55 Corneal donation in the hospice setting: maintaining momentum and ensuring wishes are heard and realised

<h3>Background</h3> The UK faces an on-going shortage of donor corneas to meet needs - to such an extent that NHSBT recently removed the upper age limit on potential donors. Hospice and palliative care teams are well positioned to discuss and consent for corneal donation in life with individuals under their care and after death with their families. This audit continued an audit loop, evaluating hospice processes from admission to successful retrieval to identify any fail points in processes. Some were identified. This has led to recommendations towards a goal of an average of &gt;3 donations per month. Results will include a re-auditing to see if this has been achieved. <h3>Method(s)</h3> Retrospective data collection from electronic patient record on all hospice admissions from December 2023 to April 2024 including admission discussions/decisions regarding donation, follow-up discussion if initially uncertain, quality of documentation, admission outcome, donations achieved and reason why if not achieved. Alongside a Google forms survey for ward staff concerning processes. <h3>Results</h3> 9 donations achieved (2.25/month), exceeding our previous audit target of 2/month. <h3>Key Findings</h3> Almost 70% of patients are having a discussion at admission, with 17 stating ‘for’. Donations following discussions after death: 4 No discussion recorded before or after death: 21 Commonest reason for donation not achieved in those wanting to: Not referred to NHSBT after death. Five common failure points were identified. Survey identified low staff confidence in after death discussions. <h3>Conclusion(s)</h3> Previous audits have maintained donation momentum, however this audit identified several missed opportunities for donation. Improvement recommendations include: Face to face education sessions, facilitating more staff to see retrieval, updated mandatory training, pocket guide to discussions, a new EPR tag to prompt outstanding discussions and discussions after death if donation wish uncertain. A second audit cycle is underway assess success of the changes implemented.