|
1
|
Silva E Silva V, Dupuis KL, Shoalts K, Dhanani S, Silva A. Exploring educational and training approaches for organ and tissue donation coordinators: A scoping review. NURSE EDUCATION TODAY 2025; 148:106630. [PMID: 39978221 DOI: 10.1016/j.nedt.2025.106630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 02/03/2025] [Accepted: 02/10/2025] [Indexed: 02/22/2025]
Abstract
INTRODUCTION Organ and tissue donation coordinators often have limited training leading to reduced service quality and increased work-related stress. Understanding the existing educational strategies and training methods is crucial for supporting their professional development. OBJECTIVES To synthesize existing literature on strategies used to educate healthcare professionals for the role of organ and tissue donation coordinators. DESIGN Scoping review guided by the Joanna Briggs Institute methodology. DATA SOURCES Searches were conducted in Medline, Embase, Cumulated Index in Nursing and Allied Health Literature, Web of Science, Cochrane Library, and Latin American and the Caribbean Literature on Health Sciences up to 2023. STUDY SELECTION Reports on education for healthcare providers working as organ and tissue donation coordinators were included. Reviewers independently screened documents for eligibility based on inclusion criteria. DATA EXTRACTION Data on study design, sample, educational strategies, and outcomes were extracted using a specially developed tool. The data were analyzed quantitatively (simple numeric count) and qualitatively (content analysis). RESULTS From 5420 articles, 33 met the inclusion criteria. The results were categorized into (1) Education Types and Engagement, (2) Education Strategy Development and Delivery, and (3) Education Evaluation Methods and Outcomes. CONCLUSION The findings highlight the diverse types, delivery methods, and evaluation approaches in organ and tissue donation coordinators' educational training. Ongoing education is vital to equip organ and tissue donation coordinators with essential skills for complex scenarios in organ donation and transplantation. Investing in comprehensive education programs is crucial for enhancing organ and tissue donation coordinators' work-related wellbeing, improving organ donation and transplantation outcomes, and promoting continued research and development tailored to their unique needs.
Collapse
Affiliation(s)
| | | | - Kerry Shoalts
- Department of Nursing, Brock University, St. Catharines, Canada
| | - Sonny Dhanani
- Research Institute, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Amina Silva
- Department of Nursing, Brock University, St. Catharines, Canada
| |
Collapse
|
|
2
|
Al-Salhi A, Othman EH. Public knowledge about and attitudes toward organ donation, and public barriers to donate in Jordan: A cross-sectional study. World J Transplant 2024; 14:95419. [PMID: 39697461 PMCID: PMC11438934 DOI: 10.5500/wjt.v14.i4.95419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/11/2024] [Accepted: 07/01/2024] [Indexed: 09/20/2024] Open
Abstract
BACKGROUND Organ donation is a critical issue that is receiving greater attention worldwide. In Jordan, the public's knowledge about and attitudes toward organ donation play a significant role in the availability of organs for transplantation. AIM To assess the public knowledge about and attitudes toward organ donation in Jordan. METHODS A cross-sectional design was used to collect data from 396 Jordanian citizens via an online self-reported questionnaire. RESULTS Overall, 396 participants were recruited. Of the entire sample, 93.9% of the participants had heard about and had sufficient knowledge about organ donation but they had limited knowledge about brain death. The most common source of information about organ donation was social media networks. Females were found to score significantly higher than males for attitude. Those who had thought about organ donation or registered their names to donate scored significantly higher in terms of attitudes to donation than their counterparts who had not. The most common reasons for limited organ donation practices in Jordan were a lack of awareness programs and insufficient knowledge in society. CONCLUSION Greater public understanding of organ donation appears to be associated with more positive attitudes toward organ donation. Most participants responded positively regarding their attitude toward organ donation as they believed that this action could give another person a chance to live. Moreover, most agreed that they would donate their organs after their death. Otherwise, the participants had limited general knowledge about brain death, and most had not registered their names to donate their organs. These findings indicate the need for public awareness campaigns and educational programs to encourage more people to become organ donors.
Collapse
Affiliation(s)
- Adham Al-Salhi
- Faculty of Nursing, Applied Science Private University, Amman 11962, Jordan
- Department of Nursing, Jordan Hospital, Amman 11152, Jordan
| | - Elham H Othman
- Faculty of Nursing, Applied Science Private University, Amman 11962, Jordan
| |
Collapse
|
|
3
|
Alirezaei A, Latifi M, Pourhosein E, Dehghani S. Enhancing Donor Transport Success: Lessons From the Iranian Experiences. EXP CLIN TRANSPLANT 2024; 22:675-678. [PMID: 39431834 DOI: 10.6002/ect.2024.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2024]
Abstract
OBJECTIVES Organ transplant is a complex process that involves various medical, legal, and social factors. The organ demand continues to outweigh the supply, leading to global challenges in the expansion of transplant programs. Ischemic time is crucial for the viability of organs, and efforts are being made to reduce transport time to improve transplant success rates. The viability and quality of the organ for transplant depends on minimized ischemic time. MATERIALS AND METHODS A new method is presently being implemented in Iran, in which, instead of transfer of organs, leading to reduced organ quality due to ischemic time, the donors themselves are transferred to transplant centers with the help of a trained team after brain death is confirmed and with the consent of the family. During the transfer process, an anesthesiologist or nurse specialized in donor care performs the relevant pretransplant procedures. RESULTS The successful transportation of donors to centers for organ procurement requires meticulous planning, trained personnel, and adherence to safety protocols. Quality assurance measures, including audits and safety protocols, are in place to ensure the timely and safe delivery of donated organs. Ultimately, improvements in the transportation process for organ donation can enhance transplant success. CONCLUSIONS Successful transportation of donors to organ procurement units is crucial for reducing ischemic time and improving the success rate and quality of organ transplants. Careful planning, communication, and collaboration among health care professionals are necessary for the timely and safe delivery of donated organs.
Collapse
Affiliation(s)
- Amirhesam Alirezaei
- >From the Department of Nephrology, Shahid Modarres Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | | | | | | |
Collapse
|
|
4
|
Mahdi S, Marzieh L, Habib R, Elahe P, Sanaz D. The role of healthcare professionals to improve organ donation and transplantation outcome: a national study. Cell Tissue Bank 2024; 25:159-165. [PMID: 36707455 PMCID: PMC9883121 DOI: 10.1007/s10561-023-10071-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 01/10/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Improve the quality of donor coordination activities caused by an increased organ donation rate. The aim of this study was to assess the influence of organ donation coordinators' characteristics on rate of donation and family consent rate in Recognition Centers (RCs) and Organ Procurement Units (OPUs) in Iran by analyzing the organ procurement and transplantation data. MATERIALS AND METHODS Based on a questionnaire, this retrospective study evaluated the number of confirmed brain deaths, family consent rate, organ recoveries, rate of expired brain death cases before and after family consent in Iran. RESULTS According to results, the overall family consent rate in the entire country is equal to 60.63%. The work experience had a significant effect on the number of procured organs (P < 0.004), death rate after family consent (P < 0.04), and eligible donor death before family consent (P < 0.03). The type of unit (RCs or OPUs) had significant difference on death after family consent (P < 0.023), the death before family consent (P < 0.014), the sum of procured organ (P < 0.04). CONCLUSION The consent rate and donor management in the cases of brain death are unacceptable. The coordinators need training to increase their efficiency in terms of family approach and maintenance of brain death. Only by improving the level of family consent and increasing the coordinators' maintenance skills for brain death cases can the amount of organ donation in Iran be doubled to the current amount.
