Introduction: Australian guidelines recommend separating the surgical retrieval (SR) and donation after circulatory determination of death (DCDD) teams. However, they stress the importance of continuous monitoring for determination of death and onset of warm ischemia time, which are important factors for the SR team to be aware of. In New South Wales, Australia Donation Specialist Nurses (DSNs), who are present with the patient, typically relay this information to the donation coordinator in the operating room via phone. We report our experience of using a data-transfer cable to mirror donor observations to a secondary monitor inside the operating theatre.
Methods: From May to December 2023, mirror monitoring was introduced for 11 DCDD cases at John Hunter Hospital. A post-intervention survey was conducted among members of both teams to evaluate perceptions, challenges, and support for the intervention.
Results: Of 57 surveys distributed to donation and retrieval staff, 39 were returned. Post-intervention, 63% (25/40) had used mirror monitoring and 80% (20/25) endorsed its ongoing use, 12% were unsure, and 8% did not support continuation. Notably, 53% (21/40) of non-users still supported future use. Perceived benefits included faster decision-making for the SR team, minimising technical communication difficulties for the donation team and discreet, compassionate care for families. Technical issues occurred in 3 cases. One SR team member reported emotional distress after observing a death via the mirrored feed.
Conclusion: Mirror monitoring was a low-cost, acceptable innovation that improved communication between DCDD and SR teams. Benefits included accurate and quicker decision-making and enhanced family privacy and sensitivity for family grief. Broader implementation would require training in technical setup and psychological support for staff less familiar with end-of-life care.