Nursing Clinical Practice Guide
Clinical Scenario: Mr. Johnson, 60, admitted with terminal pancreatic cancer, has a "Donor" designation on his driver's license and his family confirms his wish for corneal donation. He passes away peacefully at 2:00 AM. As the primary nurse, you are responsible for the initial post-mortem care to facilitate donation.
Nursing Intervention Strategy:- 1Assessment & VerificationConfirm the patient's identity, time of death, and documented consent for donation (check chart, donor registry, or next-of-kin authorization). Perform a quick visual assessment of the eyes for any obvious injury or infection that might contraindicate donation (though the eye bank makes final determination).
- 2Immediate Actions (First 5-10 minutes)• Gently close the patient's eyelids.
• Elevate the head of the bed to at least 30 degrees.
• Apply sterile gauze pads lightly moistened with sterile normal saline over the closed eyelids. Do not soak them; they should be damp, not dripping.
• Simultaneously, or immediately after, notify the charge nurse and/or follow facility protocol to contact the designated eye bank or organ procurement organization (OPO). The clock starts at the time of death.
- 3Ongoing Care & Documentation• Maintain head elevation and moisture to the eyes until the eye bank team arrives.
• Document meticulously: time of death, time of notification to eye bank, actions taken for eye care, and any communications with the family or donation coordinator.
• Provide compassionate, private space for the family to grieve, explaining the steps you are taking to honor their loved one's wishes.
Patient Safety and Precautions:
• Key Point! Never use tape on the eyelids, as it can damage the skin and lashes.
• Avoid contamination: Use sterile saline and gauze. Wash hands and wear gloves.
• No pressure: Do not place any significant weight or pressure on the eyes.
• Communication: Coordinate with the mortuary or funeral home staff upon their arrival to inform them the patient is a corneal donor, so they continue appropriate care.
Nursing Procedure & Medication Flow
This is a non-medication procedure. The "flow" is a sequence of time-critical tasks:
Step 1: Verify death and consent. → Step 2: Perform eye care (close lids, elevate HOB, apply moist gauze). → Step 3: Notify eye bank/OPO (per facility policy). → Step 4: Continue care (maintain moisture, position) until procurement team arrives. → Step 5: Complete documentation and provide family support.
A Word from Your Senior Nurse
"Honoring a patient's final wish to be a donor is a profound and sacred nursing responsibility. It turns a moment of loss into a legacy of gift. In the quiet of the night after a death, it's easy to feel rushed or unsure. Remember your protocol: Moisture, Elevation, Notification. Doing these simple steps correctly can literally give someone else the gift of sight. On the NCLEX, they test this because it's a clear, protocol-driven intervention where your knowledge has a direct, tangible impact. In real life, it's one of the most meaningful procedures you'll ever perform."