Background In 2012 a study to explore hospice nursing and medical staff knowledge of, and attitudes towards, organ and tissue donation was undertaken. The study identified that the barriers to discussing tissue and organ donation were multiple and the results highlighted several recommendations:

• ▸ Increase staff awareness and knowledge

• ▸ Introduce guidelines on who can donate what and how

• ▸ Increase patient awareness of the option of tissue donation

• ▸ Explore when is the right time to ask a patient about their wishes relating to organ and tissue donation

Background

Putting research findings into practice To address these, key links have been established with the National and local acute Trust Organ and Tissue Donation Teams. This has enabled the facilitation of a teaching and awareness session for clinical staff to enhance their knowledge about who can donate, which tissues can be donated, the process of donation, and what to do if a patient expresses a wish to be a donor.

Exploring when to ask a patient about their wishes was also discussed at the Patient and Carer Participation Group. The general consensus was that it is acceptable to ask patients, but the timing of this needs to be sensitively considered. Ideally, the outpatient setting was seen as the most favourable environment as part of the patient's holistic assessment acknowledging that it is also acceptable to ask patients in discussions about dying.

A simple question “Do you carry a donor card?” may provide a good opening to discussion.

The next steps The implementation of change is ongoing. Currently we are considering written information for patients and carers, reviewing the most appropriate place to record the patient's wishes within the patient's electronic record and formulating clear guidelines for clinical staff to refer to.