Readiness of critical care physicians and nurses to handle requests for organ donation

1998 ◽  
Vol 7 (1) ◽  
pp. 4-12 ◽  
Author(s):  
MJ Evanisko ◽  
CL Beasley ◽  
LE Brigham ◽  
C Capossela ◽  
GR Cosgrove ◽  
...  
Keyword(s):  
Critical Care ◽  
Brain Death ◽  
Organ Donation ◽  
The United States ◽  
Critical Care Nurses ◽  
Care Staff ◽  
Factual Knowledge ◽  
Donation Process ◽  
Nurses And Physicians ◽  
Effective Procedures

BACKGROUND: Critical care nurses and physicians usually care for those patients whose condition progresses to brain death and are also often responsible for requesting organ donation from the family of a brain-dead patient. We hypothesized that staff support, knowledge, and training levels would be significantly associated with organ donation rates. OBJECTIVE: To assess the readiness of critical care staff to successfully handle requests for organ donation. METHODS: A total of 1061 critical care staff from 28 hospitals in four separate regions of the United States completed a questionnaire that assessed (1) factual knowledge about organ donation, (2) understanding of brain death, (3) previous training in procedures for requesting donations, and (4) comfort levels with the donation process. RESULTS: Staff training in effective procedures for requesting organ donations was significantly correlated with hospitals' donation rates. Less than a third of respondents, however, had received training in explaining brain death to and requesting organ donation from a grieving family. In hospitals with high rates of organ donation, 52.9% of staff had received training; in hospitals with low rates of organ donation, 23.5% of staff had received training. Levels of factual knowledge about organ donation and brain death were unexpectedly low but were not significantly related to hospitals' rates of organ donation. CONCLUSIONS: Training of critical care nurses and physicians in effective procedures for requesting organ donation is significantly associated with higher rates of organ donation, yet two thirds of critical care staff report no relevant training. Consequently, critical care staff cannot be considered ready to effectively handle requests for organ donation.

scholarly journals Critical Care Nurses’ Attitudes Towards Organ Donation and its Relationship With Empathy

2020 ◽  
Vol 24 (6) ◽  
pp. 544-555
Author(s):  
Mahnaz Taherkhani ◽  
◽  
Leili Yekefallah ◽  
Leila Dehghankar ◽  
Peyman Namdar ◽  
...  
Keyword(s):  
Critical Care ◽  
Organ Donation ◽  
Organ Donor ◽  
Educational Interventions ◽  
Critical Care Nurses ◽  
Reactivity Index ◽  
Average Score ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Donation Process

Background: Critical care nurses play an important role in the organ donation process, and their attitudes towards it and willingness to register as an organ donor are related to various factors, including empathy. Objective: This study aims to compare the attitudes of nurses in Intensive Care Unit (ICU), Emergency Department (ED), and Dialysis Unit (DU) towards organ donation and its relationship with empathy. Methods: This descriptive study with cross-sectional design that was conducted in 2019 in hospitals affiliated to Qazvin University of Medical Sciences in Qazvin, Iran on 222 nurses from the three critical care units who were selected by stratified random sampling method. Data collection tools were Chakradhar’s Organ Donation Questionnaire (ODQ) and Davis’s Interpersonal Reactivity Index (IRI), completed by nurses were completed. Data were analyzed by descriptive and analytical tests. Findings: The mean ODQ score was higher in DU and ICU nurses than in ED nurses (P=0.23), where the nurses of ICU-General had the highest score (51±6.07) and the nurses of ED-Trauma had the lowest score. The highest and lowest IRI scores were related to DU and ICU-General nurses, respectively. The total IRI score (r=0.13, P=0.04) and its dimensions of perspective taking ( r=0.152, P=0.02) and fantasy (r=0.14, P=0.03) had a positive correlation with the nurses’ attitudes. Conclusion: Critical care nurses have greater than the average score in ODQ. There is a significant relationship between empathy and their attitudes towards organ donation. Their empathy with patients has a significant effect on increasing their attitudes towards accepting organ donation. Therefore, it is necessary to implement educational interventions for changing the critical care nurses’ attitudes in order to increase their empathy.

