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Understanding the antecedents of the acceptance of donation after cardiac death by healthcare professionals.

Abstract：

OBJECTIVE:A 3-yr study funded by the U.S. Department of Health and Human Services was conducted to identify potential barriers to and opportunities for increasing the number hospitals with donation after cardiac death (DCD) protocols, the support of DCD by individuals involved in the donation request process, and the number DCD donors recovered. This study reports the qualitative findings. DESIGN:Methods used included an advisory committee and an extensive array of key informant interviews and focus groups. SETTING:Hospitals and telephone contact. SUBJECTS:Discussions with nurses, physicians, social service staff, clergy, administrators, and organ procurement organization staff. A total of 216 people participated. INTERVENTIONS:Collection and analysis of information regarding perceptions of DCD, potential barriers and opportunities, and strategies for gaining support. MEASUREMENT AND MAIN RESULTS:Key barriers included a lack of knowledge about DCD, psychological barriers for DCD vs. brain death, concerns about whether death has been reached, saving vs. killing patients, trust in the organ procurement organization, moving from saving patients to being a donation advocate, and concerns with the DCD process. Opportunities included education initiatives, well-trained requesters, a cultural shift, a consistent DCD protocol separating care from recovery, process monitoring, and a strong sense of teamwork. CONCLUSIONS:Our findings provide a better understanding of healthcare professionals' knowledge, attitudes, and behaviors regarding DCD. Understanding these issues is critical to the implementation of strategic plans for DCD programs. One of the biggest barriers to overcome is a lack of knowledge of DCD, which leads to misperceptions, which in turn contribute to negative attitudes and/or discomfort by healthcare professionals. Communication efforts that are able to educate healthcare professionals and eliminate misperceptions will increase support for DCD. Key to future success requires confident and well-trained DCD requesters.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

D'Alessandro AM,Peltier JW,Phelps JE

doi

10.1097/CCM.0b013e3181691b2b

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

1075-81

issue

eissn

0090-3493

issn

1530-0293

pii

00003246-200804000-00006

journal_volume

pub_type

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Understanding the antecedents of the acceptance of donation after cardiac death by healthcare professionals.