The Development of Nursing Service System for Organ and Eye Donation Patients at Udon Thani Hospital

Abstract

This research and development aimed to develop and evaluate the results of the development of the nursing service system for patients who donated organs and eyes at Udon Thani hospital by using the concept of integrated quality development with nursing processes. The research was conducted in 4 steps: 1) study and situation analysis 2) design and implementation 3) trial use and 4) outcome evaluation. The sample group was purposively selected, consisting of 60 registered nurses and 6 professional nurses who had completed a specialized nursing course in organ, tissue and transplantation total 66 nurses, and 76 volunteers; 35 relatives of brain-dead patients who were not contraindicated to donate organs and 41 relatives of patients who died in cardiac arrest who were not contraindicated to donate eyes to the Thai Red Cross Society. The research instruments were 1) the developed nursing service system for patients who donated organs and eyes. The quality of the service system was assessed by AGREE II by 4 experts. It passed all 6 assessment criteria with a score of 87.6 percent and an overall score of 90.4 percent. 2) The instruments used to collect data included (1) a knowledge assessment form (2) an assessment form for the use of the nursing service system (3) a questionnaire on satisfaction with the nursing service system and (4) an assessment form for the donation outcome, which had been examined for content validity by experts and the reliability was 0.82. Data analysis used content analysis, descriptive statistics included percentage, mean, standard deviation and inferential statistics used paired t-test.

The research results found that the nursing service system obtained was the I AM CARE model, consisting of 3 stages; pre-donation, intra-donation and post-donation. As for the development results in terms of service providers, it was found that the mean scores of knowledges about organ and eye donation of nurses before ( =11.95±1.52) and after the development of the nursing service system ( =17.77±1.28), these were significantly different (p < 0.001). The overall satisfaction of nurses and the deceased's relatives with the use of the nursing service system were at the highest level ( ₁=4.53±0.57 and ₂=4.19± 0.73 respectively). After using the developed nursing service system for patients with organ and eye donations, there was no incidence of lose potential organ donor. It was showed that the rate of actual organ donors were increase from 1.25 to 2.74 and actual eye donors were increase from 1.50 to 3.24 per 100 hospital dead. It was also found that increase of organs and corneas could be transplanted, many recipients had transplanted resulting a better quality of life.