Brain Death, Organ Donation, and Transplantation

2018 ◽  
pp. 276-285
Author(s):  
Hilary H. Wang ◽  
David M. Greer
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
The United States ◽  
Apnea Test ◽  
Unit Management ◽  
Legal Context ◽  
History Of ◽  
Brain Death Determination ◽  
Brain Dead ◽  
Death Determination

This chapter reviews the history of brain death determination, current guidelines for performing the brain death examination including the apnea test, details of apnea testing, the role of brain dead donors in organ donation, physiologic changes seen in brain dead patients, and the relevant challenges in intensive care unit management of such patients for donor organ optimization. The goal of this chapter is to provide clear guidance for a critical care provider to perform an accurate and thorough brain death examination and to further the reader’s understanding of the historical and legal context surrounding brain death and organ donation in the United States.

A national survey of critical care nurses' practices related to administration of neuromuscular blocking agents

2001 ◽  
Vol 10 (3) ◽  
pp. 139-145 ◽  
Author(s):  
JG Foster ◽  
SK Kish ◽  
CH Keenan
Keyword(s):  
Critical Care ◽  
Peripheral Nerve ◽  
The United States ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Critical Care Nurses ◽  
Blocking Agents ◽  
Care Facilities ◽  
Acute Care Facilities

BACKGROUND: Recommendations on use of neuromuscular blocking agents include using peripheral nerve stimulators to monitor depth of blockade and concomitantly administering sedatives and/or analgesics. OBJECTIVE: To evaluate critical care nurses' practices in administering neuromuscular blocking agents. METHODS: A 16-item survey was mailed to 483 acute care facilities in the United States. Of these, 246 surveys (51%) were returned and analyzed to determine use of neuromuscular blocking agents, peripheral nerve stimulators, sedatives, and analgesics. Logistic regression analysis was used to find independent predictors of use of peripheral nerve stimulators. RESULTS: Seventy-five percent of respondents reported long-term use of neuromuscular blocking agents in critically ill patients. Of those, 63% monitored the level of blockade with peripheral nerve stimulators. Reasons for not using peripheral nerve stimulators included unavailability of equipment (48%), lack of training (36%), and insufficient evidence that peripheral nerve stimulators improve care (23%). Predictors of use of stimulators were facilities with more than 150 beds (P < .001) and administration of neuromuscular blocking agents by continuous infusion (P < .001). Ninety-five percent of respondents reported using concurrent analgesics/sedatives always or most of the time. Facilities with fewer than 10 beds in the intensive care unit used concurrent analgesics/sedatives significantly less often than did facilities with 10 beds or more (90% vs 98%, respectively; P = .03). CONCLUSIONS: Small and large facilities differ in concomitant use of analgesics/sedatives and peripheral nerve stimulators. Education and research are needed to ensure that patients receive adequate monitoring and sedation during administration of neuromuscular blocking agents.

Novel Spanish Translators for Acute Care Nurses and Physicians: Usefulness and Effect on Practitioners’ Stress

2005 ◽  
Vol 14 (6) ◽  
pp. 545-550 ◽  
Author(s):  
Andrew C. Bernard ◽  
Audra Summers ◽  
Jennifer Thomas ◽  
Myrna Ray ◽  
Anna Rockich ◽  
...  
Keyword(s):  
Critical Care ◽  
Stress Reduction ◽  
Quality Care ◽  
Healthcare Providers ◽  
Critical Care Nurses ◽  
Survey Period ◽  
Acute Care Nurses ◽  
Quality Healthcare ◽  
Stress Levels ◽  
Nurses And Physicians