Collapse
Affiliation(s)
- Shadnoush Mahdi
- Nutrition & Food Technology, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - Latifi Marzieh
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahban Habib
- Cardiovascular Research Foundation of Southern California, Beverly Hills, CA USA
- Southern California Medical Education Consortium, Universal Health System, Temecula, CA USA
| | - Pourhosein Elahe
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Dehghani Sanaz
- Organ Procurement Unit, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Tissue Bank & Research Center, Tehran University of Medical Sciences, Sina University Hospital, Hassan-abad Sq. Emam Khomeini St, Tehran, Iran
| |
Collapse
|
|
5
|
Peralta P, Istrate M, Ballesté C, Manyalich M, Valero R. "Train the Trainers" Program to Improve Knowledge, Attitudes and Perceptions About Organ Donation in the European Union and Neighbouring Countries: Pre- and Post- Data Analysis of the EUDONORGAN Project. Transpl Int 2023; 36:10878. [PMID: 36776900 PMCID: PMC9911461 DOI: 10.3389/ti.2023.10878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/10/2023] [Indexed: 01/29/2023]
Abstract
EUDONORGAN, a European Union-funded project to improve organ and tissue donation, included a blended-based "Train the Trainers" program, which was implemented with the support of an international consortium from Croatia, Italy, Slovenia, and Spain. The web-based training included seven modules for which medical aspects, educational tips, and practical activities were scored using a 5-point Likert scale. The overall mean scores of satisfaction were higher than 4 for each module, without significant differences between HCPs and OKPs. In the face-to-face training survey similar scores above 4 were obtained for most items. Knowledge acquisition improved significantly in both HCPs and OKPs, as well as in transplant/donor coordinators, medical doctors, registered nurses, anesthesiologists/intensivists, and intensive care nurses. Improvements in attitudes and perceptions regarding organ donation were also observed, particularly among HCPs. In the accomplishment of the learning process, a successful pass mark of 95% was obtained. The "Train the Trainers" program was associated with an improvement in learning and attitudes of healthcare and non-healthcare professionals for the benefit of organ and tissue donation.
Collapse
Affiliation(s)
- Patricia Peralta
- Surgery and Surgical Specializations Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Melania Istrate
- European Society of Intensive Care Medicine, Brussels, Belgium
| | - Chloe Ballesté
- Surgery and Surgical Specializations Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain,Donation and Transplantation Institute (DTI), Barcelona, Spain
| | - Martí Manyalich
- Surgery and Surgical Specializations Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain,Donation and Transplantation Institute (DTI), Barcelona, Spain
| | - Ricard Valero
- Surgery and Surgical Specializations Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain,Donation and Transplantation Institute (DTI), Barcelona, Spain,Department of Anesthesiology, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain,*Correspondence: Ricard Valero,
| | | |
Collapse
|
|
6
|
Araujo CAS, Siqueira MM. The Effect of Educational Initiatives on the Attitude and Knowledge of Health Care Professionals Regarding Organ Donation and Transplantation: An Integrative Literature Review. Transplant Proc 2023; 55:13-21. [PMID: 36609025 DOI: 10.1016/j.transproceed.2022.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/24/2022] [Accepted: 09/20/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND This integrative literature review synthesizes evidence on the effect of educational initiatives (EI) on the attitude and knowledge of health care professionals regarding organ donation and transplantation (ODT), and the EI effect considering the risks of the ODT process related to the professionals' attitudes and knowledge. METHODS This search included 8 databases, with search terms across 4 groups: ODT activities, health professionals, attitude/knowledge, and EI. We applied the PICO framework to select articles: Population - health care professionals; Intervention - any EI; Comparison - pre/post or intervention/control designs; and Outcomes - indicators of attitudes or knowledge toward ODT. After the appraisal of 2,221 citations, 21 studies were included in this review. RESULTS The EI varied to a great extent in terms of format (seminars, workshops, video lectures; online or in-person training), duration (from 15 minutes to 3 months), and the number of participants (from 12 to 1011). The effects reported were positive, increasing professionals' knowledge and attitude regarding the ODT process for all EI formats. Most articles (14; 67%) presented positive results with statistical significance for all indicators analyzed, and the remaining studies (7; 35%) reported statistical significance for some of the indicators analyzed. All EIs focused on donation or post-transplantation activities, lacking studies on the transplantation stage. CONCLUSIONS Results suggest that different types of EIs may positively affect the attitude and knowledge of health care professionals regarding the ODT process. This study provides an up-to-date overview of the main themes examined in this literature, highlighting critical knowledge gaps and methodological flaws.
Collapse
Affiliation(s)
- Claudia A S Araujo
- The Coppead Graduate School of Business, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Fundação Getulio Vargas's Sao Paulo School of Business Administration -FGV/EAESP, São Paulo, Brazil.
| | - Marina Martins Siqueira
- The Coppead Graduate School of Business, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
|
7
|
Xie Q, Lei L, Duan F, Luo Y, Luo C. Exploration of Profession Experience Among In-Hospital Organ Procurement Coordinators in China: A Qualitative Study. Transplant Proc 2022; 54:2082-2087. [PMID: 36127172 DOI: 10.1016/j.transproceed.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/02/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The gap between the supply and demand of organs is continuously increasing. The emergence of organ procurement coordinators (OPCs), to a certain extent, has decreased the gap. In China, a majority of OPCs work in hospitals that are qualified for transplants, namely in-hospital OPCs (Ih-OPCs). Their profession experiences are closely related to donation rates and indirectly reveal aspects that should be further improved. However, no data are available in China. We sought to explore Ih-OPCs' subjective feeling of the practice experience and provide targeted interventions for administrators. METHODS A project team was established and then interview outlines were listed by virtue of discussion and literature review. Furthermore, a total of 13 Ih-OPCs were selected as participants for interview. After that, the conversation was analyzed and encoded, and themes were finally identified according to phenomenology. RESULTS A total of 3 themes including positive emotions, negative emotions, and personal needs were identified, which were furthermore divided into 7 minor themes ranging from professional identity, competence improvement, recruitment methods, quality of life, workload evaluation, career prospects, and training courses. CONCLUSIONS Social support and public understanding play a pivotal role in strengthening positive emotions. Meanwhile, the administrators should put more emphasis on negative emotions and personal needs, and management system should be further optimized.
