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Nursing News HighlightsNurses Leading Innovation

Nurse-Led Needs Assessment Leads to Increased Viability of Donated Lungs

A close-up of a gurney in front of an EMS vehicle
While working as an organ procurement coordinator and and pursuing his Doctorate of Nursing Practice (DNP), Adam K. Schneider was inspired to help his team reach a higher standard of care and education around maintaining donated lungs.

According to the U.S. Department of Health and Human Services, more than 114,866 men, women, and children were waiting for necessary organ transplants as of March 2018. Each donor can potentially provide eight lifesaving organs, including the heart, liver, and intestines; however, these organs need to be obtained with precision and care to ensure they are viable for the recipient. 

This dilemma is what inspired Adam K. Schneider, DNP, AGACNP-BC, to help his team reach a higher standard of care through continued education and updated protocols around maintaining eligible lungs for donation.

At the start of his career in 2012, Adam helped families find solace after losing a loved one while he worked as an organ procurement coordinator at University of Wisconsin (UW) Organ and Tissue Donation. Schneider coordinated the entire donation process for donors and patients from Wisconsin, Michigan, Illinois, and Minnesota.

“I quickly found that I had a passion for providing end-of-life care to critically ill patients,” Adam said. “I felt honored to be able to support patients and families who often experience sudden and difficult loss.”

While working as an organ procurement coordinator and working on his Doctor of Nursing Practice (DNP) degree program project at UW-Madison – a cornerstone of the degree program that helps groom students into practice and policy leaders – Adam realized that one third of organ donors cannot donate lungs due to poor oxygenation. After ruling out more obvious reasons for this, such as obstructive lung disease and trauma, Adam identified a lack of resources and education as a primary barrier to maintaining viable lungs for donation.

“We completed a needs assessment [to determine what was needed to address poor lung oxygenation so that the lungs could be successfully donated] and learned that more tools and donor management skills could help improve the organ procurement coordinator team’s ability to recuperate lungs back into their normal state,” Adam said. “I performed a comprehensive literature review on donor management to understand what the latest research showed about how to manage lung donors and created tools for the organ procurement coordinators to utilize to help standardize their medical management.”

After providing an education session on his findings to those at University of Wisconsin Organ and Tissue Donation, and conducting continued conversations with each nurse on every new organ donation case throughout 2017, Adam and his team successfully obtained viable lungs from 31 donors.

“According to national averages, this was 10 more donors who were able to donate lungs than we should have anticipated based on donor characteristics,” Adam said. “Those 31 donors resulted in 56 lungs transplanted this past year. Our team is thrilled and proud of the additional lives saved as a result of this quality improvement project.”

Adam shared that a new workgroup at University of Wisconsin Organ and Tissue Donation was developed as a result of this project, a donor management steering committee that meets once a month to review organ donors and determine why organs may not have been transplanted. From there, the team develops an action plan to implement and share with staff, contributing to continued growth and learning – and, hopefully, more successful organ donations.

Innovation and collaboration with the nursing community were essential components to the success of this project, according to Adam, who noted that nurses are involved at every stage of patient care.

“Nurses work with everyone, including physicians, advanced practice [nurses], pharmacists, social workers, respiratory therapists, and more,” Adam said. “Nurses are set up to lead these multidisciplinary teams to ensure patients are receiving the best care possible. Innovating new ways to collaborate and provide best practices is essential to ensuring our patients have the best outcomes.”

Adam’s ability to identify a potential problem and establish an ongoing solution has resulted in more organ donations and lives saved, but this project has also impacted his impression of the nursing profession and how he interacts with patients and their families.

“These families have decided to donate their loved one’s organs under difficult circumstances, and it is our responsibility to provide best evidence-based practices to ensure their gift is used to save other lives,” Adam said. “I learn something new from them every day and I strive to ensure they receive the best care possible.”

To learn more about University of Wisconsin Organ and Tissue Donation, click here.

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