Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Internal post 710, 6500 HB, Nijmegen, The Netherlands.
Dutch Transplant Foundation, Leiden, The Netherlands.
Crit Care. 2019 Jun 20;23(1):227. doi: 10.1186/s13054-019-2509-3.
The last decade, there have been many initiatives worldwide to increase the number of organ donors. However, it is not clear which initiatives are most effective. The aim of this study is to provide an overview of interventions aimed at healthcare professionals in order to increase the number of organ donors.
We systematically searched PubMed, EMBASE, CINAHL, PsycINFO, and the Cochrane Library for English language studies published until April 24, 2019. We included studies describing interventions in hospitals aimed at healthcare professionals who are involved in the identification, referral, and care of a family of potential organ donors. After the title abstract and full-text selection, two reviewers independently assessed each study's quality and extracted data.
From the 18,854 records initially extracted from five databases, we included 22 studies in our review. Of these 22 studies, 14 showed statistically significant effects on identification rate, family consent rate, and/or donation rate. Interventions that positively influenced one or more of these outcomes were training of emergency personnel in organ donation, an electronic support system to identify and/or refer potential donors, a collaborative care pathway, donation request by a trained professional, and additional family support in the ICU by a trained nurse. The methodological quality of the studies was relatively low, mainly because of the study designs.
Although there is paucity of data, collaborative care pathways, training of healthcare professionals and additional support for relatives of potential donors seem to be promising interventions to increase the number of organ donors.
PROSPERO, CRD42018068185.
过去十年，全球范围内有许多举措旨在增加器官捐献者的数量。然而，目前尚不清楚哪些举措最为有效。本研究旨在概述旨在提高医护人员数量的干预措施。
我们系统地检索了 PubMed、EMBASE、CINAHL、PsycINFO 和 Cochrane Library 中截至 2019 年 4 月 24 日发表的英文研究。我们纳入了描述医院中针对参与识别、转介和照护潜在器官捐献者家属的医护人员的干预措施的研究。在标题、摘要和全文筛选后，两名评审员独立评估了每一项研究的质量并提取数据。
从五个数据库中最初提取的 18854 条记录中，我们纳入了 22 项研究进行综述。这 22 项研究中有 14 项研究表明在识别率、家庭同意率和/或捐献率方面具有统计学意义。对一个或多个上述结果产生积极影响的干预措施包括对器官捐献培训的急救人员、识别和/或转介潜在供体的电子支持系统、协作护理途径、经过培训的专业人员提出的捐献请求以及在 ICU 中由经过培训的护士为潜在供体家属提供的额外支持。这些研究的方法学质量相对较低，主要是因为研究设计。
尽管数据匮乏，但协作护理途径、医护人员培训以及对潜在供体家属的额外支持似乎是增加器官捐献者数量的有前途的干预措施。
PROSPERO，CRD42018068185。
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