Original ResearchCan eye donation rates be increased in hospitals: a pilot study in a tertiary care hospital in North India?
Introduction
There are around two million people in India who are blind due to a defective cornea, with 20,000 new corneal blind patients added every year.1 A healthy cornea from a deceased person is a simple requirement to restore the vision of a corneal blind patient. The death rate of India as per the latest census is 8/1000 population but the statistics provided by the Ministry of Health and Family Welfare, Government of India, show that the number of corneal donations has been stagnant at around 40 thousand per year since 2007.2 This shows that the potential for increasing eye donation rates is huge. A program to retrieve corneas of deceased patients in tertiary care hospitals of the country which receive a large number of critical patients, if implemented effectively and successfully, can help tap this potential. Cornea retrieval in India is opt in; the next of kin of deceased patients decide about eye donation and convey their decision to the hospital at the time of death of their patient. Therefore, an effective method to increase eye donation would be to counsel and convince the next of kin on their patient's death of the need for eye donation.
The main thrust of the study institute, like in all similar institutes, is providing the best possible medical care to the huge number of patients visiting the hospital. So, for obvious constraints, promoting eye donation does not receive the utmost attention. Over the last couple of years, the institution has been trying to increase the eye donation rate through IEC measures such as posters and radio shows, but with limited success. At the beginning of 2014, a comprehensive plan of action was put into place in the institution for increasing eye donation. The idea behind this intervention was to ensure that counsellors of the eye bank did not miss any opportunity to motivate the next of kin of every patient expiring in the institute. The crux of the intervention was ensuring that intimation of every death in the institute reached the counsellors in real time and that the counsellors sincerely and wholeheartedly attended to each of these intimations immediately.
Section snippets
Intervention
A dedicated mobile phone connected to the Closed User Group network of the institute was provided to the counsellors. The nurses were asked through the medical superintendent of the institute to report every death occurring in the institute immediately on the number. To ensure that no intimation about a single death was missed, software was embedded in the Hospital Information System which was linked to the Closed User Group network. As soon as a nurse entered the information of expiry of any
Impact
The period from February 2011 to January 2014 was taken as pre-intervention period & February 2014 to January 2015 as the post intervention period to evaluate the impact of this intervention. The hospital received 312, 324 & 274 corneas respectively in three successive years of the pre-intervention phase while in the post intervention phase of one year the hospital received 510 corneas. It was seen that cornea donation increased by 68% in the post intervention phase which was found to be
Summary
In the opt-in system of eye donation, it is the next of kin of expired patients who decide at the time of death of their patient if they wish to donate eyes of their patient as revealed in a study done by Emmanouil K et al. which showed that only 2.2% of the willing donors had donor cards.3 Similarly, a study done by Guleria K et al. found high willingness for eye donation in urban (76%) and in rural areas (78%) but only 6% had actually pledged their organs.4 Hence the time of death of a
Author statements
This study was conducted in a public sector tertiary care hospital of India. This hospital, like all other hospitals in the country, is trying to increase its organ donation rate as per the mandate of the Government. This study was conducted with this mandate & as such no funding was taken from any organization. There is no competing interest for this study. Efforts to promote eye donation have been mandated by the Government of India and countries world over are attempting the same. The study
References (7)
- et al.
Factors influencing the propensity of nurses to counsel patients for eye donation: a pilot study in a tertiary care hospital in North India
Public Health
(2014) - Ministry of Health & Family Welfare (NPCB) website. Rapid assessment of avoidable blindness-India report 2006-07....
- National Program for Control of Blindness in India website. Available at:...
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