Introduction There is a shortage of over 500 corneas for transplant each year in the UK. Most people up to age 85 are eligible to donate, even those with metastatic cancer. From March 2018, following a period of staff education, all eligible patients admitted to Martlets Hospice were asked routinely about cornea donation and offered an information leaflet to enable informed decision-making. Prior to this period, only one inpatient per year on average donated their corneas.

Method Evaluation of the project had two components:

1) Audit - the electronic records of all inpatient admissions from March to May 2018 were analysed to identify:

• eligibility for donation and the proportion of patients approached about this

• factors that may have hindered eligible and willing patients successfully donating corneas

2) Staff Opinion Survey - all staff working on the inpatient unit were emailed with an online questionnaire asking about their experiences and suggestions for improvement

Results Audit:

• 27 of the 56 eligible patients were asked

• 14 wanted to donate

• 6 went on to donate

Not informing next of kin and not adequately recording suitable alerts in the notes led to some missed donations

Staff opinion survey:

• 55 responses

• 34 respondents felt able to initiate conversations about cornea donation

Factors that would improve staff confidence were identified as: further training and more time for discussion with patients and families

Conclusions

1. Staff education in and engagement with cornea donation in the hospice setting can empower patients to make informed decisions

2. Sensitive conversations regarding the option of cornea donation are integral to advance care planning

3. Simple changes in practice and culture in our unit led to an increase in donated corneas in just 3 months.

4. Further improvements to the process are planned with a re–audit next year.