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Der Praxisleitfaden Organspende orientiert sich am Aufbau und dem Inhalt der Richtlinie Spendererkennung der Bundesärztekammer. Kernelement der Richtlinie ist, dass die intensivmedizinisch tätige Ärzteschaft im Krankenhaus eine Organspende bei potenziellen Organspendern ermöglichen muss, wenn ein prinzipieller Wunsch zur Organspende besteht. Der Praxisleitfaden vermittelt das relevante Wissen zur Erkennung von potentiellen Organspendern und das Vorgehen bei diesem im komplexen klinischen Alltag eher seltenen Ereignisses. Auch der Spendeprozess wird im Hinblick auf die Spendererkennung grundlegend erörtert. Das Buch wendet sich an Ärztinnen und Ärzte auf den Intensivstationen, an die Transplantationsbeauftragten sowie an alle Health Professionals, die bei potenziellen Organspendern konfrontiert werden können.

Medical / Surgery --- Medicine --- organ transplant --- donor --- organ donation --- itensive care unit --- organ donor --- pediatrics

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Der Praxisleitfaden Organspende orientiert sich am Aufbau und dem Inhalt der Richtlinie Spendererkennung der Bundesärztekammer. Kernelement der Richtlinie ist, dass die intensivmedizinisch tätige Ärzteschaft im Krankenhaus eine Organspende bei potenziellen Organspendern ermöglichen muss, wenn ein prinzipieller Wunsch zur Organspende besteht. Der Praxisleitfaden vermittelt das relevante Wissen zur Erkennung von potentiellen Organspendern und das Vorgehen bei diesem im komplexen klinischen Alltag eher seltenen Ereignisses. Auch der Spendeprozess wird im Hinblick auf die Spendererkennung grundlegend erörtert. Das Buch wendet sich an Ärztinnen und Ärzte auf den Intensivstationen, an die Transplantationsbeauftragten sowie an alle Health Professionals, die bei potenziellen Organspendern konfrontiert werden können.

Medicine --- organ transplant --- donor --- organ donation --- itensive care unit --- organ donor --- pediatrics

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The work deals intensively with the very complex topic of post-mortem organ donation and the question of why it is that not all organs of potential organ donors are considered in transplantation. It covers central questions of the legally and ethically required handling of dying and death. In addition to a presentation of the relevant legal situation, the statistical findings on organ transplants performed in Switzerland during the observation period, the relatively high rates of rejection and low rates of conversion of organ donations by means of retrospective analysis of the data of all in 2013 at their then place of work, the Cantonal Hospital of St. Gallen are made and their results compared with those of the national SwissPOD study. The "primary desirable goal" of the measures taken to promote organ donation appears to the author to be less the "increase in available organs, but rather reflection on dying and one's own death", which is why she would welcome an increase in the number of living wills and organ donation cards available, in order to thereby reduce the emotionally stressful proxy decisions - regardless of the will specified therein.

Law --- Organ transplantation; organ donor card; brain death; cardiovascular arrest; dying process; DBD process; DCD process; preparatory medical measures; non heart beating donation

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Problème étudié : Cette étude explore le processus d’identification des potentiels donneurs d’organes décédés, auprès des staffs psycho-médico-infirmiers d’unités de soins intensifs pour proposer une action, spécifique aux besoins dégagés, en vue de l’améliorer.

Population étudiée : Le personnel infirmier, médical (y compris les chefs de service et les coordinateurs locaux médicaux et infirmiers) et psychologue des unités de soins intensifs des hôpitaux Érasme, Saint Luc, Marie-Curie, Notre-Dame, du Centre de Santé des Fagnes et de la Clinique Notre-Dame de Grâce.

Méthode : Cette recherche qualitative, inductive et de type exploratoire a été menée à travers des entretiens individuels et semi-structurés, d’une durée moyenne d’une heure, par visioconférence et préparés à l’aide d’une guide d’entretien. Ceux-ci étaient réalisés sur base volontaire, en réponse à un mail de sollicitation de participation, envoyé à la population cible. Les données ont été retranscrites puis analysées par l’investigatrice, d’abord individuellement, puis selon une méthode d’analyse thématique standardisée.

Résultats : 15 participants ont été interrogés. Le processus d’identification du potentiel donneur d’organes aux soins intensifs a pu être illustré par un ensemble de relations entre les différentes unités d’analyse thématique qui s’articulent autour de trois thèmes majeurs : « la sensibilisation médico-infirmière », « l’identification du potentiel donneur d’organes aux soins intensifs » et « l’après-identification ». Les participants ont soulevé 10 pistes d’amélioration du processus exploré.

Conclusion : Cette étude a mis en évidence la priorisation de la formation et de l’information des équipes médico-infirmières des unités de soins intensifs pour améliorer l’identification des potentiels donneurs d’organes. Elle figure dans les initiatives des équipes de coordination locale pour le don d’organes pour qui les moyens sont parfois peu définis. L’apprentissage des adultes autonomes peut se faire à la lumière de l’andragogie. La simulation peut être envisagée mais doit encore être validée par les futurs apprenants. Studied problem: This study explores the process of identifying potential deceased organ donors, by psycho-medico-nursing staff in intensive care units to propose an action, specific to the needs identified, with a view to improving it.

Population: The nursing and medical staff (including department heads and local medical and nursing coordinators) and psychologists of intensive care units at Erasme, Saint-Luc, Marie Curie, Notre-Dame, Centre de Santé des Fagnes and Notre-Dame de Grâce Clinic.

Method: This qualitative, inductive and exploratory research has been conducted through individual and semi-structured interviews lasting an average of one hour, by videoconference, prepared with an interview guide. These were carried out on a voluntary basis, in response to an email requesting participation sent to the studied population. The data were transcribed and analyzed by the investigator, first individually, then according to a standardized thematic analysis method.

Results: 15 participants were interviewed. The process of identifying a potential organ donor in intensive care has been illustrated by a set of relationships between the different thematic analysis units which revolve around three major themes: "medical-nursing awareness", " identification of the potential organ donor in intensive care” and “post-identification”. The participants raised 10 improvement clues in the process explored.

Conclusion: This study highlighted the prioritization of training and information of medical and nursing teams in intensive care units was the priority action to be considered in order to improve the identification of potential organ donors. It appears in the initiatives of the local coordination teams for organ donation for which the resources are sometimes poorly defined. Learning for independent adults can take place in the light of andragogy. Simulation can be considered but still needs to be validated by future learners.

don d'organes --- potentiel donneur d'organes --- identification --- soins intensifs --- organ donation --- potential organ donor --- identification --- intensive care --- Sciences de la santé humaine > Santé publique, services médicaux & soins de santé

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