ryde hospital perioperative unit and operating … · m u/s patient refusal thr’s 2014 missed...

Intended

donors

Actual

donors

2014

M

U/S

Patient

Refusal

THR’s

2014

Missed

donors

Discarded

post

donation

Donors

2013

THR’s

2013

9 13 7 0 43+ 3 3 1 31

Intended

donors

Actual

donors

2015

M

U/S

Patient

Refusal

THR’s

2015

Missed

donors

Discarded

post

donation

Donors

2014

THR’s

2014

23 19 20 1 52 4 2 13 47

Suitable donors participating in 2014

Suitable donors participating in 2015

2014 2015

‘The overall donation rate (which is measured as the number of actual donors compared to the potential donor pool) is 36%, which is well above the expected rate of 25% experienced at most hospitals. The donation rate has also been shown to be fairly consistent over the year indicating awareness of the staff and the programme. During 2015 Ryde has capitalised on its great start and is going from strength to strength. It is clear that the femoral head donation programme has been firmly embedded in the culture at Ryde. The staff are to be congratulated on their diligence and support’

- Helen McKeon (Living Donor Coordinator)

Participating Bone Donors 2012 - 2015

After the lack of femoral head donation was identified as an area for improvement, the Living Donor Coordinator, NSW Organ and Tissue Donation Service was sourced to assist the Perioperative Unit, Pre-Admission Clinic and OT at Ryde to look at ways of improving donor rates. Education took place for all Perioperative, Pre-Admission Clinic and OT staff. Resource folders were supplied to the Pre-admission staff and OT by the Bone Bank. This contained background information about the Bone Bank, the need for femoral heads and outcomes for transplants and copies of all forms and policies regarding donor consents, role of the staff involved in consenting and FH retrieval. These folders are updated as required by the Bone Bank ensuring staff are aware of changes to Bone Bank selection criteria or changes to retrieval requirements. Practice Development methodology was used to gain engagement of the staff following education. In a collaborative manner, the questionnaire used to assess patient suitability for femoral head donation was modified enabling more efficient identification of suitable patients. To help identify any major deficiencies or required practice changes and ensure the best outcome for the donation, all staff engaged in continuous feedback, evaluation and action planning until concerns were exhausted and an agreed way of working was established. All Orthopaedic surgeons fully supported the implementation of the Femoral Head Donation program. In review of the time consumed processing the retrieval of the femoral head, it is evident that these extra efforts from the OT staff enhanced performance.

The staff in the Perioperative Unit and Operating Theatres (OT) at Ryde Hospital were recognised in 2014 by the New South Wales (NSW) Bone Bank for their hugely improved donor identification resulting in increased femoral head (FH) donations. Bone is the second most commonly transplanted tissue, second only to blood. The bone is used for transplantation for various recipients including but not limited to patients receiving spinal surgery to assist with the stabilisation of the bone, leg re-alignment surgery and hip revision surgery.

Our Journey

Most people in the community are in favour of donation, and are enthusiastic to be a part of this initiative. Femoral head donation following elective total hip replacement allows patients to donate their bone which would otherwise be discarded for the purposes of transplantation. This innovative clinical practice has improved patient outcomes and health care delivery. Ryde Hospital will continue their efforts in championing femoral head donation. References: Nather, Aziz, MD, M.B.B.S., F.R.C.S. & David, Vilkram,M.B.B.S.,F.R.C.S. 2007, “Femoral Head Banking:NUH Tissue Bank Experience “, Orthopedics, vol. 30, no.4, pp. 308-312. NSW Organ & tissue donation service 2014, Donor Statistics for 2014 Ryde, prepared by Living Donor Coordinator, NSW. NSW Organ & tissue donation service 2014, Donor Statistics for 2015 Ryde, prepared by Living Donor Coordinator, NSW. Young, V. 2012, “Adrift after donation”, Narrative inquiry in bioethics, vol. 2, no. 1, pp.34

Impact

DEBBIE BOLTON, ROWENA HOOLAHAN, ANGELINE SWAMY, KATHERINE LAVERY. (02) 9858 7633 Karen.Jones1@health.nsw.gov .au

RYDE HOSPITAL PERIOPERATIVE UNIT AND OPERATING THEATRES