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Journal of critical care · Feb 2019
Multicenter Study Observational StudyAdherence to guidelines for the management of donors after brain death.
- Pieter Hoste, Patrick Ferdinande, Dirk Vogelaers, Kris Vanhaecht, Eric Hoste, Xavier Rogiers, Kristof Eeckloo, and Koenraad Vandewoude.
- 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.
- J Crit Care. 2019 Feb 1; 49: 56-63.
PurposeGuideline 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.Materials And MethodsThis 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.ResultsA 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.ConclusionsGuideline 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.Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
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