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Table 2 Overview of the interventions classified in three categories

From: Interventions aimed at healthcare professionals to increase the number of organ donors: a systematic review

Study [reference]

Intervention

Relevant actions

Key players

Classification

Significant effects

Identification and referral

Education

Support of relatives

Adanir et al. [12]

Psychological support for relatives

The relatives in the intervention group attended interviews every 2 days with a psychologist if they wanted to. At least 3 therapeutic interviews were completed.

Psychologists

  

X

Yes

Beasley et al. [13]

Hospital adapted interventions

Monitoring of organ donation, implementation strategy, introduction of recommended practices, development of multidisciplinary team.

Physicians, residents, nurses, social workers, chaplains and administrators

X

  

Yes

Beigee et al. [14]

Donor identification

The procurement centers call every day to ICUs, emergency departments, coronary care unit, neurosurgery and supervisors of medical centers and trauma centers.

Trained personnel from organ procurement centers

X

  

NR

Bires [15]

Training of requestors

An 8-h designated requestor program was conducted by the OPO.

Requestors

 

X

 

NR (noa)

Bleakley [16]

Donor identification

Implementation of a donor identification scheme.

Staff members

X

  

NR

Feest et al. [17]

Donor identification

The protocol describes the criteria of identification of potential organ donors and enables transfer of patients to ICU for ventilatory support until organ retrieval can be arranged.

Physicians, transplant team, representatives of nurses from medical wards, ICU

X

  

NR (yesa)

Garside et al. [18]

Specialist nurse in organ donation (SNOD) and collaborative care pathway

The role of the SNOD involves close liaison with ICU and ED staff at all levels, ensuring a multidisciplinary collaborative approach to the early identification and management of potential donors. A collaborative care pathway was introduced to identify clinical triggers and facilitate the referral of potential organ donors.

SNODs and ICU and ED staff

X

 

X

Yes

Henderson et al. [19]

Training of emergency personnel

The OPO educated the emergency personnel on the process of identifying potential donors, and the need for early OPO referral. The OPO also visits the ED every 2 to 3 months to reeducate the staff.

Emergency personnel

X

X

 

Yes

Ismail et al. [20]

Support by a CaD-trained psychologist for requesters

The Communication about Donation Telephone Advice by Psychologist (CaD-TAP) intervention was developed. The CaD-TAP intervention allows the requester to get general practical advice on effective communication from a CaD-trained psychologist shortly before the actual donation request.

Requesters

 

X

 

Yes

Jansen et al. [21]

Training of nurses

Nurses completed the training ‘Communication about donation’. The trained donation practitioners are always available, 24 h a day, and guide the relatives through the donation decision process.

Nurses

  

X

Yes

Krekula et al. [22]

Training of nurses

The donation specialist nurse (DOSS) on call supports the local team with the medical care of the donors and with the actual donation request, primarily together with the local physician. The DOSSes also promote adherence to standard routines concerning organ donation and take responsibility for the follow-up with DR at their local hospitals.

Nurses

  

X

Yes

Lenzi et al. [23]

Donation request by trained professional

Performances in obtaining informed consent from potential donors’ families were compared according to the type of healthcare professional conducting the interviews: OPO, In-hospital coordinator or ICU physician (not trained).

OPO, in-hospital coordinators, ICU physicians

 

X

 

NR (yesa)

Linyear et al. [24]

Family communication protocol

A standard family communication protocol was developed to ensure consistent identification of all patients with devastating neurological insults who might progress to brain death, optimal family communication and support, and a request for organ donation in accordance with best-demonstrated practices.

Nurses and physicians from the ICUs, as well as hospital administrators, chaplains, and LifeNet representatives

X

 

X

NR (noa)

Manyalich et al. [25]

Training of healthcare professionals

Three educational initiatives were designed and implemented: 1) essentials in organ donation 2) professional training for junior transplant coordinators and 3) organ donation quality management. A public website, a private virtual platform and an e-learning campus were used as communication tools.

Professionals in ICUs, postoperative recovery, emergency rooms, etc. (in areas where organ donors can be actively detected)

 

X

 

Yes

Mulvania et al. [26]

Training of healthcare professionals

A customized, self-sustaining training program. Two 1-day pilot training sessions were provided to 45 Australian donation leaders. Also, 26 2-day family donation conversation workshops were held in 8 cities (646 participants).

Professionals from the Australian DonateLife Network, ICU, and emergency specialists

 

X

 

NR

Sandiumenge et al. [27]

Donor identification and referral

Ninety percent of the specialists playing a key role in the management of possible donors outside the ICU were voluntarily included in a virtual collaborative group using an instant messaging application (WhatsApp@) in order to refer to the DC all patients presenting with GCS < 9 and who fulfilled any of the established by consensus criteria.

Professionals playing a key role in the management of possible donors outside the ICU

X

  

Yes

Siminoff et al. [28]

Training of healthcare professionals

The training was divided into a day-long interactive group workshop, taught by the principal investigator and then individual skills-based simulated donation scenarios with feedback.

OPO staff members

 

X

 

No

Siminoff et al. [29]

Online training of healthcare professionals

Two versions were developed: 1) CEaD1: requesters viewed a series of 4 donation scenarios of increasing difficulty embedded within a web-based tutorial. An accompanying workbook detailed the specific skills needed to effectively initiate request, etc. 2) CEaD2: requesters received the same training as CEaD1, together with live practice and feedback using simulated family scenarios.

Requesters

 

X

 

Yes

Stark et al. [30]

Training of nurse requestors

The education program was designed to encompass four concepts: awareness, recognition, offering the option of donation and bereavement.

Nurse requesters

X

X

 

NR (noa)

von Pohle [31]

Donation request by OPO representative

Institution started working with a dedicated representatives from the local OPO who uses decoupling routinely. They spend whatever amount of time is needed with the family to explain the process of donation.

OPO representatives

  

X

Yes

Young et al. [32]

Collaborative requesting

Collaborative requesting by clinician and donor transplant coordinator.

Clinician and transplant coordinator

  

X

No

Zier et al. [33]

Donor identification

An Electronic Decision Support system was developed to identify patients who meet OPO notification criteria impending brain death. When the algorithm detects a patient who fulfills notification criteria, a system-generated email is sent directly to the OPO.

OPO

X

  

Yes

  1. Abbreviations: ICU intensive care unit, NR not reported, OPO organ procurement organization, SNOD specialist nurse in organ donation, ED emergency department, DOSS donation specialist nurse, CEaD communicating effectively about donation
  2. ap value was not reported in article, but was calculated based on the outcomes and number of participants given