Collapse
Affiliation(s)
- Qin Xie
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing 400038, P.R. China
| | - Lei Lei
- Xinqiao Hospital, Army Medical University (Third Military Medical University), No. 83 Xinqiao Street, Shapingba District, Chongqing, 400037, P.R. China
| | - Fangjian Duan
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing 400038, P.R. China
| | - Yu Luo
- Xinqiao Hospital, Army Medical University (Third Military Medical University), No. 83 Xinqiao Street, Shapingba District, Chongqing, 400037, P.R. China.
| | - Chunmei Luo
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing 400038, P.R. China.
| |
Collapse
|
|
8
|
Gondolesi GE. Measuring Long-term Outcomes of Pediatric Liver Transplantation: The Japanese Exemplar. Transplantation 2021; 105:2526-2527. [PMID: 33988348 DOI: 10.1097/tp.0000000000003611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Gabriel E Gondolesi
- Chief of General Surgery, Chief of Liver, Pancreas and Intestinal Transplant. Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| |
Collapse
|
|
9
|
Ballesté C, Valero R, Istrate M, Peralta P, Mosharafa AA, Morsy AA, Bakr MA, Kamal Abdelkader AI, Sheashaa H, Juvelekian GS, Khachab M, Ahdab R, Faour W, Tahiri Jouti N, Benghanem Gharbi M, Bayahia R, Dakka T, Desatnik P, Jambou P, Pisarski P, Samson-Himmelstjerna P, Lücking KM, Manyalich M. Design and implementation of the European-Mediterranean Postgraduate Programme on Organ Donation and Transplantation (EMPODaT) for Middle East/North Africa countries. Transpl Int 2021; 34:1553-1565. [PMID: 33993570 DOI: 10.1111/tri.13918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
This prospective study reports the design and results obtained after the EMPODaT project implementation. This project was funded by the Tempus programme of the European Commission with the objective to implement a common postgraduate programme on organ donation and transplantation (ODT) in six selected universities from Middle East/North Africa (MENA) countries (Egypt, Lebanon and Morocco). The consortium, coordinated by the University of Barcelona, included universities from Spain, Germany, Sweden and France. The first phase of the project was to perform an analysis of the current situation in the beneficiary countries, including existing training programmes on ODT, Internet connection, digital facilities and competences, training needs, and ODT activity and accreditation requirements. A total of 90 healthcare postgraduate students participated in the 1-year training programme (30 ECTS academic credits). The methodology was based on e-learning modules and face-to-face courses in English and French. Training activities were evaluated through pre- and post-tests, self-assessment activities and evaluation charts. Quality was assessed through questionnaires and semi-structured interviews. The project results on a reproducible and innovative international postgraduate programme, improvement of knowledge, satisfaction of the participants and confirms the need on professionalizing the activity as the cornerstone to ensure organ transplantation self-sufficiency in MENA countries.
Collapse
Affiliation(s)
- Chloe Ballesté
- Surgery and Surgical Specializations Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- Transplant Counseling Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- Donation and Transplantation Institute (DTI), Barcelona, Spain
| | - Ricard Valero
- Surgery and Surgical Specializations Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- Department of Anesthesiology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Melania Istrate
- Surgery and Surgical Specializations Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- Donation and Transplantation Institute (DTI), Barcelona, Spain
| | - Particia Peralta
- CETT-UB Department, SE-elearning, University of Barcelona, Barcelona, Spain
| | | | | | - Mohamed Adel Bakr
- Mansoura Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | | | - Hussein Sheashaa
- Mansoura Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Georges S Juvelekian
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
- Saint George Hospital UMC, Beirut, Lebanon
| | - Maha Khachab
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Reshdi Ahdab
- American University Medical Center Rizk Hospital, Beirut, Lebanon
- Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon
| | - Wissam Faour
- Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon
| | - Nadia Tahiri Jouti
- Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco
| | - Mohammed Benghanem Gharbi
- Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco
- Ibn Rochd Hospital, Casablanca, Morocco
| | - Rabia Bayahia
- Nephrology Department, University Hospital Ibn Sina, Rabat, Morocco
- Faculty of Medicine, Mohammed V University, Rabat, Morocco
| | - Taoufik Dakka
- Faculty of Medicine, Mohammed V University, Rabat, Morocco
| | | | - Patrick Jambou
- Faculty of Medicine, University Côte d'Azur, Nice, France
| | | | | | | | - Martí Manyalich
- Surgery and Surgical Specializations Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- Transplant Counseling Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- Donation and Transplantation Institute (DTI), Barcelona, Spain
| |
Collapse
|
|
10
|
Silva e Silva V, Schirmer J, Roza BD, de Oliveira PC, Dhanani S, Almost J, Schafer M, Tranmer J. Defining Quality Criteria for Success in Organ Donation Programs: A Scoping Review. Can J Kidney Health Dis 2021; 8:2054358121992921. [PMID: 33680483 PMCID: PMC7897821 DOI: 10.1177/2054358121992921] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/22/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Well-established performance measures for organ donation programs do not fully address the complexity and multifactorial nature of organ donation programs such as the influence of relationships and organizational attributes. OBJECTIVE To synthesize the current evidence on key organizational attributes and processes of international organ donation programs associated with successful outcomes and to generate a framework to categorize those attributes. DESIGN Scoping Review using a mixed methods approach for data extraction. SETTING Databases included PubMed, CINAHL, Embase, LILACS, ABI Business ProQuest, Business Source Premier, and gray literature (organ donation association websites, Google Scholar-first 8 pages), and searches for gray literature were performed, and relevant websites were perused. SAMPLE Organ donation programs or processes. METHODS We systematically searched the literature to identify any research design, including text and opinion papers and unpublished material (research data, reports, institutional protocols, government documents, etc). Searches were completed on January 2018, updated it in May 2019, and lastly in March 2020. Title, abstracts, and full texts were screened independently by 2 reviewers with disagreements resolved by a third. Data extraction followed a mixed method approach in which we extracted specific details about study characteristics such as type of research, year of publication, origin/country of study, type of journal published, and key findings. Studies included considered definitions and descriptions of success in organ donation programs in any country by considering studies that described (1) attributes associated with success or effectiveness, (2) organ donation processes, (3) quality improvement initiatives, (4) definitions of organ donation program effectiveness, (5) evidence-based practices in organ donation, and (6) improvements or success in such programs. We tabulated the type and frequency of the presence or absence of reported improvement quality indicators and used a qualitative thematic analysis approach to synthesize results. RESULTS A total of 84 articles were included. Quantitative analysis identified that most of the included articles originated from the United States (n = 32, 38%), used quantitative approaches (n = 46, 55%), and were published in transplant journals (n = 34, 40.5%). Qualitative analysis revealed 16 categories that were described as positively influencing success/effectiveness of organ donation programs. Our thematic analysis identified 16 attributes across the 84 articles, which were grouped into 3 categories influencing organ donation programs' success: context (n = 39, 46%), process (n = 48, 57%), and structural (n = 59, 70%). LIMITATIONS Consistent with scoping review methodology, the methodological quality of included studies was not assessed. CONCLUSIONS This scoping review identified a number of factors that led to successful outcomes. However, those factors were rarely studied in combination representing a gap in the literature. Therefore, we suggest the development and reporting of primary research investigating and measuring those attributes associated with the performance of organ donation programs holistically. TRIAL REGISTRATION Not applicable.
