Urquhart Robin, Kureshi Nelofar, Dirk Jade, Weiss Matthew, Beed Stephen
Department of Community Health and Epidemiology, Dalhousie University, Room 413, Centre for Clinical Research, 5790 University Avenue, Halifax, NS, B3H 1V7, Canada.
Division of Neurosurgery, QEII Health Sciences Centre and Dalhousie University, Halifax, NS, Canada.
Can J Anaesth. 2023 Feb;70(2):245-252. doi: 10.1007/s12630-022-02372-4. Epub 2022 Dec 1.
In April 2019, the Human Organ and Tissue Donation Act (HOTDA) in Nova Scotia was modified to incorporate a deemed consent model. In this study, we sought to understand intensive care unit (ICU) and emergency department (ED) nurses' knowledge of and confidence around organ donation and transplantation, experiences with organ donors and recipients, attitudes toward organ donation and deemed consent, and perceived opportunities and barriers to a deemed consent approach in view of the legislative change.
We sent an electronic, self-administered survey to all ICU and ED nurses in Nova Scotia. The survey queried respondents on their knowledge of, experience with, and attitudes around organ donation and HOTDA, and opportunities and barriers to the implementation of HOTDA in clinical practice. Survey results were analyzed using descriptive statistics.
One-hundred and ninety-four nurses responded to the survey. Nearly all (98%) supported organ donation, with 86% having signed an organ donor card to donate organs and/or tissues after death. A considerable majority (89%) also supported the new legislation. Nevertheless, a minority of respondents (13%) believed that deemed consent legislation would be considered a violation of the general principles of freedom and autonomy. The three most identified topics for ongoing training were coordination of the donation process (70%), clinical management of donors (70%), and family issues in decision-making (70%).
Intensive care unit and ED nurses had positive attitudes toward organ donation, including deemed consent model. The findings should inform educational initiatives in Nova Scotia and beyond to optimize organ donation processes and outcomes.
2019年4月，新斯科舍省的《人体器官和组织捐赠法》（HOTDA）进行了修订，纳入了推定同意模式。在本研究中，我们试图了解重症监护病房（ICU）和急诊科（ED）护士对器官捐赠和移植的知识与信心、与器官捐赠者和接受者的经历、对器官捐赠和推定同意的态度，以及鉴于立法变化，对推定同意方法的感知机会和障碍。
我们向新斯科舍省所有ICU和ED护士发送了一份电子自填式调查问卷。该调查询问了受访者对器官捐赠和HOTDA的知识、经历和态度，以及HOTDA在临床实践中实施的机会和障碍。使用描述性统计分析调查结果。
194名护士回复了调查。几乎所有人（98%）支持器官捐赠，86%的人签署了器官捐赠卡，以便在死后捐赠器官和/或组织。绝大多数人（89%）也支持新立法。然而，少数受访者（13%）认为推定同意立法会被视为违反自由和自主的一般原则。三个最确定的持续培训主题是捐赠过程的协调（70%）、捐赠者的临床管理（70%）和决策中的家庭问题（70%）。
重症监护病房和急诊科护士对器官捐赠，包括推定同意模式，持积极态度。这些发现应为新斯科舍省及其他地区的教育举措提供参考，以优化器官捐赠流程和结果。
