Immediate donation of eyes after life: The first prospective, nurse driven, smart phone-based observational study on cornea donation in India

Abstract

Aim: This study aims to evaluate the efficacy of the Immediate Donation of Eyes after Life (IDEAL) protocol in establishing and monitoring hospital-based cornea retrieval programs. Methods: Nursing staff was sensitized to the process of cornea donation (CD), contraindications, and counseling by holding workshops and role-plays. All deaths in each of the participating hospitals of the prospective study were reported on WhatsApp “Code Angel Group” in a specific format. Each death was evaluated to rule out any contraindication to CD, the family was approached by the nurse on duty and counseled for donation. In case of negative or equivocal response to counseling for CD, smart phone-based messages were sent by eye bank (EB), followed by a phone call. Cornea retrieval was carried out by the same EB throughout the study period. In case of negative consent to donation, follow-up phone call to the next of kin at 1–2 weeks was done and response recorded. Results: Of 2140 deaths recorded, 1540 (71.9%) were ineligible for donation, largely due to sepsis. Of the remaining 600, counseling was done in 484 (83%). Ninety-nine of 484 (20.5%) families consented to donation. Counseling was carried out by a total of 70 nurses. Of the 45 nurses who counseled 3 or more families, conversion rate for CD was above 50% in 4, 40%–49% in 2, 30%–39% in 5, 20%–29% in 11, and below 20% in 12. Conclusions: Nursing teams on duty, with brief training on CD, can effectively drive the CD program in hospital setting.