Collapse
Affiliation(s)
| | | | | | | | - Sonny Dhanani
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Joan Almost
- School of Nursing, Queen’s University, Kingston, ON, Canada
| | - Markus Schafer
- Department of Sociology, University of Toronto, ON, Canada
| | - Joan Tranmer
- School of Nursing, Queen’s University, Kingston, ON, Canada
| |
Collapse
|
|
11
|
Physician Experiences with Communicating Organ Donation with the Relatives: A Dutch Nationwide Evaluation on Factors that Influence Consent Rates. Neurocrit Care 2020; 31:357-364. [PMID: 30767119 PMCID: PMC6757095 DOI: 10.1007/s12028-019-00678-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background The aim of this nationwide observational study is to identify modifiable factors in communication about organ donation that influence family consent rates. Methods Thirty-two intensivists specialized in organ donation systematically evaluated all consecutive organ donation requests with physicians in the Netherlands between January 2013 and June 2016, using a standardized questionnaire. Results Out of 2528 consecutive donation requests, 2095 (83%) were evaluated with physicians. The questionnaires of patients registered with consent or objection in the national donor registry were excluded from analysis. Only those questionnaires, in which the family had to make a decision about donation, were analyzed (n = 1322). Independent predictors of consent included: requesting organ donation during the conversation about futility of treatment (OR 1.8; p = 0.004), understanding of the term ‘brain death’ by the family (OR 2.4; p = 0.002), and consulting a donation expert prior to the donation request (OR 3.4; p < 0.001). Conclusions Our study showed that decoupling the organ donation conversation from the conversation about futility of treatment was associated with lower family consent rates. Comprehension of the concept of brain death by the family and consultation with a transplant coordinator before the organ donation request by the physician could positively influence consent rates. Electronic supplementary material The online version of this article (10.1007/s12028-019-00678-8) contains supplementary material, which is available to authorized users.
Collapse
|
|
12
|
Witjes M, Jansen NE, van Dongen J, Herold IHF, Otterspoor L, Haase-Kromwijk BJJM, van der Hoeven JG, Abdo WF. Appointing nurses trained in organ donation to improve family consent rates. Nurs Crit Care 2019; 25:299-304. [PMID: 31294520 PMCID: PMC7507830 DOI: 10.1111/nicc.12462] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 11/29/2022]
Abstract
Background One of the most important bottlenecks in the organ donation process worldwide is the high family refusal rate. Aims and objectives The main aim of this study was to examine whether family guidance by trained donation practitioners increased the family consent rate for organ donation. Design This was a prospective intervention study. Methods Intensive and coronary care unit nurses were trained in communication about donation (ie, trained donation practitioners) in two hospitals. The trained donation practitioners were appointed to guide the families of patients with a poor medical prognosis. When the patient became a potential donor, the trained donation practitioner was there to guide the family in making a well‐considered decision about donation. We compared the family consent rate for donation with and without the guidance of a trained donation practitioner. Results The consent rate for donation with guidance by a trained donation practitioner was 58.8% (20/34), while the consent rate without guidance by a trained donation practitioner was 41.4% (41/99, P = 0.110) in those patients where the family had to decide on organ donation. Conclusions Our data suggest that family guidance by a trained donation practitioner could benefit consent rates for organ donation. Relevance to clinical practice Trained nurses play an important role in supporting the families of patients who became potential donors to guide them through the decision‐making process after organ donation request.
Collapse
Affiliation(s)
- Marloes Witjes
- Dutch Transplant Foundation, Leiden, The Netherlands.,Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Jacqueline van Dongen
- Department of Intensive Care Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Ingeborg H F Herold
- Department of Intensive Care Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Luuk Otterspoor
- Department of Intensive Care Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | | | | | - Wilson F Abdo
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
|
13
|
Witjes M, Jansen NE, van der Hoeven JG, Abdo WF. Interventions aimed at healthcare professionals to increase the number of organ donors: a systematic review. Crit Care 2019; 23:227. [PMID: 31221214 PMCID: PMC6587298 DOI: 10.1186/s13054-019-2509-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/06/2019] [Indexed: 11/24/2022] Open
Abstract
Background The last decade, there have been many initiatives worldwide to increase the number of organ donors. However, it is not clear which initiatives are most effective. The aim of this study is to provide an overview of interventions aimed at healthcare professionals in order to increase the number of organ donors. Methods We systematically searched PubMed, EMBASE, CINAHL, PsycINFO, and the Cochrane Library for English language studies published until April 24, 2019. We included studies describing interventions in hospitals aimed at healthcare professionals who are involved in the identification, referral, and care of a family of potential organ donors. After the title abstract and full-text selection, two reviewers independently assessed each study’s quality and extracted data. Results From the 18,854 records initially extracted from five databases, we included 22 studies in our review. Of these 22 studies, 14 showed statistically significant effects on identification rate, family consent rate, and/or donation rate. Interventions that positively influenced one or more of these outcomes were training of emergency personnel in organ donation, an electronic support system to identify and/or refer potential donors, a collaborative care pathway, donation request by a trained professional, and additional family support in the ICU by a trained nurse. The methodological quality of the studies was relatively low, mainly because of the study designs. Conclusions Although there is paucity of data, collaborative care pathways, training of healthcare professionals and additional support for relatives of potential donors seem to be promising interventions to increase the number of organ donors. Trial registration PROSPERO, CRD42018068185 Electronic supplementary material The online version of this article (10.1186/s13054-019-2509-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Marloes Witjes
- Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Internal post 710, 6500 HB, Nijmegen, The Netherlands.,Dutch Transplant Foundation, Leiden, The Netherlands
| | | | - Johannes G van der Hoeven
- Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Internal post 710, 6500 HB, Nijmegen, The Netherlands
| | - Wilson F Abdo
- Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Internal post 710, 6500 HB, Nijmegen, The Netherlands.
| |
Collapse
|
|
14
|
Pimentel RRS, Garcia IM, Galdino MJQ, Pissinati PSC, Rossaneis MA, Gvozd Costa R, Silva LGC, Haddad MCFL. Liver Donations and Transplants in the State of Paraná, Brazil. Transplant Proc 2019; 51:632-638. [PMID: 30979445 DOI: 10.1016/j.transproceed.2018.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/03/2018] [Accepted: 12/05/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The increase in the waiting list for a liver and the high mortality rate of patients with terminal liver disease represent serious public health problems in Brazil. OBJECTIVE To analyze donations and liver transplants in the State of Paraná, Brazil. METHOD A cross-sectional study was carried out with data from 3931 reports of deaths due to brain death and 8146 solid organ transplants made available by the State Transplant System of Paraná between 2011 and 2016. The data related to donation and liver transplantation were analyzed using descriptive statistics and inference. RESULTS A total of 751 (28.9%) liver donations were carried out. Of these, the greatest chance of effectiveness occurred in patients younger than 50 years OR: 1.94 (CI: 1.60-2.34; P < .01) and male OR: 1.27 (CI: 1.06-1.52; P < .01). A total of 720 (8.8%) liver transplants were performed, most of which were funded by the Unified Health System. There was a significant increase in donations and liver transplants over the years. CONCLUSION Donor numbers and liver transplants increased in the State but did not meet the need for the waiting list within the analyzed period.
