Nursing Staff at Transplant Centre Increase Their Oncall Responsibilities to Ensure National DCD Heart Pilot Can Continue

Abstract

<h3>Purpose</h3> In September 2020 the UK Joint Innovation Fund commissioned a pilot in order that the UK transplant community could assess the feasibility of formally commissioning a National DCD heart transplant programme. The pilot is scheduled to finish in May/June 2022. Three transplant centres provide organ procurement support for this initiative with one centre (Centre A) providing 50% of the cover and two centres providing 25% each (Centres B and C). Centre A utilises its nursing staff to operate the organ perfusion device whilst the rest of the teams use their medical staff or perfusionists. This nurse led element is unique to Centre A and has been a great success in advancing the extended role element of our nurses. <h3>Methods</h3> Centre C was unable to continue to support the pilot due to local workforce pressures. The nursing team from Centre A proposed that they increase their oncall activity and a plan was put in place to introduce a "Hybrid" team. A ‘Hybrid' team was introduced with surgeons from Centre B attending DCD heart retrievals and all of the nursing team consisting of the perfusion practitioner, organ preservation practitioner and scrub nurse attending from Centre A during the week every month where historically Centre C would have covered the pilot. This resulted in increased activity for both remaining centres, a new and collaborative way of working between two different transplant centres and also resulted in minimising the risk of the pilot failing. <h3>Results</h3> The "hybrid era" has ensured that 9 patients in the UK have been transplant who otherwise might not have been due to the lack of an available procurement team. The table below shows some of the benefits of this new way of working. <h3>Conclusion</h3> Inter Organisational collaboration instigated and implemented at short notice by the nursing staff at one of the UK Transplant Centres has ensured that the National pilot continued and that many patients received a transplant that otherwise might not have.