The number of organs being recovered for transplantation is increasing. Potential organ donors require a team of clinicians who possess expertise and skills to optimize organ function, coordinate care, and minimize potential conflicts of interest. Organ donation support teams are a unique way to provide these services, and nurse practitioners are well poised to provide this specialized care as part of these teams. This article reviews the emerging role nurse practitioners play as members of the organ donation support team. Nurse practitioners support potential organ donors by optimizing organs before donation. They apply their specialized clinical knowledge and skills to support patient care, coordinate care, and perform documentation. As organ donation continues to expand, nurse practitioners who are willing to participate on the organ donation support team need specific knowledge to support organs for transplant.
Despite scientific advancements, demand for life-saving organs continues to outpace supply. Together, hospitals and organ procurement organizations facilitate deceased organ donations; however, a lack of structured inpatient processes and quality improvement mechanisms for potential donor management can lead to delayed referrals by organ procurement organizations, physiological instability, and suboptimal donation outcomes. Goal-directed strategies applied during the inpatient and preprocurement phases of care can significantly increase the number and quality of organs recovered. The aim of this nurse-driven, evidence-based practice quality improvement project was to optimize clinical management and implement accountability measures for adults in the intensive care unit with catastrophic brain injury who are potential organ donors. Within 6 months, the multidimensional change initiative yielded clinically significant improvements across nearly all quality indicators, demonstrating that hospitals can simultaneously support clinical recovery, preserve a legacy for the deceased, and extend hope for renewed life through proactive potential donor care.
A strong working relationship between nurse practitioners and registered nurses is essential for strengthening staff morale and a collaborative learning environment. Within our academic health system, leaders are expected to support collaboration while striving for exceptional quality care and sustained staff engagement in a transplant unit. In recent years, through strong nursing leadership, clear goals, and shared ownership, we have improved quality metrics and strengthened nurse practitioner-registered nurse collaboration. Upholding these principles has enabled the team to consistently deliver safe, high-quality care while enhancing outcomes for both patients and staff. This article highlights the evolution of effective team building on an acute solid organ transplant unit, emphasizing shared professional goals, engagement, accountability, and the application of high-reliability organization principles. Leadership-driven interventions centered on communication, collaboration, transparency, respect, and role clarity have positively influenced patient experience, job satisfaction, and staff wellness.
Background The intensive care unit is a highly demanding nursing environment. Nurse leader communication is crucial for fostering team cohesion, improving performance, and improving health care quality. Objective To examine the association between nurse leader communication styles and team cohesion among intensive care unit nurses in Jordanian governmental hospitals. Methods A descriptive, cross-sectional, correlational design recruited 120 nurses from 3 hospitals using convenience sampling. Data were collected using the Perceived Leadership Communication Questionnaire and Erlangen Team Cohesion at Work Scale. Results This study included 120 nurses (mean [SD] age, 33.44 [7.34] years; 80 men [66.7%]). Leadership communication styles (mean [SD], 3.25 [0.67]) and team cohesion (mean [SD], 4.04 [0.07]) were high. A moderate positive correlation existed between communication styles and team cohesion (r = 0.567; P < .001). Communicative leadership was associated with team cohesion (β = 0.536; P < .001). Conclusions Effective nurse leader communication enhances team cohesion with the potential to improve health care quality and nursing performance. Education programs are recommended to strengthen communication skills among nursing leaders.
Extracorporeal membrane oxygenation is increasingly used in the early postoperative period after lung transplantation, mainly to support patients with primary graft dysfunction and severe right ventricular failure. Recipients with high risk, particularly those with pulmonary arterial hypertension, may benefit from prophylactic extracorporeal membrane oxygenation to promote controlled reperfusion and reduce early allograft injury. This review synthesizes current evidence on indications for postoperative extracorporeal membrane oxygenation, optimal selection between venovenous and venoarterial support, and cannulation strategies tailored to cardiopulmonary physiology. Key challenges, including recirculation, vascular complications, infection risk, and altered pharmacokinetics, are discussed along with methods to detect and mitigate them. Emphasis is placed on the critical care nurse’s integral role in ensuring the safety and success of extracorporeal membrane oxygenation, coordinating multidisciplinary care, identifying complications early, and applying evidence-based management to support allograft recovery and improve patient outcomes.
