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Scholar's Report

Research: A qualitative study of critical care staff experiences of organ donation following the death of a patient

2016/64 - Gregory Bleakley

Abstract

Research question: A qualitative study exploring critical care staff experiences of organ donation following the death of a patient. 

Background to the study:

The aim of the study was explore the experiences of critical care staff regarding organ donation following the death of a patient in their care. In the United Kingdom (UK), 7,000 patients are listed and waiting for a life saving organ transplant (NHSBT 2016). However, the UK observes one of the highest family refusal rates for organ donation in Europe which represents a significant barrier in the provision of organs for  transplant operations. The family refusal rate for organ donation is fixed at 40% and further investigation is needed to explore the reason why families / relatives / carers decline organ donation (Barber et al 2006). Some of the reasons are known why a family declines organ donation (Sque et al 2007) but there is little research or evidence which specifically explores the interactions, experiences, perceptions and beliefs of critical care staff regarding organ donation following the death of a patient in their care. The study seeks to explore these experiences in greater detail, generating new knowledge and the development of a conceptual framework to support critical care staff in the difficult donation discussions. 

Methodological approach: 

The research study adopted a qualitative research paradigm given the intention was to explore the experiences of critical care staff. Specifically, the Constructivist Grounded Theory model developed by Kathy Charmaz (2007) became the theoretical perspective used to conduct the research. The researcher believed that the social world is constructed by social interaction and data can be provided by participants which, in turn, can be collated and analysed. 

Data collection and analysis: 

Data was collected using a series of semi structured interviews with critical care staff. The interview questions were developed with the support of a donor family who had direct experience of organ donation. This ensured that the service user (donor family) featured within the study during construction of the interview questions. Full ethical approval was granted from the University of Salford, NHS Blood and Transplant and the hospital Trust where the research was conducted. 

Findings and discussion:

Interview data was transcribed line by line and analysed which supported the development of themes. The emergent themes allowed the generation of codes which included personal beliefs, integrity / trustworthy, fear / anxiety with the donation question, competence and professional maturity. However, this is an early period in the data analysis process and full results need to be collated.

Conclusion:

Early scrutiny of the findings suggests that professional experience / maturity and trust / integrity are key influencing factors when critical care staff engage with potential donor families. Organ donation is an emotive subject but equipping critical care staff with the correct skills, knowledge and competence to engage in difficult donation conversations enhances the likelihood of a family agreeing to organ donation.

Acknowledgements:

I am indebted to the Florence Nightingale Foundation and NHS Professionals for their belief in my study and the research scholarship to fund my doctoral study for the academic year 2015-16. In July 2015, I attended the FNF in London to talk about my study before a prestigious panel. I was overwhelmed with their response to my research study and grateful for their kind sponsorship. 

In addition, I am grateful to NHS Blood and Transplant, Health Education North West (HENW) and the University of Manchester for providing funding for the remaining years of my study. Finally, I would like to thank my supervisory team at the University of Salford. Without the unrelenting support of Dr Michelle Howarth and Professor Martin Johnson my research project would not have come to fruition. Thank you.