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住院医师和研究员对器官捐献者转诊流程的知识评估。

Assessment of resident and fellow knowledge of the organ donor referral process.

作者信息

Gupta Natasha, Garonzik-Wang Jacqueline M, Passarella Ralph J, Salter Megan L, Kucirka Lauren M, Orandi Babak J, Law Andrew H, Segev Dorry L

机构信息

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD.

出版信息

Clin Transplant. 2014 Apr;28(4):443-449. doi: 10.1111/ctr.12338. Epub 2014 Mar 27.

Abstract

Maximizing deceased donation rates can decrease the organ shortage. Non-transplant physicians play a critical role in facilitating conversion of potential deceased donors to actual donors, but studies suggest that physicians lack knowledge about the organ donation process. As residency and fellowship are often the last opportunities for formal medical training, we hypothesized that deficiencies in knowledge might originate in residency and fellowship. We conducted a cross-sectional survey to assess knowledge about organ donation, experience in donor conversion, and opinions of the process among residents and fellows after their intensive care unit rotations at the Johns Hopkins Hospital. Of 40 participants, 50% had previously facilitated donor conversion, 25% were familiar with the guidelines of the organ procurement organization (OPO), and 10% had received formal instruction from the OPO. The median score on the knowledge assessment was five of 10; higher knowledge score was not associated with level of medical training, prior training in or experience with donor conversion, or with favorable opinions about the OPO. We identified a pervasive deficit in knowledge among residents and fellows at an academic medical center with an active transplant program that may help explain attending-level deficits in knowledge about the organ donation process.

摘要

提高已故者捐赠率可减少器官短缺。非移植医生在促使潜在的已故捐赠者转变为实际捐赠者方面发挥着关键作用,但研究表明医生对器官捐赠过程缺乏了解。由于住院医师培训和专科培训往往是接受正规医学教育的最后机会,我们推测知识方面的欠缺可能源于住院医师培训和专科培训阶段。我们开展了一项横断面调查,以评估约翰·霍普金斯医院重症监护病房轮转后的住院医师和专科培训医生对器官捐赠的了解、促成捐赠者转变的经验以及对该过程的看法。在40名参与者中,50%曾促成过捐赠者转变,25%熟悉器官获取组织(OPO)的指导方针,10%曾接受过OPO的正规培训。知识评估的中位数得分是10分中的5分;较高的知识得分与医学培训水平、之前接受的捐赠者转变培训或经验,以及对OPO的好感度均无关联。我们发现,在一个开展活跃移植项目的学术医疗中心,住院医师和专科培训医生普遍存在知识欠缺,这或许有助于解释主治医生在器官捐赠过程知识方面的欠缺。

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本文引用的文献

1
The Organ Donation Breakthrough Collaborative: has it made a difference?器官捐献突破协作组织:有效果吗?
Am J Surg. 2013 Apr;205(4):381-6. doi: 10.1016/j.amjsurg.2012.11.004. Epub 2013 Feb 13.
3
Consent for organ donation.器官捐献同意书。
Br J Anaesth. 2012 Jan;108 Suppl 1:i80-7. doi: 10.1093/bja/aer353.
4
Potential limitations of presumed consent legislation.假定同意立法的潜在局限性。
Transplantation. 2012 Jan 27;93(2):136-40. doi: 10.1097/TP.0b013e31823173e0.
6
Does quality improvement work? Evaluation of the Organ Donation Breakthrough Collaborative.质量改进有效吗?器官捐赠突破协作项目评估。
Health Serv Res. 2007 Dec;42(6 Pt 1):2160-73; discussion 2294-323. doi: 10.1111/j.1475-6773.2007.00732.x.

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