Collapse
Affiliation(s)
- R R S Pimentel
- Department of Nursing, State University of Londrina, Londrina, Paraná, Brazil.
| | - I M Garcia
- Department of Nursing, State University of Londrina, Londrina, Paraná, Brazil
| | - M J Q Galdino
- Department of Nursing, State University of Maringá, Maringá, Paraná, Brazil; Department of Nursing, State University of North Paraná, Bandeirantes, Paraná, Brazil
| | - P S C Pissinati
- Department of Nursing, State University of Maringá, Maringá, Paraná, Brazil
| | - M A Rossaneis
- Department of Nursing, State University of Londrina, Londrina, Paraná, Brazil
| | - R Gvozd Costa
- Department of Nursing, State University of Londrina, Londrina, Paraná, Brazil
| | - L G C Silva
- Department of Nursing, State University of Londrina, Londrina, Paraná, Brazil
| | - M C F L Haddad
- Department of Nursing, State University of Londrina, Londrina, Paraná, Brazil
| |
Collapse
|
|
15
|
Weiss J, Elmer A, Béchir M, Brunner C, Eckert P, Endermann S, Lenherr R, Nebiker M, Tisljar K, Haberthür C, Immer FF. Deceased organ donation activity and efficiency in Switzerland between 2008 and 2017: achievements and future challenges. BMC Health Serv Res 2018; 18:876. [PMID: 30458762 PMCID: PMC6247533 DOI: 10.1186/s12913-018-3691-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/05/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Various actions have been taken during the last decade to increase the number of organs from deceased donors available for transplantation in Switzerland. This study provides an overview on key figures of the Swiss deceased organ donation and transplant activity between 2008 and 2017. In addition, it puts the evolution of the Swiss donation program's efficiency in relation to the situation in the neighboring countries. METHODS This study is an analysis of prospective registry data, covering the period from 1 January 2008 to 31 December 2017. It includes all actual deceased organ donors (ADD) in Switzerland. Donor data were extracted from the Swiss Organ Allocation System. The "donor conversion index" (DCI) methodology and data was used for the comparison of donation program efficiency in Switzerland, Germany, Austria, Italy and France. RESULTS During the study period there were 1116 ADD in Switzerland. The number of ADD per year increased from 91 in 2008 to 145 in 2017 (+ 59%). The reintroduction of the donation after cardiocirculatory death (DCD) program in 2011 resulted in the growth of annual percentages of DCD donors, reaching a maximum of 27% in 2017. The total number of organs transplanted from ADD was 3763 (3.4 ± 1.5 transplants per donor on average). Of these, 48% were kidneys (n = 1814), 24% livers (n = 903), 12% lungs (n = 445), 9% hearts (n = 352) and 7% pancreata or pancreatic islets (n = 249). The donation program efficiency assessment showed an increase of the Swiss DCI from 1.6% in 2008 to 2.7% in 2017 (+ 69%). The most prominent efficiency growth was observed between 2012 and 2017. Even though Swiss donation efficiency increased during the study period, it remained below the DCI of the French and Austrian donation programs. CONCLUSION Swiss donation activity and efficiency grew during the last decade. The increased donation efficiency suggests that measures implemented so far were effective. The lower efficiency of the Swiss donation program, compared to the French and Austrian programs, may likely be explained by the lower consent rate in Switzerland. This issue should be addressed in order to achieve the goal of more organs available for transplantation.
Collapse
Affiliation(s)
- Julius Weiss
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Andreas Elmer
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland
| | - Markus Béchir
- Zentrum für Innere Medizin, Hirslanden Klinik Aarau, Aarau, Switzerland
| | - Christian Brunner
- Zentrum für Intensivmedizin, Luzerner Kantonsspital, Luzern, Switzerland
| | - Philippe Eckert
- Service de Médecine Intensive Adulte et Centre des Brûlés, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Susann Endermann
- Klinik für Anästhesiologie, Intensiv-, Rettungs- und Schmerzmedizin, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Renato Lenherr
- Chirurgische Intensivmedizin USZ, Universitätsspital Zürich, Zürich, Switzerland
| | - Mathias Nebiker
- Transplantationszentrum, Direktion Medizin und Universitätsklinik für Intensivmedizin, Inselspital, Universitätsspital Bern, Bern, Switzerland
| | - Kai Tisljar
- Medizinische Intensivstation, Universitätsspital Basel, Basel, Switzerland
| | - Christoph Haberthür
- Klinik Hirslanden, Institut für Anästhesiologie und Intensivmedizin, Zürich, Switzerland
| | - Franz F Immer
- Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland.
| | | |
Collapse
|
|
16
|
Arredondo E, López-Fraga M, Chatzixiros E, Senemaud B, Brezovsky P, Carella C, Ballesté C, Aydin Mehmet A, Tomadze G, Codreanu I, Sarkissian A, Simeonova M, Nikonenko A, Zota V, Gómez M, Manyalich M, Bolotinha C, Franca A, Costa A, Ott MO, Buchheit KH. Council of Europe Black Sea Area Project: International Cooperation for the Development of Activities Related to Donation and Transplantation of Organs in the Region. Transplant Proc 2018; 50:374-381. [DOI: 10.1016/j.transproceed.2017.12.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/04/2017] [Indexed: 10/17/2022]
|
|
17
|
Gois RSS, Galdino MJQ, Pissinati PDSC, Pimentel RRDS, Carvalho MDBD, Haddad MDCFL. Efetividade do processo de doação de órgãos para transplantes. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700089] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Resumo Objetivo: Verificar a efetividade do processo de doação de órgãos para transplantes no Estado do Paraná. Métodos: Estudo transversal realizado com dados disponibilizados pelo Sistema Estadual de Transplantes do Paraná referentes ao processo de doação de órgãos, no período de 2011 a 2016. Das 3.872 notificações de potenciais doadores em morte encefálica, 2.600 foram incluídas neste estudo por se constituírem em doadores elegíveis de órgãos. Avaliou-se os desfechos dos protocolos e variáveis relacionadas aos doadores elegíveis, aos centros notificantes e às notificações. Os dados foram analisados descritivamente por frequências absolutas e relativas, e calculou-se odds ratio verificando-se a associação pelo teste de Qui-Quadrado de Wald, em que considerou-se p<0,05 como significância estatística. Resultados: Entre os 2.600 doadores elegíveis, 1.267 (48,7%) tornaram-se doadores efetivos de órgãos. Como principais obstáculos do processo destacaram-se a parada cardiorrespiratória, a sepse e a recusa familiar. As chances de efetivação da doação foram significativamente maiores nos indivíduos com menos de 60 anos (p<0,001), do sexo masculino (p=0,001) e notificados pelas Macrorregionais Leste e Oeste do Estado (p<0,001). O percentual de doações de órgãos aumentou de 38,8% para 66,5% no período estudado. Conclusão: O Paraná apresentou crescimento expressivo no número de notificações e doações de órgãos nos últimos seis anos. As fragilidades identificadas no processo se referiram às questões clínicas e culturais, que indicam a necessidade de intervenções gerenciais de capacitação dos profissionais de saúde na identificação e manutenção do potencial doador, bem como na sensibilização da sociedade quanto a importância do consentimento à doação.
