Adherence to guidelines for the management of donors after brain death.

Adult Aged Belgium Brain Death / diagnosis Consensus Cross-Sectional Studies Documentation / standards Female Guideline Adherence / standards Humans Male Middle Aged Retrospective Studies Tissue and Organ Procurement / standards
Donation after brain death Guideline adherence Importance-performance analysis Level of performance Organ donation Quality of care

Journal

Journal of critical care
ISSN: 1557-8615
Titre abrégé: J Crit Care
Pays: United States
ID NLM: 8610642

Informations de publication

Date de publication:
02 2019
Historique:
received: 31 07 2018
revised: 02 10 2018
accepted: 19 10 2018
pubmed: 6 11 2018
medline: 8 2 2020
entrez: 3 11 2018
Statut: ppublish

Résumé

Guideline adherence for the management of a donor after brain death (DBD) is largely unknown. This study aimed to perform an importance-performance analysis of prioritized key interventions (KIs) by linking guideline adherence rates to expert consensus ratings for the management of a DBD. This observational, cross-sectional multicenter study was performed in 21 Belgian ICUs. A retrospective review of patient records of adult utilized DBDs between 2013 and 2016 used 67 KIs to describe adherence to guidelines. A total of 296 patients were included. Thirty-five of 67 KIs had a high level of adherence congruent to a high expert panel rating of importance. Nineteen of 67 KIs had a low level of adherence in spite of a high level of importance according to expert consensus. However, inadequate documentation proved an important issue, hampering true guideline adherence assessment. Adherence ranged between 3 and 100% for single KI items and on average, patients received 72% of the integrated expert panel recommended care set. Guideline adherence to an expert panel predefined care set in DBD donor management proved moderate leaving substantial room for improvement. An importance-performance analysis can be used to improve implementation and documentation of guidelines.

Identifiants

DOI: 10.1016/j.jcrc.2018.10.016 PMID: 30388489
pubmed: 30388489
pii: S0883-9441(18)31085-2
doi: 10.1016/j.jcrc.2018.10.016
pii:
doi:

Types de publication

Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

56-63

Informations de copyright

Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Pieter Hoste (P)

Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 3K3, 9000 Ghent, Belgium; Department of Internal Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium; Department of Intensive Care, General Hospital Sint-Lucas Ghent, Groenebriel 1, 9000 Ghent, Belgium. Electronic address: piehoste.hoste@ugent.be.

Patrick Ferdinande (P)

Surgical and Transplantation ICU, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: patrick.ferdinande@uzleuven.be.

Dirk Vogelaers (D)

Department of General Internal Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 3K3, 9000 Ghent, Belgium; Department of Internal Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium. Electronic address: dirk.vogelaers@ugent.be.

Kris Vanhaecht (K)

Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium; Department of Quality Management, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium; European Pathway Association, Kapucijnenvoer 35, 3000 Leuven, Belgium. Electronic address: kris.vanhaecht@med.kuleuven.be.

Eric Hoste (E)

Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 3K3, 9000 Ghent, Belgium; Department of Internal Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium; Department of Intensive Care Medicine, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; Research Foundation - Flanders (FWO), Egmontstraat 5, 1000 Brussels, Belgium. Electronic address: eric.hoste@ugent.be.

Xavier Rogiers (X)

Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 3K3, 9000 Ghent, Belgium; Department of Transplant Surgery, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium. Electronic address: xavier.rogiers@ugent.be.

Kristof Eeckloo (K)

Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 3K3, 9000 Ghent, Belgium. Electronic address: kristof.eeckloo@ugent.be.

Koenraad Vandewoude (K)

Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 3K3, 9000 Ghent, Belgium; Department of Internal Medicine, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium. Electronic address: koenraad.vandewoude@ugent.be.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adherence to guidelines for the management of...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Adherence to guidelines for the management of...
questionsmedicales.fr › Régions géographiques › Europe › Belgique › Adherence to guidelines for the management of...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Mort › Mort cérébrale › Adherence to guidelines for the management of...
questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Pensée (activité mentale) › Prise de décision › Consensus › Adherence to guidelines for the management of...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études transversales › Adherence to guidelines for the management of...
questionsmedicales.fr › Sciences de l'information › Sources d'information › Services d'information › Documentation › Adherence to guidelines for the management of...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Adhésion aux directives › Adherence to guidelines for the management of...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Adherence to guidelines for the management of...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Adherence to guidelines for the management of...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Adherence to guidelines for the management of...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Acquisition d'organes et de tissus › Adherence to guidelines for the management of...