Implementation of clinical guidelines for requesting family informed consent to deceased organ donation for transplantation: Positive effect on consent rates

This study aimed to analyse the effectiveness of implementation of a clinical guide for requesting family informed consent to deceased organ donation for transplantation at the Hospital de la Santa Creu i Sant Pau (HSCSP). From 1st January 2011 to 28th February 2013 there were 52 consecutive brain-dead patients at HSCSP. Fifty-two family interviews took place requesting organ donation for transplantation. In all cases experienced hospital transplant coordination staff performed the family interview. Transplant coordinator case reports are comprehensive records of clinical data and the process of requesting donation in every family interview. Quantitative descriptive analysis was used to describe the main features of the data. Free text items were analysed using content analysis focusing on contributing factors to consent/refusal for organ donation. A retrospective case note review (secondary analysis) was carried out for 52 referrals during this audit period. These were also compared with data from the period of 1994-2010 before the clinical guide was implemented. Percentage difference of family refusal before and after clinical guide implementation was used in the statistical analysis of data. The percentage of family refusals before and after clinical guide implementation was 17.5% (95% confidence interval, 14.7 to 20.3) and 1.9% (95% confidence interval, 0.04 to 10.3), respectively, reaching statistical significance (p=0.001). The implementation by experienced transplant coordination staff of a clinical guide for requesting family consent for deceased organ donation significantly increased consent rates