Collapse
|
|
18
|
Jones CP, Papadopoulos C, Randhawa G. Primary care interventions to encourage organ donation registration: A systematic review. Transplant Rev (Orlando) 2017; 31:268-275. [PMID: 28951124 DOI: 10.1016/j.trre.2017.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/17/2017] [Accepted: 08/24/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous research has proposed that primary care interventions to increase organ donation rates can help address the discrepancy between organ donation rates and the number of patients awaiting transplant. However, no systematic review has been conducted to examine interventions in this setting. OBJECTIVE To synthesise evidence from previous organ donation interventions conducted in a primary care setting. METHODS Six databases and grey literature were systematically searched between November 2016 and July 2017. Inclusion criteria included English language, studies published after the year 2000 and unpublished studies. A quality assessment and narrative synthesis was conducted. RESULTS Ten studies met the inclusion criteria, nine of which examined actual organ donor registration as their primary outcome. Eight interventions increased registration to be an organ donor. Successful interventions utilised active methods of participant engagement that encouraged donation at the point of patient contact. DISCUSSION Despite the small pool of studies that met the inclusion criteria, the results suggest that primary care interventions could produce promising results for increasing organ donation registration. However, additional higher quality studies are required before firm conclusions can be made. Barriers to implementation were also found and suggest that the feasibility of a primary care environment for organ donation intervention should be investigated.
Collapse
Affiliation(s)
- Catrin Pedder Jones
- Institute of Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton LU2 8LE, United Kingdom
| | - Chris Papadopoulos
- Institute of Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton LU2 8LE, United Kingdom
| | - Gurch Randhawa
- Institute of Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton LU2 8LE, United Kingdom.
| |
Collapse
|
|
19
|
Sarlo R, Pereira G, Surica M, Almeida D, Araújo C, Figueiredo O, Rocha E, Vargas E. Impact of Introducing Full-time In-house Coordinators on Referral and Organ Donation Rates in Rio de Janeiro Public Hospitals: A Health Care Innovation Practice. Transplant Proc 2017; 48:2396-2398. [PMID: 27742307 DOI: 10.1016/j.transproceed.2015.11.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 11/11/2015] [Indexed: 11/24/2022]
Abstract
Establishing an organization to promote organ donation and a good organ procurement team assure quality and improve performance on organ donation rates. Brazil's organ procurement structure is based on 2 models disseminated worldwide: the "Spanish model," based on in-house coordinators, and the "American organ procurement organization (OPO) model," with extra-hospital coordinators. In 2006, Brazil's Federal Government had formally introduced the in-house coordination model for every hospital equipped with a mechanical ventilator bed. In January 2012, the Rio de Janeiro State OPO, Programa Estadual de Transplantes, introduced an innovation in the organization of the in-house coordination model in 4 selected public hospitals with high organ donation potential. It consisted in launching full-time in-house coordination teams, with ≥1 physician and 2 nurses per hospital fully dedicated to organ procurement. The objectives were to observe the impact of this innovation in referral and organ donor conversion rates and to analyze the importance of middle managers in health care innovation implementation. Comparing the year before implementation (2011) and the year of 2014 showed that this innovation led to an overall increase in referrals-from 131 to 305 per year (+132%) and conversion rates-from 20% to 42% per year-resulting in an increase in number of donors from 26 to 128 per year (+390%). Despite wide variations among hospitals in the outcomes, our results seem very encouraging and express a positive impact of this model, suggesting that dissemination to other hospitals may increase the number of donors and transplants in our region.
Collapse
Affiliation(s)
- R Sarlo
- Programa Estadual de Transplantes, Rio de Janeiro, Brazil; COPPEAD Business School, Universidade Federal do Rio de Janeiro, Brazil.
| | - G Pereira
- Programa Estadual de Transplantes, Rio de Janeiro, Brazil
| | - M Surica
- Programa Estadual de Transplantes, Rio de Janeiro, Brazil
| | - D Almeida
- Programa Estadual de Transplantes, Rio de Janeiro, Brazil
| | - C Araújo
- COPPEAD Business School, Universidade Federal do Rio de Janeiro, Brazil
| | - O Figueiredo
- COPPEAD Business School, Universidade Federal do Rio de Janeiro, Brazil
| | - E Rocha
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brazil
| | - E Vargas
- COPPEAD Business School, Universidade Federal do Rio de Janeiro, Brazil
| |
Collapse
|
|
20
|
Lam HD, Schaapherder AF, Kopp WH, Putter H, Braat AE, Baranski AG. Professionalization of surgical abdominal organ recovery leading to an increase in pancreatic allografts accepted for transplantation in the Netherlands: a serial analysis. Transpl Int 2016; 30:117-123. [PMID: 27874968 DOI: 10.1111/tri.12893] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/14/2016] [Accepted: 11/18/2016] [Indexed: 02/06/2023]
Abstract
Professional abdominal organ recovery with certification has been mandatory in the Netherlands since 2010. This study analyses the effects of certification (January 2010-September 2015) on pancreas transplantation and compares it to an era before certification (February 2002-May 2008) for surgical injuries and the number of pancreases transplanted. A total of 264 cases were analysed. Eighty-four recovered pancreases (31.8%) with surgically injuries were encountered. Forty-six of those were surgically salvaged for transplantation, resulting in a total of 226 (85.6%) being transplanted. It was found that certified surgeons recovered grafts from older donors (36.8 vs. 33.3; P = 0.021), more often from donation after circulatory death (DCD) donors (18% vs. 0%; P < 0.001) and had less surgical injuries (21.6% vs. 41.0%; P < 0.001). Certification (OR: 0.285; P < 0.001) and surgeons from a pancreas transplant centre (OR: 0.420; P = 0.002) were independent risk factors for surgical organ injury. Predictors for proceeding to the actual pancreas transplantation were a recovering surgeon from a pancreas transplantation centre (OR: 3.230; P = 0.003), certification (OR: 3.750; P = 0.004), donation after brain death (DBD) (OR: 8.313; P = 0.002) and donor body mass index (BMI) (OR: 0.851; P = 0.023). It is concluded that certification in abdominal organ recovery will limit the number of surgical injuries in pancreas grafts which will translate in more pancreases available for transplantation.
Collapse
Affiliation(s)
- Hwai-Ding Lam
- Department of Transplantation Surgery, LUMC, Leiden, The Netherlands
| | | | - Wouter H Kopp
- Department of Transplantation Surgery, LUMC, Leiden, The Netherlands
| | - Hein Putter
- Department of Statistics, LUMC, Leiden, The Netherlands
| | - Andries E Braat
- Department of Transplantation Surgery, LUMC, Leiden, The Netherlands
| | | |
Collapse
|
|
21
|
Hoste P, Ferdinande P, Hoste E, Vanhaecht K, Rogiers X, Eeckloo K, Van Deynse D, Ledoux D, Vandewoude K, Vogelaers D. Recommendations for further improvement of the deceased organ donation process in Belgium. Acta Clin Belg 2016; 71:303-12. [PMID: 27594299 DOI: 10.1080/17843286.2016.1216259] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Belgium has achieved high deceased organ donation rates but according to the medical record data in the Donor Action database, deceased potential donors are still missed along the pathway. Between 2010 and 2014, 12.9 ± 3.3% of the potential donors after brain death (DBD) and 24.6 ± 1.8% of the potential donors after circulatory (DCD) death were not identified. Conversion rates of 41.7 ± 2.1% for DBD and 7.9 ± 0.9% for DCD indicate room for further improvement. We identify and discuss different issues in the monitoring of donation activities, practices and outcomes; donor pool; legislation on deceased organ donation; registration; financial reimbursement; educational and training programs; donor detection and practice clinical guidance. The overall aim of this position paper, elaborated by a Belgian expert panel, is to provide recommendations for further improvement of the deceased organ donation process up to organ procurement in Belgium.
