“…1 ). In addition, several review articles [ 42 – 49 ] and the results of the ODEQUS project [ 23 ] were also included. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…In addition to the QIs listed in the guidelines and review articles, the QIs identified in the organ donation process of the Organ Donation European Quality System (ODEQUS) project were also analyzed. These were developed by a consortium involving associated and collaborating partners from 16 European countries [ 23 ].…”
BackgroundA substantial degree of variability in practices exists amongst donor hospitals regarding the donor detection, determination of brain death, application of donor management techniques or achievement of donor management goals. A possible strategy to standardize the donation process and to optimize outcomes could lie in the implementation of a care pathway. The aim of the study was to identify and select a set of relevant key interventions and quality indicators in order to develop a specific care pathway for donation after brain death and to rigorously evaluate its impact.MethodsA RAND modified three-round Delphi approach was used to build consensus within a single country about potential key interventions and quality indicators identified in existing guidelines, review articles, process flow diagrams and the results of the Organ Donation European Quality System (ODEQUS) project. Comments and additional key interventions and quality indicators, identified in the first round, were evaluated in the following rounds and a subsequent physical meeting. The study was conducted over a 4-month time period in 2016.ResultsA multidisciplinary panel of 18 Belgian experts with different relevant backgrounds completed the three Delphi rounds. Out of a total of 80 key interventions assessed throughout the Delphi process, 65 were considered to contribute to the quality of care for the management of a potential donor after brain death; 11 out of 12 quality indicators were validated for relevance and feasibility. Detection of all potential donors after brain death in the intensive care unit and documentation of cause of no donation were rated as the most important quality indicators.ConclusionsUsing a RAND modified Delphi approach, consensus was reached for a set of 65 key interventions and 11 quality indicators for the management of a potential donor after brain death. This set is considered to be applicable in quality improvement programs for the care of potential donors after brain death, while taking into account each country’s legislation and regulations regarding organ donation and transplantation.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3386-1) contains supplementary material, which is available to authorized users.
“…1 ). In addition, several review articles [ 42 – 49 ] and the results of the ODEQUS project [ 23 ] were also included. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…In addition to the QIs listed in the guidelines and review articles, the QIs identified in the organ donation process of the Organ Donation European Quality System (ODEQUS) project were also analyzed. These were developed by a consortium involving associated and collaborating partners from 16 European countries [ 23 ].…”
BackgroundA substantial degree of variability in practices exists amongst donor hospitals regarding the donor detection, determination of brain death, application of donor management techniques or achievement of donor management goals. A possible strategy to standardize the donation process and to optimize outcomes could lie in the implementation of a care pathway. The aim of the study was to identify and select a set of relevant key interventions and quality indicators in order to develop a specific care pathway for donation after brain death and to rigorously evaluate its impact.MethodsA RAND modified three-round Delphi approach was used to build consensus within a single country about potential key interventions and quality indicators identified in existing guidelines, review articles, process flow diagrams and the results of the Organ Donation European Quality System (ODEQUS) project. Comments and additional key interventions and quality indicators, identified in the first round, were evaluated in the following rounds and a subsequent physical meeting. The study was conducted over a 4-month time period in 2016.ResultsA multidisciplinary panel of 18 Belgian experts with different relevant backgrounds completed the three Delphi rounds. Out of a total of 80 key interventions assessed throughout the Delphi process, 65 were considered to contribute to the quality of care for the management of a potential donor after brain death; 11 out of 12 quality indicators were validated for relevance and feasibility. Detection of all potential donors after brain death in the intensive care unit and documentation of cause of no donation were rated as the most important quality indicators.ConclusionsUsing a RAND modified Delphi approach, consensus was reached for a set of 65 key interventions and 11 quality indicators for the management of a potential donor after brain death. This set is considered to be applicable in quality improvement programs for the care of potential donors after brain death, while taking into account each country’s legislation and regulations regarding organ donation and transplantation.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3386-1) contains supplementary material, which is available to authorized users.
