The impact of simulation education amongst nurses to raise the option of tissue donation in an intensive care unit

Abstract
When a person dies, tissue donation is possible in most circumstances, but raising the option of tissue donation with family is difficult at such a stressful time. It is suggested that a lack of education and experience deters nurses from entering into that conversation. However, this impacts on the availability of tissue for transplantation. This study explores the impact of simulation education on the nurses’ perception and experiences of raising the option of tissue donation with families of deceased patients in an intensive care unit. A qualitative descriptive approach using semi-structured interviews was used. Twenty-one nurses took part in simulated education sessions involving family conversations about tissue donation. Five of these consented to be interviewed about their perceptions and the impact of the simulation on their clinical practice. Thematic analysis revealed four main themes: rehearsal, confidence, the nurse-family relationship, and sharing. The nurses gained a better understanding of the language to use to raise the option of tissue donation. All appreciated the opportunity to learn from each other and share experiences. The simulation reassured the nurses that their role is to raise the option of tissue donation rather than seek family consent. This study provides evidence that simulated tissue donation conversations are of benefit to nurses in the intensive care unit. Increasing nurses’ confidence and abilities in raising the option of tissue donation will potentially impact on the availability of tissue for transplantation in Aotearoa New Zealand.

Ngā ariā matua
Ina mate he tangata ka taea te koha pūtautau tinana mō te nuinga, engari he uaua te whakaara i te pātai ki te whānau i tēnei wā taumaha. Ko te huatau, nā te kore i akona, nā te tauhou ki ēnei āhuatanga, ka pēhia ngā whakaaro o ngā tapuhi, e kore ai e tīmata te kōrerorero. Ahakoa, ka pā tēnei ki te wāteatanga mai o ngā pūtautau tinana hei whakawhitinga ki te tangata kē. Tā tēnei rangahau he tūhura i te pānga o te akoranga whakataruna ki ngā whakaaro me ngā wheako o ngā tapuhi mō te whakaara i te kōwhiringa kia kohaina he pūtautau tinana, ki ngā whānau pani, i roto i tētahi taiwhanga whakaora mate taumaha. I whakamahia tētahi huarahi kounga whakaahua nā te whakamahi uiuinga i āhua whakatepea. I whai wāhi ētahi tapuhi (n=21) ki ētahi wāhanga akoranga whakataruna kei roto nei ngā kōrerorero ā-whānau mō te koha pūtautau tinana. Tokorima i whakaae kia uia mō ō rātou whakaaro me te pānga o te whakataruna ki ā rātou mahi āwhina tūroro. Nā te tātaritanga ariā ka puea ake ētahi ariā matua e whā: ko te whakaharatau, ko te māia, ko te whanaungatanga i waenga i te tapuhi me te whānau, me te whakawhitiwhiti. Nā konei ka piki ake te kaha o ngā tapuhi ki te whakamahi reo tōtika hei whakaara i te kōwhiringa o te koha pūtautau tinana. He mea tino whai-kiko ki te katoa te ako tētahi i tētahi, te whakawhiti kōrero hoki. Ka noho te whakataruna nei hei whakamaharatanga mā ngā tapuhi ko tā rātou he whakaara i te kohanga pūtautau, ehara i te mea, he kimi i te whakaaetanga a te whānau. Nā tēnei rangahau kua takoto he taunakitanga he whai hua ngā whakataruna kōrerorero mō te koha pūtautau mā ngā tapuhi i tētahi taiwhanga whakaora mate taumaha. Mā te whakapiki i te māia me ō rātou pūkenga whakaara i te kohatanga pūtautau ka piki ake, ki te titiro rā i muri nei, te wātea o te pūtautau hei whakawhitinga ki te tangata kē, i Aotearoa.

Keywords / Ngā kupu matua
intensive care / te whakaora mate taumaha; New Zealand / Aotearoa; nursing education / te akoranga tapuhi; simulation / te whakataruna; tissue donation / te koha pūtautau