DCD Pronouncement Team Interest Survey

1 Survey Intro / Background

Baylor Scott & White is evaluating whether to create a dedicated nursing-supported process for deceased cardiac donors, also called donation after circulatory death or DCD.

A DCD patient is a patient with severe, irreversible neurologic injury who is near death but does not meet formal brain-death criteria. When the family has authorized organ donation and the medical team has decided to withdraw life-sustaining treatment, the patient may be taken to a controlled setting, such as the OR, for withdrawal of support and observation.

Importantly, the nurse serving in this role would be acting independently from the organ donation / organ recovery team. The nurse would be functioning as part of the Baylor Scott & White care team only, not as part of the organ procurement or transplant surgical team.

2 Relevant BSWH Policy

Excerpt from the BSWH Determination and Pronouncement of Death policy, POLICY section, paragraph 1.

The policy states that, an RN may determine and pronounce cardiopulmonary death after organ support has been withdrawn by physician order, including where the patient experiences sustained cessation of spontaneous respiratory and circulatory function.

📄 View the full Determination and Pronouncement of Death policy →

3 What This Role Would Involve

If you choose to participate, your role may include:

Being present during the DCD withdrawal-of-support period, which may occur in or near the operating room.
Monitoring the patient after withdrawal of life-sustaining treatment and possibly providing comfort medications.
Assessing for cessation of spontaneous respiratory and circulatory function.
Observing the required period after loss of heartbeat / circulation, which may be up to 5 minutes without a heartbeat, depending on the applicable DCD process.
Determining and pronouncing time of death when appropriate under BSWH policy.
Notifying the appropriate BSWH team members and/or organ procurement team after death has been pronounced for immediate organ procurement.
Documenting the pronouncement of death in the medical record, including date, time, and the individual pronouncing death.

The organ recovery team would not begin organ recovery until after death has been declared.

4 Operational Expectations

These cases may occur approximately twice per month, though frequency may increase over time.
The withdrawal-of-support observation period may last up to two hours. If the patient does not die within the allowed time window, the patient would return to comfort care.

Because OR availability varies, cases may occur during:

Day shift Evening shift Night shift Weekends Holidays

This role would involve increased clinical autonomy, including independent determination and pronouncement of death consistent with BSWH policy.

5 Survey Questions

1. Are you interested in participating in a DCD / deceased cardiac donor pronouncement team? Yes No Unsure / would like more information

2. Would you be comfortable determining and pronouncing time of death for a DCD patient when permitted under BSWH policy? Yes No Maybe, with additional training Unsure

3. Would you be comfortable being present for an observation period that may last up to two hours after withdrawal of life support? Yes No Maybe, depending on staffing / scheduling Unsure

4. Would you be willing to participate if these cases occur during nights, evenings, weekends, or holidays? Yes No Maybe, depending on availability Unsure

5. What shifts or times would you be willing to cover? Select all that apply. Day shift Evening shift Night shift Weekends Holidays Any shift / flexible None

6. What additional support would you want before participating? Select all that apply. Written protocol / checklist In-person training Simulation training Physician backup immediately available Ethics support available Clear documentation template Debriefing process after cases Other:

Responses are used only to gauge interest and staffing feasibility.

DCD Pronouncement Team
Interest Survey

Deceased Cardiac Donor / DCD
Pronouncement Team Interest Survey

1 Survey Intro / Background

2 Relevant BSWH Policy

3 What This Role Would Involve

4 Operational Expectations

5 Survey Questions

Thank you for your response.

DCD Pronouncement TeamInterest Survey

1 Survey Intro / Background

2 Relevant BSWH Policy

3 What This Role Would Involve

4 Operational Expectations

5 Survey Questions

Thank you for your response.

DCD Pronouncement Team
Interest Survey