Organ Donation Research Today is a free monthly online journal that collates and summarizes the latest research about Organ Donation, including details on risks, procedure, surgery, outcomes.

Understanding the antecedents of the acceptance of donation after cardiac death by healthcare professionals.

D'Alessandro AM, Peltier JW, Phelps JE

University of Wisconsin School Medicine and Public Health, Madison, WI, USA.

OBJECTIVE: A 3-yr study funded by the U.S. Department of Health and Human Services was conducted to identify potential barriers to and opportunities for increasing the number hospitals with donation after cardiac death (DCD) protocols, the support of DCD by individuals involved in the donation request process, and the number DCD donors recovered. This study reports the qualitative findings. DESIGN: Methods used included an advisory committee and an extensive array of key informant interviews and focus groups. SETTING: Hospitals and telephone contact. SUBJECTS: Discussions with nurses, physicians, social service staff, clergy, administrators, and organ procurement organization staff. A total of 216 people participated. INTERVENTIONS: Collection and analysis of information regarding perceptions of DCD, potential barriers and opportunities, and strategies for gaining support. MEASUREMENT AND MAIN RESULTS: Key barriers included a lack of knowledge about DCD, psychological barriers for DCD vs. brain death, concerns about whether death has been reached, saving vs. killing patients, trust in the organ procurement organization, moving from saving patients to being a donation advocate, and concerns with the DCD process. Opportunities included education initiatives, well-trained requesters, a cultural shift, a consistent DCD protocol separating care from recovery, process monitoring, and a strong sense of teamwork. CONCLUSIONS: Our findings provide a better understanding of healthcare professionals' knowledge, attitudes, and behaviors regarding DCD. Understanding these issues is critical to the implementation of strategic plans for DCD programs. One of the biggest barriers to overcome is a lack of knowledge of DCD, which leads to misperceptions, which in turn contribute to negative attitudes and/or discomfort by healthcare professionals. Communication efforts that are able to educate healthcare professionals and eliminate misperceptions will increase support for DCD. Key to future success requires confident and well-trained DCD requesters.

Published 1 April 2008 in Crit Care Med, 36(4): 1075-81.
Full-text of this article is available online (may require subscription).

© 2004-2008 Organ Donation Research Today. All Rights Reserved.