Exploring nurses' knowledge, attitudes and feelings towards organ and tissue donation after circulatory death within the paediatric intensive care setting in the United Kingdom: A qualitative content analysis study

Objective: This study explored nurses' knowledge, attitudes and feelings towards donation after circulatory death identifying these domains as barriers and facilitators to nurses effectively undertaking their role in the donation after circulatory death donation process. Design: A single-phase qualitative study design. Setting: One paediatric cardiac intensive care unit in a tertiary paediatric hospital in England. Methods: Data was collected from eight paediatric cardiac intensive care nurses using semi-structured face to face or telephone interviews facilitated by a clinical vignette. Qualitative content analysis was undertaken adopting both inductive and deductive lenses. Key findings: Three categories were deductively generated within which eleven inductively generated themes were situated. Barriers included: knowledge deficits of both process and resources; assumptions about parental views and reluctance to facilitate sensitive discussions, facilitators included positive attitudes toward donation aligned with a strong professional ethos and family-centred values. Conclusions: The paper identifies barriers to the donation after circulatory death process including nurses feeling unprepared for their role, anxiety over family approach and communication methods and support. Highlighted is the need for specific educational interventions, appropriate resources and development of paediatric focussed policy to guide practice. Facilitators to donation include timely, sensitive and appropriate family discussions, trusting nurse-family relationships and improved public awareness. (C) 2019 Elsevier Ltd. All rights reserved.