“…This result likely means that, in the rest of the hospitals (n ¼ 98), additional activities promoting organ donation, apart from the employment of coordinators, should be introduced, including implementation of the hospital quality systems for organ donation (according to the standards of the European project ODEQUS) [3]; continuation of in-hospital trainings (according to the European Commission model ETPOD) [4]; introduction of another techniques in monitoring and reporting of the potential of donation (according to the Donor Action program) [5]; and Table 2. Donation Activity in Hospitals Before and After the Employment of Donor Coordinators by Regions With Low and High Donation Activity changes in the profile of a coordinator (a doctor instead of a nurse or a team of 2 coordinatorsda nurse and a doctor).…”
“…Organų transplantacija pagerina gyvenimo kokybę, pailgina gyvenimo trukmę ir yra ekonomiškai naudingiausias gydymo būdas pacientams, sergantiems paskutinės stadijos inkstų nepakankamumu (1)(2)(3)(4). Esant kepenų ar plaučių terminaliniam nepakankamumui tai gali būti vienintelis gydymo būdas (5)(6)(7).…”
Section: įVadasunclassified
“…Esant kepenų ar plaučių terminaliniam nepakankamumui tai gali būti vienintelis gydymo būdas (5)(6)(7). Pagrindinė kliūtis organų transplantacijai -donorinių organų trūkumas (2,4). Pasaulinė sveikatos organizacija (PSO) skatina maksimaliai išnaudoti kiekvienos šalies organų donorystės galimybes siekiant užtikrinti donorinių organų poreikio patenkinimą.…”
Raktažodžiai: organų donoras, donorystė dėl negrįžta-mai nutrūkusios kraujotakos, potencialus donoras, mirčių analizė, donorinis centras.
SantraukaOrganų transplantacija yra efektyviausias ir ekonomiškai naudingiausias, o kai kuriais atvejais ir vienintelis gydymo būdas esant terminaliniam vidaus organų funkcijos nepakankamumui. Pagrindinė kliūtis transplantacijai -donorinių organų trūkumas. Pasaulinėje praktikoje geriausi rezultatai pasiekiami, kai kartu taikomi skirtingi donorystės modeliai: gyvoji donorytė, donorystė po smegenų mirties ir donorystė dėl negrįžtamai nutrūkusios kraujotakos (DNNK). Nuo 2016 m. sausio 1d., pakeitus įstatyminę bazę, Lietuvoje atsirado galimybė ruošti DNNK, tačiau kokia galima šio modelio įtaka organų donorų skaičiui šalyje nėra žinoma. Siekiant pamatuoto ir tvaraus DNNK programos diegimo LSMUL KK atlikta visų suaugusių pacientų mirčių, 2015 m. registruotų Kauno klinikose ir Valstybinės teismo medicinos tarnybos (VTMT) Kauno skyriaus registre, analizė ir identifikuoti potencialūs DNNK. Analizės metu naudoti visuotinai priimti potencialaus DNNK demografiniai, ligos anamnezės ir su mirties procesu susiję laiko kriterijai. Dėl Lietuvoje galiojančių įsta-tymų įtraukti tik nekontroliuojami DNNK. Nustatyta, kad iš 2356 mirusiųjų potencialaus DNNK kriterijus atitiko 56 mirusieji, taip padidindami potencialių organų donorų skaičių LSMUL KK donoriniame centre 119,5 %. Remiantis atlikta analize galima teigti, kad sėkmingai įdiegus nekontroliuojamos DNNK modelį Kauno klinikų donoriniame centre galima tikėtis žen-klaus donorinių organų padidėjimo. DNNK -donoras dėl negrįžtamai nutrūkusios kraujotakos, ŽIV -žmogaus imunodeficito virusas, CD -cukrinis diabetas, IFN -inkstų funkcijos nepakankamumas, CNS -centrinė nervų sistema. PD -potencialūs donorai, SM -smegenų mirtis, DNNK -donorai dėl negrįžtamai nutrūkusios kraujotakos. DNNK -donorai dėl negrįžtamai nutrūkusios kraujotakos, SPS -skubios pagalbos skyrius, ITS -intensyviosios terapijos skyrius.
ĮvadasOrganų transplantacija pagerina gyvenimo kokybę, pailgina gyvenimo trukmę ir yra ekonomiškai naudingiausias gydymo būdas pacientams, sergantiems paskutinės stadijos inkstų nepakankamumu (1-4). Esant kepenų ar plaučių terminaliniam nepakankamumui tai gali būti vienintelis gydymo būdas (5-7). Pagrindinė kliūtis organų transplantacijai -donorinių organų trūkumas (2, 4). Pasaulinė sveikatos organizacija (PSO) skatina maksimaliai išnaudoti kiekvienos šalies organų donorystės galimybes siekiant užtikrinti donorinių organų poreikio patenkinimą. Tai atlikti optimizuojant vidinius resursus ir ypatingas pastangas skiriant negyvosios donorystės skatinimui, nes tokiu būdu kovojama su organų prekyba iš trečiųjų šalių (8, 9). Lietuvoje, kaip ir kitose išsivysčiusiose Vakarų šalyse, stebimos organų donorų po smegenų mirties mažėjimo tendencijos, sąlygotos mažėjančio eismo įvykių skaičiaus su letaliomis baigtimis, gerėjančių neurokritinių ligonių gydymo rezultatų (10-12). Organų trū-kumo problemai spręsti įvairios šalys naudoja skirtingas strategijas ir donoryst...
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