Emergency departments as the front door to hope: Strengthening the role of emergency nurses in organ and tissue donation

Background: Emergency Departments (EDs) play a pivotal role in the early identification and referral of potential organ, tissue, and ocular donors. Emergency nurses are often the first clinicians to recognize donor triggers, support families during critical moments, and collaborate with donation organizations. Despite this essential role, variability in knowledge, comfort level, and referral patterns continues to be a barrier to maximizing donation opportunities. As jurisdictions across Canada work to increase donation rates and expand tissue and ocular capabilities, strengthening ED engagement has become a national priority within organ and tissue donation systems. Objectives: This presentation will: • Highlight the essential role of emergency nurses and ED teams in the organ and tissue donation process. • Identify barriers and opportunities related to early referral, communication, and collaboration between EDs and donation organizations. • Share practical tools, education strategies, and system improvements used to enhance ED donation readiness. • Inspire emergency nurses to see themselves as catalysts for donation culture, family support, and system-wide improvement. Methods: This session integrates evidence-based guidelines, CIHI performance data, and frontline experiences from emergency departments across Canada. Content includes: • A review of ED-led triggers and referral pathways for organ, tissue, and ocular donation • Lessons learned from province-wide and regional initiatives focused on engaging ED leadership, coroners/medical examiners, inpatient teams, and frontline staff. • Case examples illustrating effective communication, missed opportunities, and successful collaboration. • Strategies used to modernize donor screening processes, expand education, reduce referral barriers, and streamline ED-to-donation team workflows. • Insights from the presenter’s dual perspectives as a former ED nurse/manager and current organ and tissue donation leader. Results: Following strengthened ED engagement initiatives, many jurisdictions have observed improvements in donor identification, increased staff confidence in making referrals, and enhanced collaboration between emergency clinicians and donation teams. Feedback from ED nurses often highlights greater clarity around triggers, earlier consultation with donation specialists, and reduced uncertainty during family interactions. Emerging data demonstrate increases in tissue referral volumes and improved responsiveness to time-sensitive ocular donation opportunities. Implications and lessons learned: Emergency nurses are uniquely positioned to influence donation outcomes, family experience, and system performance. Key lessons include: • Early education and simple, standardized referral triggers significantly reduce missed opportunities. • ED leaders benefit from structured support to reinforce donation culture within their teams. • Integrating donation workflows into routine ED practice removes uncertainty and empowers nurses. • Strong partnerships between provincial donation programs and emergency departments drive measurable improvements in donation rates. • Practical, actionable takeaways will be shared to help emergency nurses champion donation readiness, enhance family-centered care, and strengthen collaboration with organ and tissue programs nationwide.