Prog Transplant
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Limited organ availability and an increasing demand for organ transplantation has extended transplant waiting times and thus increased morbidity and mortality for potential recipients on waiting lists. The Queensland Liver Transplant Service identified use of clinical practice guidelines developed from evidence-based practice as a strategic clinical management/workflow tool that could improve clinical outcomes for patients awaiting liver transplant. ⋯ Practices that required change to comply with identified best practice were investigated, and clinical practice for the outpatient medical management of potential liver transplant recipients with chronic liver disease were developed collaboratively. These guidelines have been accepted and are being implemented within the gastroenterology and hepatology department at the Princess Alexandra Hospital.
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Public education campaigns about organ donation are common, but their association to actual attitudes, beliefs, and decisions about organ donation among family members of donation-eligible individuals is unknown. ⋯ When examined in the context of other recent research, these findings argue for continued development and implementation of public education campaigns for organ donation, with an emphasis on repeated exposure over time.
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Deficiencies in the donation process continue to contribute to the shortage of organs available for transplant. Continuous quality improvement of hospitals' donation processes is needed to identify and correct the problems. ⋯ The RAPiD hospital evaluations revealed gaps in respondents' knowledge of organ donation, brain death, and referral criteria; a reluctance to declare brain death; and a rocky relationship between the hospitals and the organ procurement organization. As a result of the interventions, 9 hospitals' environments for organ donation improved, 7 showed no change, and 1 was worse.