scholarly journals Prior family communication and consent to organ donation: using intensive care physicians’ perception to model decision processes

2012 ◽  
Vol 1 (2) ◽  
pp. 19 ◽  
Author(s):  
Peter J. Schulz ◽  
Ann Van Ackere ◽  
Uwe Hartung ◽  
Anke Dunkel
Keyword(s):  
Intensive Care ◽  
Organ Donation ◽  
Family Communication ◽  
Cross Validation ◽  
Decision Processes ◽  
Potential Donor ◽  
Face To Face ◽  
Relative Information ◽  
The Family ◽  
Brain Dead

Generally, the Swiss hold favourable attitudes to organ donation, but only few carry a donor card. If no card is found on a potential donor, families have to be approached about donation. The aim of this paper is to model the role that some family communication factors play in the family decision to consent or not to organ donation by a brain dead relative. Information was gathered in face-to-face interviews, using a questionnaire and recording open answers and comments. Eight heads of intensive care units (ICU) of Swiss hospitals and one representative from <em>Swisstransplant</em> were interviewed. Questions asked respondents to estimate the prevalence and effect of communication factors in families facing a decision to consent to donation. Answers were averaged for modelling purposes. Modelling also relies on a previous representative population survey for cross-validation. The family of the deceased person is almost always approached about donation. Physicians perceive that prior thinking and favourable predisposition to donation are correlated and that the relatives’ predisposition is the most important factor for the consent to donation, up to the point that a negative predisposition may override an acknowledged wish of the deceased to donate. Donor cards may trigger family communication and ease the physicians’ approach to family about donation. Campaigns should encourage donate-willing people to talk to their families about it, make people think about organ donation and try to change unfavourable predispositions.

scholarly journals Retrospective Analysis of Brain Death Cases

2021 ◽  
Author(s):  
Özlem Özkan Kuşcu ◽  
Meltem Aktay
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Death ◽  
Organ Donation ◽  
Death Time ◽  
The Family ◽  
The Mean ◽  
End Stage ◽  
Cadaveric Donors ◽  
Death Cases

Objective: Organ transplantation is important for patients with end-stage organ failure to survive. For this reason, detection of brain death cases and adequate number of donations are necessary. Methods: 31 cases diagnosed with brain death between 01.01.2018-01.01.2020 were evaluated retrospectively. Demographic characteristics, diagnoses causing brain death, time to detect brain death, additional tests applied for the diagnosis of brain death, time to diagnosis of brain death and cardiopulmonary arrest or donation, the proportion of families accepting organ donation, the proportion of donors, organ removed from donors the number and blood types of the cases were recorded Results: The number of cases diagnosed with brain death was 31, and the mean age of the cases was 46,71 (1-89) years. 71% (n=22) of the patients were admitted to the intensive care unit from the emergency department. The most common reason for admission to the intensive care unit 67.7% (n=21) was intracranial bleeding. While the family donation rate was 19% (n=5), three cases who accepted the donation could be donors. The mean age of the patients for whom organ donation was accepted was 35.80±11 years, while the mean age of the patients for whom organ donation was not accepted was 57.43±21.30 years (p=0.04). Conclusion: Due to the increasing number of end-stage organ failure patients awaiting transplantation, it is necessary to increase the number of cadaveric donors. Timely and sufficient detection of brain death cases, increasing the family donation rate and increasing the number of cadaveric donors will be contributed.

scholarly journals Role of intensive care nurses on guiding patients’ families/relatives to organ donation

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Ahmet Karaman ◽  
Neriman Akyolcu
Keyword(s):  
Intensive Care ◽  
Brain Death ◽  
Organ Donation ◽  
Organ Transplant ◽  
University Hospitals ◽  
Intensive Care Nurses ◽  
Creative Commons ◽  
The Family ◽  
Using Data

Objective: The aim was to determine the role of intensive care nurses on guiding the families/relatives of brain-death patients to organ donation. Methods: This research is a descriptive study. While the population of the study consisted of 1710 nurses working in the intensive care units of public, private and university hospitals in the city of Istanbul, the sample consisted of 353 intensive care nurses selected with stratified random sampling method from the probability sampling methods from this population. The data were collected by using “Data Collection Form”. Results: It was determined that 74.5% of the intensive care nurses carefully listened the family/relatives of the patient with possible brain death or suffering from brain death and supported them to express their emotion and thoughts clearly; when the family/relatives of the patients hospitalised in the intensive care unit wanted to get information about organ donation, 20.7% of the nurses made the preliminary explanation themselves and then guided the patient to an organ transplant coordinator for detailed information and 3.1% of the nurses generally gave this information themselves. Conclusions: It was determined that the knowledge of the intensive care nurses about brain death and organ donation was partially adequate and the function of guiding the families/relatives of brain-death patients to organ donation was mostly done by the physician. doi: https://doi.org/10.12669/pjms.35.4.1285 How to cite this:Karaman A, Akyolcu N. Role of intensive care nurses on guiding patients’ families/relatives to organ donation. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1285 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The donor potential of twenty six donor bases in the Russian Federation: external audit (a pilot project)

