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Preserving the Opportunity

Preserving the Opportunity. How the UAGA protects the potential donor, family sensitivity, and complements the plan of care Mike Thomas Manager, Hospital Services OneLegacy. Preserving the Opportunity.

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Preserving the Opportunity

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  1. Preserving the Opportunity How the UAGA protects the potential donor, family sensitivity, and complements the plan of care Mike Thomas Manager, Hospital Services OneLegacy

  2. Preserving the Opportunity • Early Consultation • Early Medical Intervention • Guard against early withdrawal of support • Sensitivity to the Family Dynamics and The Trained Requestor

  3. Preserving the Opportunity Early Consultation • Evaluate for donor suitability • Understand & complement the Plan of Care • Normalize and monitor Early Consultation may lead to early medical intervention (Preserve the Opportunity)

  4. Preserving the Opportunity Early Medical Intervention Provide clinical management to maintain oxygenation & organ perfusion in order to prevent secondary injury to the organs. How can a family give the gift of life when the organs are not preserved for transplantation?

  5. Preserving the Opportunity Early Withdrawal of Support / DNR During OneLegacy evaluation of donor suitability, “measures necessary to ensure the medical suitability of the part may not be withdrawnunless the hospital or procurement organization knows that the individual expressed a contrary intent”. (California Health and Safety Code Section 7150.65 (c)).

  6. Preserving the Opportunity In the event of an Advanced Directive where the patient expresses conflicting intent between the desire to be a donor and the withdrawal of support, the attending physician shall confer with the decision maker to resolve the conflict (California Health and Safety Code Section 7151.10 (b)).  This shall be done in consultation with One Legacy.

  7. Preserving the Opportunity Watchful Measures for Nursing: • Changes in neurologic status • Discussion of DNR / Withdrawal of Ventilator Monitor: • Systolic Blood Pressure < 100mm Hg • Urinary Output < 100ml / hour • PaO2 < 100mm Hg Please notify OneLegacy of immediately

  8. Preserving the Opportunity Family Sensitivity / Trained Requestor We can protect family sensitivity by guarding against a premature approach on donation. We ensure this by “huddling” to: • Incorporate organ donation into the End of Life care plan, and • Determine the right time and method to offer the family the opportunity of donation using trained requestors

  9. Preserving the Opportunity The UAGA authorizes us to continue treatment needed to maintain organ donor viability or preserve the opportunity of donation. The first people to benefit from organ donation is the donor family California Health & Safety Code 7150-7151.40 (UAGA) http://www.leginfo.ca.gov/calaw.html

  10. Preserving the Opportunity Thank you

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