Holloway Justine A C, Ranse Kristen, Bail Kasia, Jamieson Maggie, Van Haren Frank
Discipline of Nursing, Faculty of Health, University of Canberra, Canberra, ACT, Australia.
School of Nursing and Midwifery, Gold Coast Campus, Griffith University, Queensland, QLD, Australia.
Transplant Direct. 2019 Jul 23;5(8):e471. doi: 10.1097/TXD.0000000000000906. eCollection 2019 Aug.
Physical examination of potential organ and tissue donors is standard practice to mitigate risks and optimize outcomes for transplant recipients, but the content and process of the examination has not been investigated. The aim of this study was to determine current practice of performing a physical examination on potential organ and tissue donors in Australia.
An online cross-sectional survey was circulated to all Australian Donor Coordinators (n = 125).
There were 75 responses (60% response rate) to the online survey. Respondents perform a mean 10.5 physical examinations per year. Inconsistencies were observed in the approach to the physical examination, inclusive of assessment techniques used to perform the examination such as palpation. Specific staff training and education to perform the examination was reportedly provided to 77% of respondents. There was less variation reported in examination findings classified as higher risk and escalation procedures with the 3 most common findings of injection sites / track marks (86%), suspicious moles (77%), and unexplained scarring (51%), and with 97% seeking a second opinion. Current and previously removed melanomas were the main examination findings that stopped a donation from proceeding, as reported to have occurred by 18 respondents.
This study has identified variations in current physical examination practice and provided the evidence to pursue practice improvement. The inconsistencies can be partly attributed to discrepancies in training and education of staff and no standardized national guidelines to clearly outline expected practice.
对潜在器官和组织捐赠者进行体格检查是降低风险并优化移植受者治疗效果的标准做法，但该检查的内容和流程尚未得到研究。本研究的目的是确定澳大利亚对潜在器官和组织捐赠者进行体格检查的当前做法。
向所有澳大利亚捐赠协调员（n = 125）发放了一份在线横断面调查问卷。
在线调查共收到75份回复（回复率为60%）。受访者每年平均进行10.5次体格检查。在体格检查方法上存在不一致之处，包括用于进行检查的评估技术，如触诊。据报告，77%的受访者接受了进行该检查的特定工作人员培训和教育。在被归类为高风险和升级程序的检查结果方面，变异较少，最常见的3个检查结果为注射部位/痕迹（86%）、可疑痣（77%）和不明原因的瘢痕（51%），97%的人寻求二次意见。据18名受访者报告，当前和以前切除的黑色素瘤是阻止捐赠进行的主要检查结果。
本研究发现了当前体格检查做法中的差异，并提供了改进做法的证据。这些不一致部分可归因于工作人员培训和教育的差异，以及缺乏明确概述预期做法的标准化国家指南。
