Perceptions of chief nurse executives in acute care hospital organizations toward organ donation are described in this study. Leadership practices, organizational influences, and opportunities to improve the likelihood of organ donation in the current hospital environment are presented. The investigator developed the research instrument, and telephone interviews were conducted. Thematic analysis yielded one main theme: The degree to which hospital leaders consider organ donation a significant factor in patient advocacy influences decision-making practices evidenced in the management structure, commitment of resources, education programs implemented and relationships formed. Four sub-themes that emerged are (a) lack of diversity awareness: organ donation requires leader commitment to cultural change, (b) education programs: failure to standardize education fragments organ donation efforts, (c) role delineation: OPO and hospital responsibilities in organ donation require restructure, and (d) leadership style: executive leadership practices impact the success of organ donation programs.

The results of this study illustrate the ongoing importance in continuous evaluation of relationships and leadership involvement in organ donation processes in the nation's hospitals. Recommendations for future study include replication of this study at a later date, conducting a qualitative study to describe both hospital leader and OPO perceptions about organ donation in the hospital environment. This study was limited to transplant hospitals in the southern states; therefore a recommendation would be to conduct a quantitative, correlational study to survey all hospitals in this area about organ donation.