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DCD Patients Post -Authorization – Roles Clearly Defined

DCD Patients Post -Authorization – Roles Clearly Defined . 2013 National Donor Management Summit Los Angeles, California September 25, 2013. Speakers:. Marwa Kilani , MD Providence Holy Cross, Mission Hills Nancy Knudsen, MD Duke Medical Center, NC Sophoclis Alexopoulos , MD

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DCD Patients Post -Authorization – Roles Clearly Defined

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  1. DCD Patients Post -Authorization – Roles Clearly Defined 2013 National Donor Management SummitLos Angeles, California September 25, 2013

  2. Speakers: • MarwaKilani, MD Providence Holy Cross, Mission Hills • Nancy Knudsen, MD Duke Medical Center, NC • SophoclisAlexopoulos, MD Keck Medical Center of USC, Los Angeles Children’s Hospital of Los Angeles

  3. Question to Run On: • How do we safeguard process to ensure that we honor each gift by maximizing the opportunity?

  4. Case Overview Providence Holy Cross Medical Center 38 F ALOC & Respiratory Distress 1st Referral 2nd Referral 3rd Referral 6/12 - Referred to OPO 6/15 - Palliative Care Consult 6/16 – Closed NBD/WNP 6/20 -1stFamily Conference 6/21 – Re-referred due to Compassionate Extubation 6/25 – Closed NBD/WNP 7/3 - 2nd Family Conference 7/3 - Re-referral to OPO 7/3 - Approach/ Authorization for DCD

  5. DCD – Defining the Roles Post Authorization: Hospital Participation: • Intensivist (PC) • Nurse • Respiratory Therapist • Chaplain/Social Worker OPO Participation: • Procurement Transplant Coordinator • Family Care Specialist • Donation Development Specialist • Surgical Recovery Technologist

  6. Hospital Responsibilities: • Continue Caring for the Patient • Continue Supporting the Family • Communicate with the OPO – Huddle • Know the Hospital DCD Policy

  7. Palliative Care and Donation Palliative Care Collaborative Leadership Family Attending MD OPO Palliative Care Team Family Support Services Bedside Nurse Consistent, Clear Communication leads to Understanding & TRUST

  8. Intensivist (PC): • Medical Management of the Patient • Administer Comfort Medications • Prescribe the Heparin • Death Pronouncement

  9. What Drives Us: “ The recovery of organs from DCD donors is an important, medically effective and ethically acceptable approach to reducing the gap…between the demand for and the available supply of organs for transplantation.” *Institute of Medicine, 1997b, p.1

  10. Ensure the Following: • Huddle to discuss all roles: • Ensure everyone is comfortable with his/her role • Have a plan in place should the patient not expire • Prepare the OR (Drape windows, cover equipment, provide a setting that is family appropriate)

  11. And now to the OR…

  12. Declaration of Death Glen Franklin September 25, 2013

  13. Question to Run On: • How do we safeguard process to ensure that we honor each gift by maximizing the opportunity?

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