The number of organs being recovered for transplantation is increasing. Potential organ donors require a team of clinicians who possess expertise and skills to optimize organ function, coordinate care, and minimize potential conflicts of interest. Organ donation support teams are a unique way to provide these services, and nurse practitioners are well poised to provide this specialized care as part of these teams. This article reviews the emerging role nurse practitioners play as members of the organ donation support team. Nurse practitioners support potential organ donors by optimizing organs before donation. They apply their specialized clinical knowledge and skills to support patient care, coordinate care, and perform documentation. As organ donation continues to expand, nurse practitioners who are willing to participate on the organ donation support team need specific knowledge to support organs for transplant.
As extracorporeal membrane oxygenation technology has evolved, interest in awake peripheral venoarterial extracorporeal membrane oxygenation has grown. This approach poses new challenges in patient monitoring. East-west syndrome is a clinically significant but easily overlooked phenomenon associated with awake venoarterial extracorporeal membrane oxygenation. It is characterized by a mismatch in carbon dioxide levels between the extracorporeal membrane oxygenation circuit and the body. Unlike north-south syndrome, which involves cranial-caudal differential hypoxia, east-west syndrome is characterized by variation in lateral blood flow to the brachiocephalic trunk, influencing carbon dioxide levels within cerebral circulation. Early recognition and management of east-west syndrome are key for patients undergoing awake venoarterial extracorporeal membrane oxygenation. Critical care nurses are vital to preventing complications in this patient population. The goal of this article is to increase awareness of this new phenomenon and prepare critical care nurses to optimize outcomes for patients undergoing extracorporeal membrane oxygenation.
Background With advancing technology, interest is growing in the use of wearable activity trackers to promote physical activity in the inpatient and critical care settings. Objective To quantify mobility in the post-operative period using wearable fitness trackers (Fitbit). Methods This was a prospective observational study involving 22 patients. Daily postoperative step counts were recorded, and subjective mobility scores were documented. Results The fitness trackers proved unreliable and inaccurate owing to challenges with device placement, physical limitations, and patient compliance, leading to premature termination of the study. Secondary outcomes using overall patient mobility and Braden scores were used as correlational markers of disposition. Conclusions The utility of wristband activity trackers in critical care appears to be limited. Further studies examining the outpatient use of wearable devices for rehabilitation to improve accuracy in the hospital setting would be beneficial.
Partial heart transplantation has emerged as a novel, innovative solution to the problem of valvular cardiac disease in children, allowing the transplantation of living donor tissue that retains cellular viability and growth potential. Since the first pediatric partial heart transplant was performed at Duke University in 2022, the procedure has continued to grow and develop, with excellent clinical outcomes. This review examines the clinical history of partial heart transplantation; clinical outcomes to date; special considerations for perioperative multidisciplinary management specific to critical care nurses, clinical nurse specialists, nurse practitioners, and physician assistants; and future directions and implications of partial heart transplantation in the pediatric population, both locally and globally.
Nurse practitioners are essential members of the multidisciplinary team managing heart transplant candidates and recipients, a patient population with highly specialized, complex care needs. Nurse practitioners contribute to successful patient outcomes by delivering expert care, facilitating smooth transitions, and maintaining continuity of care throughout the patient's journey. This continuum of care progresses from pretransplant evaluation and optimization, to the vulnerable perioperative and recovery period, and throughout the patient's transition back into the community, which entails lifelong prevention, surveillance, and management of long-term complications. The deep familiarity of nurse practitioners with program protocols, stewardship of collaboration, and consistent presence positions them as trusted resources for nurses, trainees, allied health professionals, and consulting specialists involved in the heart transplant recipient's care. Overall, nurse practitioners help to streamline care, mitigate risk, bring forth best outcomes, and optimize patient well-being in the ever-evolving heart transplant population.