2020 ◽  
Vol 48 (3) ◽  
pp. 153-161
Author(s):  
V. L. Vinogradov ◽  
K. K. Gubarev ◽  
A. I. Zakhlevnyy ◽  
D. S. Svetlakova
Keyword(s):  
Intensive Care ◽  
Brain Injury ◽  
Brain Death ◽  
Organ Donation ◽  
Intensive Care Units ◽  
Pilot Project ◽  
Secondary Brain Injury ◽  
External Audit ◽  
Potential Donor ◽  
Donation Process

Rationale: The imbalance between the need for donor organs and their current availability is a growing problem for all countries. An assessment of potential donor numbers is considered to be an important step towards better understanding of the problem as a whole at the national scale. This would help to build up a concept of a successful strategy to resolve this inequity.Aim: To analyze the use of external audit of the efficacy of identification of potential organ donors with confirmed brain death.Materials and methods: As a part of a pilot project aimed to increase the efficacy of donor bases of the Russian Federal Medical Biological Agency (FMBA), we retrospectively analyzed 5932 medical files of patients who died from 2014 to 2018 in the departments of resuscitation and intensive care units of 26 medical establishments serving as a donor bases in Moscow, Orenburg, Saratov, Abakan, Stavropol and FMBA of Russia. The probability of brain death was assessed with a special QAPDD (Quality Assurance Program in the Deceased Donation Process) technique focused on organ donation after brain death which is used for external audit in Spanish hospitals.Results: Clinical manifestation of brain death were identified in 20.3% (95% confidence interval (CI) 18.4–22.4) of the patients aged 18 to 65 years with severe primary and secondary brain injury who died in the departments of resuscitation and had been maintained on mechanical ventilation at least 12 hours until their death was confirmed. The rate of potential donor identification with clinical manifestations of brain death in the donating in-patient departments was 12% (95% CI 10.5–13.7) of those who died with severe primary and secondary brain injury. The external audit performed in 26 donating in-patient departments, has shown that 41% (95% CI 35.8–46.4) of potential donors with brain death were not identified.Conclusion: With the use of the QAPDD technique in our study, we found that 41% of potential donors were not identified in the Russian in-patient clinics participating in organ donation. Based on the information obtained during the audit of medical files in intensive care units, we can make realistic conclusions on the current system of organ donation, identify potential pitfalls in the identification procedures of potential donors, increase the efficacy of donation process, and to improve the system as a whole. The process could become effective only through the activities of specially trained donor hospital transplant coordinators.

Organ Donation, Brain Death and the Family: Valid Informed Consent

2015 ◽  
Vol 43 (2) ◽  
pp. 369-382 ◽  
Author(s):  
Ana S. Iltis
Keyword(s):  
Informed Consent ◽  
Brain Death ◽  
Organ Donation ◽  
Organ Procurement ◽  
Organ Donor ◽  
Public Understanding ◽  
Organ Procurement Organization ◽  
The Family ◽  
Driver's License ◽  
Brain Dead

In July 2013, parents in Ohio objected to their 21-year-old son becoming an organ donor. Elijah Smith was involved in an accident and pronounced dead using neurological criteria. The organ procurement organization (OPO) went to court and argued that because the young man was brain dead and because his driver's license indicated that he wished to be a donor, the court should allow them to use his organs. The mother argued that her son did not understand what he was signing when he signed his license and that his signature did not reflect an informed decision. The court disagreed with her, saying that he had indicated a wish to donate his organs and that no one but Elijah could revoke that wish. His organs were removed.Elijah's mother suspected that he did not understand what he was signing. She might have been right, given what we know about the process for obtaining permission for organ donation and the limited public understanding of brain death.

scholarly journals Pre-mortem interventions for donation after circulatory death and overall benefit: A qualitative study

2016 ◽  
Vol 11 (4) ◽  
pp. 149-158
Author(s):  
Aisha Gathani ◽  
Greg Moorlock ◽  
Heather Draper
Keyword(s):  
Qualitative Study ◽  
Organ Donation ◽  
Healthcare Professionals ◽  
Donation After Circulatory Death ◽  
Potential Donor ◽  
Strength Of Evidence ◽  
Respect For Autonomy ◽  
Brainstem Death ◽  
The Family ◽  
Circulatory Death

This article explores how the type of consent given for organ donation should affect the judgement of a patient's overall benefit with regards to donation of their organs and the pre-mortem interventions required to facilitate this. The findings of a qualitative study of the views of 10 healthcare professionals, combined with a philosophical analysis inform the conclusion that how consent to organ donation is given is a reliable indicator only of the strength of evidence about views on donation and subsequent willingness to undergo pre-mortem interventions. It is not an indicator of the strength of actual desire to donate. Clinical management of living patients prior to donation after circulatory death must therefore respect the values, wishes and beliefs of the potential donation after circulatory death donor. Our participants, however, suggested that the information currently provided is sufficient to authorise donation and that this consent, however provided, was sufficient to proceed with pre-mortem interventions. Respect for autonomy underpinned this ‘all or nothing’ approach. Although the legal requirements for donation authorisation and the protection of patients without capacity are clear, practice and policy regarding consent in donation after circulatory death may be based on donation following brainstem death where the patient is already dead when the family is approached. Custom and practice in donation after circulatory death may need to be revised to protect the interests of the dying potential donor.

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