Critical care staff attitudes to organ donation impact on national donation rates: data from the Donor Action Database

Introduction

The aim was to investigate whether critical care (CC) staff attitudes to organ donation, the concept of brain death (BD) and self-reported skills in donation-related tasks impact on national donation rates.

Methods

Donor Action [1] Hospital Attitude Survey data were collected from 19,537 CC staff (MDs: 3,422, nurses: 13,977, others: 2,138) in 11 countries (Australia, Belgium, Croatia, Finland, France, Israel, Italy, Japan, Norway, Poland, Switzerland) between November 2006 and October 2008. Medical and nursing staff attitudes from each country were correlated with each country's donors per million population rates in 2007 (Council of Europe data). Data examined included average support to donation, respondents' willingness to donate their own, their children's and relatives' organs, the acceptance of the BD concept and reported confidence levels with donation-related tasks.

Results

National donation rates significantly correlated with respondents' attitudes to donation (R = 0.783, P = 0.0029), acceptance of the BD concept (R = 0.651, P = 0.0279), explaining organ donation to family (R = 0.544, P = 0.0845), introducing organ donation to family (R = 0.0182, P = 0.0182) and obtaining consent for donation (R = 0.628, P = 0.0368).

Conclusion

Average CC staff attitudes and donation-related skills clearly influence their assessment and are a strong predictor of a country's donation rate, as demonstrated in this study. Measures to improve donation rates should focus on guidance and education of CC staff so as to ensure that these practitioners have sufficient knowledge and confidence with donation-related issues.