O'Brien R L, Serbin M F, O'Brien K D, Maier R V, Grady M S
Northwest Organ Procurement Agency, Seattle, Wash, USA.
Arch Surg. 1996 Feb;131(2):153-9. doi: 10.1001/archsurg.1996.01430140043011.
To implement and then determine the efficacy of a "hospital development" (HD) plan designed to increase organ donation rates at an urban trauma center.
DESIGN/SETTING: Retrospective reviews of all deaths at an urban, level I trauma center for 1991 to 1994.
Potential organ donors were identified by standardized criteria, and the reasons why potential donors did not become actual organ donors ("nonproductive donors") were categorized. Actual donors were defined as individuals in whom one transplantable organ was recovered. Results also were expressed as percentages of potential donors for each year. Changes in actual donor numbers and in nonproductive donor categories were compared for the "pre-HD" (1991-1992) and "post-HD" (1993-1994) periods.
The HD plan had six components: identification of key contact individuals, development and modification of relevant hospital policies, improvement in procurement agency visibility in hospital units, education of hospital staff regarding organ donation, institution of early on-site donor evaluations, and provision of feedback to hospital staff about the disposition of potential organ donors.
Institution of the HD plan was associated with a highly significantly increase in actual donors for the post-HD period as compared with the pre-HD period (P < .001), and pre-HD and post-HD donor rates were 26.1% and 49.5%, respectively. This increase was due primarily to a marked improvement in hospital staff identification and referral of potential donors (P < .001).
A coordinated plan incorporating continuing staff education, organ donation policy refinement, and increased visibility and availability of organ procurement agency personnel can substantially increase organ donation at an urban trauma center.
实施一项旨在提高城市创伤中心器官捐献率的“医院发展”（HD）计划，并评估其效果。
设计/地点：对一家城市一级创伤中心1991年至1994年期间的所有死亡病例进行回顾性研究。
根据标准化标准确定潜在器官捐献者，并对潜在捐献者未成为实际器官捐献者（“无成效捐献者”）的原因进行分类。实际捐献者定义为至少有一个可移植器官被获取的个体。结果也以每年潜在捐献者的百分比表示。比较了“HD计划实施前”（1991 - 1992年）和“HD计划实施后”（1993 - 1994年）期间实际捐献者数量和无成效捐献者类别变化。
HD计划包括六个部分：确定关键联系人、制定和修改相关医院政策、提高器官获取机构在医院各科室的可见度、对医院工作人员进行器官捐献教育、开展早期现场捐献者评估，以及向医院工作人员反馈潜在器官捐献者的处置情况。
与HD计划实施前相比，HD计划实施后实际捐献者数量显著增加（P <.001），HD计划实施前和实施后的捐献率分别为26.1%和49.5%。这一增加主要归因于医院工作人员对潜在捐献者的识别和转诊能力显著提高（P <.001）。
一项包含持续工作人员教育、完善器官捐献政策以及提高器官获取机构人员的可见度和可及性的协调计划，可大幅提高城市创伤中心的器官捐献率。
