Prototype of a computerized scale for the active search for potential organ donors

Abstract

Objective:to develop a prototype of a computerized scale for the active search for potential organ and tissue donors. Method:methodological study, with the analysis of 377 electronic medical records of patients who died due to encephalic death or cardiorespiratory arrest in the intensive care units of a tertiary hospital. Among the deaths due to cardiorespiratory arrest, the study aimed to identify factors indicating underreported encephalic death cases. The Acute Physiology and Chronic Health Evaluation II and Sepsis Related Organ Failure Assessment severity indexes were applied in the protocols. Based on this, a scale was built and sent to five experts for assessment of the scale content, and subsequently, it was computerized by using a prototyping model. Results:34 underreported encephalic death cases were identified in the medical records of patients with cardiorespiratory arrest. Statistically significant differences were found in the Wilcoxon test between the scores of hospital admissions in the intensive care unit and the opening of the encephalic death protocol for both severity indexes. Conclusion:the prototype was effective for identifying potential organ donors, as well as for the identification of the degree of organ dysfunction in patients with encephalic death.

Organ and tissue donation: use of quality tool for process optimization

“…Otherwise, it is possible that this patient may progress to cardiac arrest even before the validation as a possible donor or during the BD diagnosis confirmation. 13 One of the great problems for opening of the BD protocol are the patient´s hemodynamic conditions, being classified as "universal problems" 3,27 of the transplantation 27 , such information met the data of the current study.…”

“…Therefore, the team must perform an ongoing monitoring in front of the changes that may happen and within minutes, since phisiopathological alterations arisen from the neurological damage may cause the circulatory collapse and invalidate the conclusion of the ME o and the process of donation and transplant. [27][28] It is worth highlighting that such alterations that cause the circulatory collapse in the patient under possible BD were identified in this study, since the patients presented hypernatremia hypotension, polyuria and hypotermia, the main causes of the nonvalidation/opening of the BD protocol. These conditions require from the professionals assistance, managerial and emotional efforts, being necessary the involvement of all the ICU´s team, in order to make it possible hemodynamic conditions to start the BD protocol.…”

“…The main actions of improvements realized in these countries include audits in the medical records in ICU´s by identifying losses of possible, as well as the main causes of these losses. [3][4][5][8][9][25][26][27][29][30] In addition, task forces of professionals seek adjustments in the system, in addition to education for improvements in this scenario.…”

Implementing of Active Brain-Dead Donor Identification Strategy in a Single Donor Center: One Year Experience

“…Although identification is the first and most important step of donation process, up to 50% of potential donors still might not be identified [20][21][22][23][24][25]. The identification process consists of healthcare professionals' ability to assess clinical triggers of potential donors and to refer them to a donor coordinator.…”

“…They upgraded their identification strategy and improved results by increasing phone calls and the inspections number to the ICU for one year. Ludwig et al [22] concluded that a computerized scale for the active search for potential donors was also effective. A computerized scale based on Sepsis-Related Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) prognostic indexes was applied as an instrument for organizing the organ donation and transplantation process in the hospital of the study.…”