Collapse
|
|
22
|
Implementation and Sustainability of European Training Program on Organ Donation in Poland: Results and the Impact on Donation Indicators. Transplant Proc 2016; 48:2429-2433. [DOI: 10.1016/j.transproceed.2015.12.144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 12/30/2015] [Indexed: 11/22/2022]
|
|
23
|
Ballesté C, Arredondo E, Gómez MP, Fernandez A, Wolf M, Gunderson S, Roberts L, Elcock B, Bradshaw P, Gardiner C, Byam J, Harnanan D, García-Buitron JM, Manyalich M. Successful Example of How to Implement and Develop a Deceased Organ Donation System in the Caribbean Region: Five-Year Experience of the SEUSA Program in Trinidad and Tobago. Transplant Proc 2016; 47:2328-31. [PMID: 26518918 DOI: 10.1016/j.transproceed.2015.08.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The SEUSA program, the Donation and Transplantation Institute foundation consultancy program, was implemented in Trinidad and Tobago (T&T) in 2010 with the support of the National Organ Transplant Unit (NOTU) and the Ministry of Health of T&T. METHODS The SEUSA program included (1) diagnosis of the current situation using the ODDS (Organ Donation Diagnostic Surveys); (2) creation of a human resources structure through Transplant Procurement Management (TPM); (3) detection of all brain and cardiac deaths in the hospitals implementing the DAS (Decease Alert System); (4) in-hospital awareness based on the EODS (Essentials in Organ Donation); and (5) external hospital audits. Additionally continued monitoring is performed. RESULTS Thus far, thanks to implementation of the SEUSA program in Trinidad and Tobago 175, healthcare professionals have been exposed to training programs in the organ donation field. The Living Kidney Program was reinforced and the structure of the Deceased Donation (DD) network was defined. Since 2010, 485 potential organ donors have been detected, and 9 have become actual organ donors; 74 patients have received a kidney transplant (59 from living and 15 from deceased donors). CONCLUSIONS This project results demonstrate that the application of the SEUSA program is an efficient methodology to develop DD programs that increase and consolidate transplant programs in the Caribbean region.
Collapse
Affiliation(s)
- C Ballesté
- Donation and Transplantation Institute, DTI Foundation, Barcelona, Spain.
| | - E Arredondo
- Donation and Transplantation Institute, DTI Foundation, Barcelona, Spain
| | - M P Gómez
- Donation and Transplantation Institute, DTI Foundation, Barcelona, Spain
| | - A Fernandez
- Donation and Transplantation Institute, DTI Foundation, Barcelona, Spain
| | - M Wolf
- Donation and Transplantation Institute, DTI Foundation, Barcelona, Spain
| | - S Gunderson
- Donation and Transplantation Institute, DTI Foundation, Barcelona, Spain
| | - L Roberts
- National Organ Transplant Unit of Trinidad and Tobago, Trinidad, Trinidad and Tobago
| | - B Elcock
- Port of Spain General Hospital, Trinidad, Trinidad and Tobago
| | - P Bradshaw
- San Fernando General Hospital, San Fernando, Trinidad and Tobago
| | - C Gardiner
- Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago
| | - J Byam
- Eric Williams Medical Sciences Complex, Champ Fleurs, Trinidad and Tobago
| | - D Harnanan
- San Fernando General Hospital, San Fernando, Trinidad and Tobago
| | - J M García-Buitron
- Donation and Transplantation Institute, DTI Foundation, Barcelona, Spain
| | - M Manyalich
- Donation and Transplantation Institute, DTI Foundation, Barcelona, Spain
| |
Collapse
|
|
24
|
Odabasi O, Elcin M, Uzun Basusta B, Gulkaya Anik E, Aki TF, Bozoklar A. Development and Evaluation of a Training Program for Organ Procurement Coordinators Using Standardized Patient Methodology. EXPERIMENTAL AND CLINICAL TRANSPLANTATION : OFFICIAL JOURNAL OF THE MIDDLE EAST SOCIETY FOR ORGAN TRANSPLANTATION 2015; 16:481-487. [PMID: 26643104 DOI: 10.6002/ect.2015.0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The low rate of consent by next of kin of donor-eligible patients is a major limiting factor in organ transplant. Educating health care professionals about their role may lead to measurable improvements in the process. Our aim was to describe the developmental steps of a communication skills training program for health care professionals using standardized patients and to evaluate the results. MATERIALS AND METHODS We developed a rubric and 5 cases for standardized family interviews. The 20 participants interviewed standardized families at the beginning and at the end of the training course, with interviews followed by debriefing sessions. Participants also provided feedback before and after the course. The performance of each participant was assessed by his or her peers using the rubric. We calculated the generalizability coefficient to measure the reliability of the rubric and used the Wilcoxon signed rank test to compare achievement among participants. Statistical analyses were performed with SPSS software (SPSS: An IBM Company, version 17.0, IBM Corporation, Armonk, NY, USA). RESULTS All participants received higher scores in their second interview, including novice participants who expressed great discomfort during their first interview. The participants rated the scenarios and the standardized patients as very representative of real-life situations, with feedback forms showing that the interviews, the video recording sessions, and the debriefing sessions contributed to their learning. CONCLUSIONS Our program was designed to meet the current expectations and implications in the field of donor consent from next of kin. Results showed that our training program developed using standardized patient methodology was effective in obtaining the communication skills needed for family interviews during the consent process. The rubric developed during the study was a valid and reliable assessment tool that could be used in further educational activities. The participants showed significant improvements in communication skills.
Collapse
Affiliation(s)
- Orhan Odabasi
- From the Department of Medical Education and Informatics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
|
25
|
Moura LC, de Oliveira PC, dos Santos JG, Paglione HB, do Nascimento Neto JM, dos Santos RCC, de Oliveira Marcos MC, Carneiro AR, Moreira FA, Correa Calado DAM, Leite RF, de Aguiar Roza B, de Oliveira Salvalaggio PR, de Matos ACC. An analysis of the quality indicators of the organ donation process in São Paulo, Brazil. Clin Transplant 2015; 29:1047-53. [PMID: 26472247 DOI: 10.1111/ctr.12618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Few studies have investigated whether quality initiatives in the process of organ donation yield better results of the organ donation process. OBJECTIVE To analyze whether the indicators of the organ donation process in Brazilian hospitals meet the standards established by the Organ Donation European Quality System (ODEQUS). DESIGN We evaluated the quality of the organ donation in a selected group of Brazilian hospitals served by the Nucleus of Organ Procurement (NOP) using standards of the ODEQUS. RESULTS Structural and process indicators had 100% conformity. Indicators of results showed a family consent rate of 61% (29% lower than ODEQUS goal); a conversion rate of potential donors to effective donors of 47% (28% below the goal); and a 12% rate of sudden cardiac arrest (higher than the quality limit). CONCLUSIONS Our findings highlight the importance for the development of quality initiatives in identifying gaps and weaknesses in the process that should be corrected or even restructured, therefore maximizing the number of donors and organs transplanted. Hospitals that participate in the NOP process met 61% of the quality indicators proposed by ODEQUS. Identification of potential donors, family consent, conversion, and sudden cardiac arrest rates are areas that did not conform to ODEQUS standard and revealed a great opportunity for improvement.
