Introduction: An increasing population and a lack of identified potential organ donor patients make the waiting list or people needing a new organ constantly growing. Donation after Circulatory Death (DCD) is a method to achieve the demand for transplantable organs. However, it implies new challenges in nursing care and there is a lack of studies investigating nurses' attitudes and knowledge of DCD.
Method: The study has a cross-sectional, mixed-method design. A convenience sampling method was employed for this case study.
A study-specific 26-item tool with fixed and free-text answers was developed and sent to n=145 intensive care nurses (ICNs) working in four intensive care units in Sweden. Data were analyzed descriptively, and correlation analyses were performed. The free-text answers were qualitatively analysed.
Results: Fifty-three percent of the participants had limited knowledge about the DCD process. Respondents who had previous education on DCD had significantly higher knowledge of DCD (r=.380, p = 0.006), followed the public debate regarding organ donation (r=.423, p=0.002), and thought about ethical perspectives of DCD (r=.386, p= 0.022).
The qualitative analysis resulted in four categories: The importance of the team, Need for ethical discussions, Increased knowledge of DCD, and Unanswered questions and unmet needs. The integrated analysis underscored the need for targeted education, clear guidelines, and ongoing ethical discussions to prepare ICU nurses for DCD.
Conclusion: Nurses with previous education in organ donor care had higher knowledge, displayed a more positive attitude towards implementing DCD in their units and followed the public debate on DCD. The importance of interprofessional teamwork and ethical perspectives were key aspects that were emphasized to facilitate DCD implementation. These findings may lead to higher motivation in identifying DCD donor patients and implementing the DCD process, which is needed due to a global lack of transplantable organs.