Femoral Head Donor Consent for SA Authorised Nurses
PLEASE FOLLOW THE BELOW STEPS OR DOWNLOAD :
Step 1 - NOTIFICATION OF A FEMORAL HEAD DONOR REQUIRING AN INTERVIEW
- Authorised Nurses will be notified that there is a femoral head donation at their hospital via email notification from a PlusLife Donor Liaison Nurse (DLN).
- The email will be sent at the time the patient has been consented (a maximum of 30 days pre-op and a minimum of the business day before the surgery).
- The email will include the patients Name, Date of Birth and Surgery date.
- A password protected PDF scanned copy of the donors Consent Form will be attached to the email.
- The password is the patients Date of Birth in the format DD/MM/YYYY. This information is contained within the body of the email.
- Password protection can be added by :
– Add PDF attachment to email
– Open PDF in ADOBE
– Select ‘Tools’ > ‘Protect’ > ‘Protect Using Password’
– Type Password and select ‘Apply’
– This will not add a password to the file if saved on the PC, only to the attachment to Outlook
Step 2 - ORGANISING THE AUTHORISED NURSE VISIT
- Where possible the donor should be seen by an Authorised Nurse pre-operatively.
- If not possible to visit prior to surgery the patient can be seen on the ward 1-2 days post-operatively, ensuring it is done before the patient is discharged.
- Upon receipt of the email notification the authorised nurse should reply with their availability to see the donor so that the visit can be allocated to a particular Authorised Nurse.
Step 3 - PERFORMING THE FACE-TO-FACE INTERVIEW AND PHYSICAL ASSESSMENT
- Prior to visiting the donor open the PDF scanned Consent Form using the password supplied and print the 4-page consent.
- When visiting the donor ensure you :
– Introduce yourself and the reason for your visit.
– Confirm identity of donor prior to discussing medical/social history.
– Maintain privacy and dignity at all times.
- Using your observational skills and clinical judgement perform the physical assessment relating to bone donation.
– This may include clinical inspection of a scar, skin lesion, surgical incision, tracks marks, tattoo, piercing or other physical features that may indicate that the donor poses a risk of infectious disease transmission.
– Gather as much information as possible to enable DLN to follow-up as needed (e.g. when, where).
- Perform the face-to-face interview.
– Show the donor any additions made to the Consent Form by the DLN and confirm they are correct.
– Obtain further information to questions as requested by the DLN.
– Confirm that the donor has no additional information to add to the Consent Form and they intend to proceed with the donation.
- Document any changes, additional information, and physical assessment findings on the Consent Form, ensuring you initial any additions.
- Witness the donors’ signature and sign, date and record the time on the Consent Form in TO BE COMPLETED IN HOSPITAL BY DONOR LIAISON box on page 4.
- Reiterate to donor :
– Follow up phone call in 6 months to enquire if any change to health.
– Inform Pluslife if there are any significant changes in health history in the next 12-18 months. Pluslife telephone number is located on all Pluslife paperwork/pamphlets.
– Confirm that the donor has no additional information to add to the Consent Form and they intend to proceed with the donation.
- Thank the patient for donating and give PlusLife brochure.
Step 4 - RETURNING THE COMPLETED CONSENT FORM TO PLUSLIFE
- Scan and email a copy of the completed Consent Form back to Pluslife via donor.liaison@pluslife.org.au.
– Ensure the Consent Form attachment is password protected using the same password format as above.
- Mail the hardcopy of the completed Consent Form to PlusLife Midland using a PlusLife supplied reply paid envelope.
