title: Utilisation of an embedded specialist nurse and collaborative care pathway increases potential organ donor referrals in the emergency department.
abstract: OBJECTIVE
  To review the impact of an embedded specialist nurse in organ donation (SN:OD) and the utilisation of a collaborative care pathway on potential solid organ donor referrals in an emergency department (ED) over a 24-month period.
  
  
  METHODS
  A retrospective cohort study of adult patient deaths within the department, (n=311) during a 24-month period. Referral rates to the organ donation team (ODT) were compared before and after the introduction of a SN:OD and collaborative care pathway.
  
  
  RESULTS
  Referrals to the ODT significantly increased from three of 151 eligible patients (2%) to 26 of 160 patients (16%; χ(2) test p<0.0001) following the introduction of a SN:OD into the trust. The number of patients proceeding to organ donation increased from none to two (Fisher's exact test p=1.0).
  
  
  CONCLUSIONS
  The presence of an embedded SN:OD in the ED and the adoption of a collaborative care pathway to establish clinical triggers for referral to the ODT have significantly increased the rate of referral of adult potential organ donors to organ donation services.
authors.affiliation: Norfolk and Norwich University Hospital NHS Trust, 48 Pightle Way, Lyng, Norwich, Norfolk NR9 5RL, UK. julian.garside@nnuh.nhs.uk
authors.forename: Julian
authors.initials: J
authors.lastname: Garside
authors.forename: Marie
authors.initials: M
authors.lastname: Garside
authors.forename: Simon
authors.initials: S
authors.lastname: Fletcher
authors.forename: Bruce
authors.initials: B
authors.lastname: Finlayson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003299:Cooperative Behavior; D016529:Emergency Nursing / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000706:statistics & numerical data; D006113:United Kingdom; D055815:Young Adult