Gyllström Krekula Linda, Malenicka Silvia, Nydahl Anders, Tibell Annika
Department of Medical Social Work, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institut, Stockholm, Sweden.
Clin Transplant. 2015 Mar;29(3):185-96. doi: 10.1111/ctr.12497. Epub 2015 Feb 2.
This study evaluates the transition from a local project to promote organ donation to a permanent county-based donation service inspired by the Spanish model. To address the problem of declining donation rates, a project with one donation-specialized nurse (DOSS) was initiated at a single neuro-intensive care unit. This project was later expanded into a permanent on-call service consisting of seven DOSSes, covering a large urban county. During the different periods (before, during project and during permanent service), the DOSS function's effect on donation rates was significant, and the number of eligible donors that became actual donors increased from 37% to 73% and 74%, respectively. The effect on family vetoes was as prominent with a decrease from 34% to 8% and 14%. The staff appreciation of the DOSS function was also evident during the periods; all areas included in the questionnaire (family care, donor care and staff support) have improved greatly owing to the DOSS. The transition from a single, local donation-nurse project, to an on-call service with several DOSSes covering a large urban county was a success considering the donation rates as well as the staff's appreciation. Hence, organizational models from abroad can be adjusted and successfully adopted.
本研究评估了从一个促进器官捐赠的地方项目向受西班牙模式启发的基于县的永久性捐赠服务的转变。为解决捐赠率下降的问题，在一个神经重症监护病房启动了一个配备一名捐赠专科护士（DOSS）的项目。该项目后来扩展为一项由七名DOSS组成的永久性随叫随到服务，覆盖一个大型城市县。在不同时期（项目前、项目期间和永久性服务期间），DOSS职能对捐赠率的影响显著，符合条件的捐赠者成为实际捐赠者的比例分别从37%增至73%和74%。对家属否决权的影响同样显著，从34%降至8%和14%。在这些时期，工作人员对DOSS职能的认可也很明显；问卷中的所有方面（家属关怀、捐赠者关怀和工作人员支持）因DOSS都有了很大改善。从单一的地方捐赠护士项目转变为覆盖大型城市县的由多名DOSS组成的随叫随到服务，从捐赠率和工作人员的认可来看是成功的。因此，国外的组织模式可以进行调整并成功采用。
