAA? Next of kin has not given permission to disclose patient's PHI to a third party (yet). Are they exempt from HIPAA under federal law?