Collapse
Affiliation(s)
- Luciana Carvalho Moura
- Nurse Program Transplant Coordinator, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil
| | - Priscilla Caroliny de Oliveira
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - Juliana Guareschi dos Santos
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - Heloisa Barboza Paglione
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - Jose Maria do Nascimento Neto
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - Roberta Cristina Cardoso dos Santos
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - Marli Cristina de Oliveira Marcos
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - André Ramos Carneiro
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - Felipe Alves Moreira
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - Dayana Aparecida Martins Correa Calado
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - Renata Fabiana Leite
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Procurement In-House Transplant Coordinator, Hospital Albert Einstein, São Paulo, Brazil
| | - Bartira de Aguiar Roza
- Organ and Tissue Transplant Study Group, GEDOTT - Escola Paulista de Enfermagem - EPE/UNIFESP, São Paulo, Brazil
| | - Paolo Rogerio de Oliveira Salvalaggio
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Medical Surgeon Liver Transplant Program, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Ana Cristina Carvalho de Matos
- Programa de Apoio ao Desenvolvimento Institucional do SUS, PROADI/SUS - Brazilian Government, São Paulo, Brazil.,Medical Transplantation Program Coordinator, Hospital Israelita Albert Einstein, São Paulo, Brazil
| |
Collapse
|
|
26
|
Revuelto-Rey J, Aldabó-Pallás T, Egea-Guerrero JJ, Vilches-Arenas Á, Lara EJ, Gordillo-Escobar E. Utilidad de la tomografía computarizada como herramienta para detectar potenciales donantes en muerte encefálica. Med Clin (Barc) 2015; 144:531-5. [DOI: 10.1016/j.medcli.2014.04.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/15/2014] [Accepted: 04/24/2014] [Indexed: 11/25/2022]
|
|
27
|
EXP CLIN TRANSPLANTExp Clin Transplant 2015; 13. [DOI: 10.6002/ect.mesot2014.o128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
|
|
28
|
Ríos A, López-Navas AI, Navalón JC, Martínez-Alarcón L, Ayala-García MA, Sebastián-Ruiz MJ, Moya-Faz F, Garrido G, Ramirez P, Parrilla P. The Latin American population in Spain and organ donation. Attitude toward deceased organ donation and organ donation rates. Transpl Int 2015; 28:437-47. [PMID: 25557362 DOI: 10.1111/tri.12511] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/17/2014] [Accepted: 12/30/2014] [Indexed: 12/20/2022]
Abstract
UNLABELLED The Latin American (LA) population has similarities with the Spanish population which makes its integration into Spanish society easier. OBJECTIVE to analyze the attitude toward organ donation among Latin American citizens residing in Spain, to determine the psychosocial variables which affect this attitude, and to examine the correlation between donation rates of LA citizens in Spain and in their countries of origin. A random sample of LA residents in Spain was taken and stratified according to the respondent's nationality (n = 1.314), in the year 2010. Attitude was assessed using a validated questionnaire (PCID-DTO Dr Rios). The survey was self-administered and completed anonymously. STATISTICAL ANALYSIS Student's t-test, the χ(2) test, and logistic regression analysis. There was a 94% completion rate (n = 1.237). Attitude toward donation was favorable in 60% of cases (n = 745), 12% (n = 145) were against, and 28% (n = 347) were undecided. The following variables were associated with attitude toward donation: sex (P = 0.038), level of formal education (P < 0.001), country of origin (P = 0.002), attitude toward the donation of a family member's organs (P < 0.001), having discussed donation with the family (P < 0.001), carrying out prosocial activities (P = 0.025), attitude toward cremation of the body (P < 0.001), attitude toward burial of the body (P < 0.001), attitude toward having an autopsy carried out (P < 0.001), previous experience of the organ donation and transplantation process (P < 0.001), fear of mutilation after donation (P < 0.001), knowledge that the Church has a positive attitude toward organ donation and transplantation (P < 0.001), knowledge of one's partner's attitude toward organ donation (P < 0.001), and a belief that one might need a transplant in the future (P < 0.001). The donation rates in this population group in Spain are higher than those recorded in their countries of origin (55.76 vs. <10 pmp; P < 0.001). The attitude toward organ donation among LA citizens residing in Spain is slightly worse than that reported in the native Spanish population and is determined by many psychosocial factors. The donation rates of LA citizens in Spain are higher than those in their countries of origin.
Collapse
Affiliation(s)
- Antonio Ríos
- Proyecto Colaborativo Internacional Donante ('International Collaborative Donor Project'), Murica, Spain; Regional Transplant Center, Consejería de Sanidad, Servicio Murciano de Salud, Murcia, Spain; Department of Surgery, Faculty of Medicine, University of Murcia, Murcia, Spain; Surgery Service, Murcia Health Service, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
|
29
|
System of Donor Hospital Transplant Coordinators Maintained and Financed by National Transplant Organization Improves Donation Rates, But It Is Effective Only in One Half of Hospitals. Transplant Proc 2014; 46:2501-4. [DOI: 10.1016/j.transproceed.2014.09.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
|
30
|
Manyalich M, Guasch X, Gomez MP, Páez G, Teixeira L. Organ Donation European Quality System: ODEQUS project methodology. Transplant Proc 2014; 45:3462-5. [PMID: 24314932 DOI: 10.1016/j.transproceed.2013.09.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Differences in the number of organ donors among hospitals cannot be explained only by the number of intensive care unit beds used or neurologic patients treated. The figures obtained are influenced by the organizational structure of the donation process and how efficient it is. The Organ Donation European Quality System (ODEQUS) is a 3-year project (from October 2010 to September 2013) co-financed by the European Agency for Health and Consumers (EAHC20091108) which aims to define a methodology to evaluate organ procurement performance at the hospital level. ODEQUS's specific objectives are to identify quality criteria and to develop quality indicators in three types of organ donation (after brain death, after cardiac death, and living donation). Those tools will be useful for hospitals' self-assessment as well as for developing an international auditing model. A consortium has been established involving 14 associated partners from Austria, Croatia, France, Germany, Italy, Poland, Portugal, Romania, Spain, Sweden, and the United Kingdom, as well as five collaborating partners from Greece, Hungary, Malta, Slovenia, and Turkey. The project has been established in three steps: 1) Design of a survey about the use of quality tools in a wide sample of European hospitals; 2) Development of quality criteria and quality indicators by the project experts. The main fields considered have been organizational structures, clinical procedures, and outcomes; and 3) Elaboration of an evaluation system to test the quality indicators in 11 European hospitals. Two types of training have been designed and performed: one concerns the development of quality criteria and quality indicators, whereas another is focused on how to use evaluation tools. Following this methodology, the project has so far identified 131 quality criteria and developed 31 quality indicators. Currently, the quality indicators are being tested in 11 selected hospitals.
Collapse
|