• Background Language barriers are significant impediments to providing quality healthcare, and increased stress levels among nurses and physicians are associated with these barriers. However, little evidence supports the usefulness of a translation tool specific to healthcare. • Objectives To evaluate the effectiveness of a novel English-Spanish translator designed specifically for nurses and physicians. The hypothesis was that the translator would be useful and that use of the translator would decrease stress levels among nurses and physicians caring for Spanish-speaking patients. • Methods Novel English-Spanish translators were developed entirely on the basis of input from critical care nurses and physicians. After 7 months of use, users completed surveys. Usefulness of the translator and stress levels among users were reported. • Results A total of 60% of nurses (n = 32) and 71% (n = 25) of physicians responded to the survey. A total of 96% of physicians and 97% of nurses considered the language barrier an impediment to delivering quality care. Nurses reported significantly more stress reduction than did physicians (P = .01). Most nurses and physicians had used the translator during the survey period. Overall, 91% of nurses and 72% of physicians found that the translator met their needs at the bedside some, most, or all of the time. All nurses thought that they most likely would use the translator in the future. • Conclusions The translator was useful for most critical care nurses and physicians surveyed. Healthcare providers, especially nurses, experienced decreased stress levels when they used the translator.

Safeguarding the Patient and the Profession: The Value of Critical Care Nurse Certification

2003 ◽  
Vol 12 (2) ◽  
pp. 154-164 ◽  
Author(s):  
◽  
Keyword(s):  
Critical Care ◽  
American Association ◽  
The United States ◽  
White Paper ◽  
Critical Care Nurses ◽  
Specialized Knowledge ◽  
Care Nurse ◽  
Call To Action ◽  
Knowledge And Skills ◽  
The Public

Today’s critically ill patients require heightened vigilance and extraordinarily intricate care. As skilled and responsible health professionals, the 403 000 critical care nurses in the United States must acquire the specialized knowledge and skills needed to provide this care and demonstrate their competence to the public, their employers, and their profession. Recognizing that nurses can validate specialty competence through certification, this white paper from the American Association of Critical-Care Nurses and the AACN Certification Corporation puts forth a call to action for all who can influence and will benefit from certified nurses’ contribution to patient care.

scholarly journals A narrative review of family members’ experience of organ donation request after brain death in the critical care setting

2019 ◽  
Vol 45 (3) ◽  
pp. 331-342 ◽  
Author(s):  
Nancy Kentish-Barnes ◽  
L. A. Siminoff ◽  
W. Walker ◽  
M. Urbanski ◽  
J. Charpentier ◽  
...  
Keyword(s):  
Critical Care ◽  
Brain Death ◽  
Organ Donation ◽  
Care Setting ◽  
Family Members ◽  
Narrative Review ◽  
Critical Care Setting

Beliefs and Brain Death

2017 ◽  
Author(s):  
Eelco F.M. Wijdicks
Keyword(s):  
United States ◽  
Native American ◽  
Brain Death ◽  
Cultural Diversity ◽  
Organ Donation ◽  
The United States ◽  
Neurological Injury ◽  
Brain Death Determination ◽  
Death Determination

Globalization has increased cultural diversity in many communities. This has immediate implications for care of patients with catastrophic neurological injury and later discussions of brain death and organ donation. While the major religions in the United States—Christianity, Islam, and Judaism—have taken a tolerant position in these matters, some denominations within them are vigorously opposed to it. This chapter presents a range of cultural and religious views of brain death determination and organ donation. In addition to the three major religions, Buddhist and native American views regarding brain death determination as well as organ donation are discussed. Conflict resolution over organ donation is discussed along with the role of clergy in mediating such conflicts between families and medical staff.

