Gregory researches what influences critical care staff to consider engaging with relatives about organ donation following end of life decisions


Gregory Paul Bleakley, Senior Lecturer in Adult Nursing and Health at the University of Bolton has been awarded a Florence Nightingale Foundation research scholarship for his Professional Doctorate in Health and Social Care at the University of Salford. As the UK observes one of the poorest organ donor rates in Europe, Greg researches ‘What influences critical care staff to consider engaging with relatives about organ donation following end of life decisions.’ We spoke to Greg to find out a bit more about his project.

How did you find out about the Florence Nightingale Foundation research scholarships?
It was through the programme lead for my Professional Doctorate at the University of Salford in May this year. I wasn’t having much luck with funding but I thought I might as well give it a go as it looked like a good option.

Can you give us an overview of what your research entails?
I am trying to find out what motivates staff to consider engaging with potential donor families. When there is a patient at the end of life, normally in intensive care, decisions are made to stop life-sustaining treatment. My research explores the experiences of critical care staff regarding organ donation following end of life decisions.

About 5,000 eligible patients die in the UK in circumstances where they could have donated organs and have potentially saved lives. There are currently around 7,000 patients on the active transplant waiting list. Each year, 1,000 of those patients, three people every day, die because no donor is found. It has also been found that forty percent of families still decline the option of donation. This forty percent refusal rate represents the single greatest barrier in providing more lifesaving transplants. Through previous research, we know some of the reasons why families may be declining but have very little evidence based research and knowledge about early conversations critical care staff have with the donor families, which could be a key factor in the decision.

I also want to find out what motivates clinicians to have a conversation about organ donation with the families. Some support the concept of organ donation while some have more difficulty and discomfort talking about it.

Why did you choose to conduct your research on this topic?
I had been a specialist nurse in organ donation for nearly 10 years. My role was to meet families at difficult times and provide them with the information they need to make the decision regarding organ donation. Even though the UK has seen a massive increase in the number of families saying yes to organ donation over the last eight years, that has only been because we are asking a larger number of people. The one thing that didn’t change over that period was the family refusal rate, stubbornly fixed at about forty percent. I am intrigued why this is and intend to look in detail to what motivates staff to consider engaging in conversation about organ donation with the families.

What research methods will you use to achieve your objectives?
It is a qualitative piece of research, using semi-structured interviews. The actual research questions have been constructed with the support of a donor family, bringing the service user to the forefront of the study.

What do you hope to achieve?
I want to know what motivates staff to engage with potential donor families. I think it’s about establishing a therapeutic relationship between the family and the critical care staff as there are many questions and awkward conversations to have at that difficult time. Research has been done on why people refuse organ donation and it suggests that the timing of the approach and where it’s made is crucial.

By interviewing critical care staff, I aim to get a better understanding about why relatives are declining organ donation. From this research, I will create a template or protocol for the best ways of engaging with families that will hopefully lead to more families agreeing to organ donation. Once this is agreed, more organs can be donated to those on the transplant waiting list, in order to save more lives.

Will the scholarship make a difference to your career?
I worked for the NHS for 19 years and have now moved into the academic world so I think it will certainly help. More importantly, investigating why forty percent of families decline organ donation will hopefully save more patients on the organ transplant list.

Finally, I would like to thank NHS Professionals for the support, I wouldn’t have been able to do it without them.

We will be following Greg’s research progress over the next year and look forward to seeing the results. 

About the author

NHS Professionals administrator

NHS Professionals manages the temporary staffing needs of around 66 NHS Trusts across England. An integral part of the NHS, it aims to reduce Trusts’ spending on flexible workers without compromising quality, by providing greater transparency of demand and supplying bank staff at the best possible rate. Its bank of more than 40,000 flexible workers comprises general and specialist nurses, doctors, midwives, admin/clerical , allied health professionals, healthcare scientists, support services among other healthcare professionals.

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