NHS Blood and Transplant, Bridle Path, Leeds LS15 7TW, UK.
Br J Anaesth. 2012 Jan;108 Suppl 1:i56-67. doi: 10.1093/bja/aer402.
Implementation of the recommendations from the Organ Donation Taskforce has introduced for the first time into the UK a nationwide framework for deceased donation. This framework is based, in principle, upon a conviction that donation should be viewed as part of end-of-life care and that the actions often necessary to facilitate it become justified when donation is recognized to be consistent with the wishes and interests of a dying patient. The implementation of the Taskforce recommendations across the complex landscape of acute hospital care in the UK represents a challenging programme of change management that has three more or less distinct phases. This programme has involved first creating and communicating the Taskforce's vision for donation in the UK, secondly introducing the structural elements of this new framework into hospital practice, and finally creating the environment in which these new elements can deliver the overall programme goals. Implementation has focused heavily upon areas of practice where significant opportunities to increase donor numbers exist. It is recognized that the greatest challenge is to overcome the societal and clinical behaviours and beliefs that currently create barriers to donation. Although national audit data may point to some of these areas of practice, international comparisons suggest that differences in approach to the care of patients with catastrophic brain injury may have a profound influence on the size of the potential donor pool.
执行器官捐赠特遣部队的建议，首次在英国引入了一个全国性的死亡捐赠框架。这个框架原则上基于这样一种信念，即捐赠应该被视为临终关怀的一部分，当捐赠被认为符合临终患者的意愿和利益时，通常为促进捐赠而采取的行动是合理的。特遣部队的建议在英国复杂的急性医院护理环境中得到实施，代表了一个具有挑战性的变革管理计划，该计划有三个或多或少不同的阶段。该计划首先在英国创建并传达了特遣部队对捐赠的愿景，其次将这个新框架的结构要素引入医院实践，最后创建了一个环境，使这些新要素能够实现整个计划目标。实施工作主要集中在有机会显著增加捐赠者数量的实践领域。人们认识到，最大的挑战是克服目前阻碍捐赠的社会和临床行为和观念。虽然国家审计数据可能指出了这些实践领域，但国际比较表明，对灾难性脑损伤患者护理方法的差异可能对潜在供体库的规模产生深远影响。