Exploratory and Confirmatory Factor Analysis of the Maslach Burnout Inventory to Measure Burnout Syndrome in Critical Care Nurses

2020 ◽  
Vol 28 (1) ◽  
pp. E18-E29
Author(s):  
Alexander Schneider ◽  
Jeri E. Forster ◽  
Meredith Mealer
Keyword(s):  
Factor Analysis ◽  
Critical Care ◽  
Confirmatory Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Factor Model ◽  
Maslach Burnout Inventory ◽  
The United States ◽  
Critical Care Nurses ◽  
Burnout Syndrome ◽  
Confirmatory Factor

Background and PurposeBurnout syndrome is common in critical care nursing. The Critical Care Societies Collaborative recently released a joint statement and call to action on burnout in critical care professionals.MethodsWe conducted an exploratory factor analysis and confirmatory factor analysis (CFA) of the 22-item MBI.ResultsThe exploratory factor analysis identified three factors but after questions were removed; we were left with a 2-factor, 10-item abridged version of the MBI-HSS to test with CFA modeling. The CFA indicated conflicting fit indices.Conclusionswe conducted an exploratory and CFA of the abridged MBI-HSS in critical care nurses from the United States and found the two-factor model was the best fit achieved.

scholarly journals The Connor-Davidson Resilience Scale in Critical Care Nurses: A Psychometric Analysis

2016 ◽  
Vol 24 (1) ◽  
pp. 28-39 ◽  
Author(s):  
Meredith Mealer ◽  
Sarah J. Schmiege ◽  
Paula Meek
Keyword(s):  
Factor Analysis ◽  
Critical Care ◽  
Factor Structure ◽  
Model Comparison ◽  
Factor Model ◽  
The United States ◽  
Critical Care Nurses ◽  
Group Differences ◽  
Resilience Scale ◽  
Confirmatory Factor

Objective: (a) To investigate the factor structure of the Connor-Davidson Resilience Scale (CD-RISC) in critical care nurses, using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and (b) to assess reliability and known group differences of the CD-RISC on critical care nurses. Methods: CD-RISC surveys were collected on 744 critical care nurses across the United States. An abridged version of the CD-RISC was used for the EFA and CFA. Further reliability and known group differences were also tested. Results: EFA identified 3 factors with eigenvalues >1.0 and an explained variance of 59%. The factors were labeled personal competence, perseverance, and leadership, and each factor had salient loadings. The 3-factor CFA provided good fit to the data, χ2 = 243.1, p < .001; RMSEA = .062; CFI = .935, although correlations among the 3 factors were high (.78–.86). A 1-factor model was subsequently tested but did not produce a better fit, and model comparison analyses supported retention of the 3-factor model. Known group differences was supported as intensive care unit (ICU) nurses with a diagnosis of posttraumatic stress disorder (PTSD) had significantly lower total resilience scores (M = 75.43) compared to those without a diagnosis of PTSD (M = 83.21; t = 5.01; p < .001). Discussion: The current investigation found that the 3-factor structure provided the best fit for the data on the abridged version of the CD-RISC in a population of ICU nurses. Analyses also supported the reliability and known group differences of the 16-item measure. Further research is needed to examine trait and capacity features of resilience as it relates to this population.

Strategies for Acute and Critical Care Nurses Implementing Complementary Therapies Requested by Patients and Their Families

2016 ◽  
Vol 36 (6) ◽  
pp. 52-58 ◽  
Author(s):  
Debra Kramlich
Keyword(s):  
Critical Care ◽  
Complementary Therapies ◽  
Care Setting ◽  
The United States ◽  
Critical Care Nurses ◽  
Critical Care Setting ◽  
Complementary And Alternative Therapies ◽  
Centered Care ◽  
Family Centered ◽  
Complementary And Alternative

As consumer use of complementary and alternative medicine or modalities continues to increase in the United States, requests for these therapies in the acute and critical care setting will probably continue to expand in scope and frequency. Incorporation of complementary therapies in the plan of care is consistent with principles of patient- and family-centered care and collaborative decision-making and may provide a measure of relief for the distress of admission to an acute or critical care setting. An earlier article provided an overview of complementary and alternative therapies that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses. This article provides key information on the legal, ethical, safety, quality, and financial challenges that acute and critical care nurses should consider when implementing patient and family requests for complementary therapies.

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