Table 4 Description of interventions on organ and tissue donation with only pre-post assessments

Alonso, Fernandez, Mataix et al. (1999); Spain

To present the results of a pilot study carried out in Seville, Spain, evaluating the donor action program

Hospital staff (n = not mentioned)

Educational:

12 months

• Provide instruction

Medical records review

Detected potential donor

81.0% → 97.5%

• Training in family interview and communication

• Training in donor detection and brain death diagnosis

Organ and/or tissue donor recovered

32.1% → 44.4%

• Creating guidelines for donation process

Beasley, Capossela, Brigham, Gunderson and Gortmaker (1997); United States

To increase organ donation in 50 hospitals in three organ procurement organization service areas simultaneously by using a large-scale intervention

Physicians, residents, nurses, social workers, chaplains and administrators (n = not mentioned)

Educational:

24 months

• Provide instruction

Medical records review

Approached family

69.0% → 85.6% (P = .001)

• Presentation of donation protocols

• Provide feedback on performance

• Review health professional role in donation process

Referred potential donor

55.5% → 80.2% (P = .001)

• Department meeting

Obtained donation consent

50.9% → 52.2% (not significant)

• In-services

Organizational:

Organ and/or tissue donor recovered

32.9% → 42.5% (P = .005)

• Organ donation protocols

o Potential donor identification

o Notification of the organ procurement organization

o Ensuring decoupled request

o Private setting to ask for donation

o Active inclusion of organ procurement organization in request

Bleakley (2010); United Kingdom

To increase the number of donated organs through an effective donor identification and referral scheme in a large acute hospital’s critical care units

Clinical staff

Educational:

12 months

• Intervention not described

Not mentioned

Referred potential donor

4 → 121 (donors)

(n = 170)

• Education program on required referral

Organizational:

• Hospital policy on how to make a referral

Milanés, Gonzalez, Hernandez, Arminio, Clesca and Rivas-Vetencourt (2003); Venezuela

To find solutions to the critical donor shortage situation, and its negative socioeconomic impact in our society, by implementing a transplant coordination program in a hospital with a variety of departments, including neurosurgery and kidney transplantation

Healthcare staff in the critical care area (n = 97)

Educational:

24 months

• Provide instruction

Medical records review

Detected potential donor

8.1% → 57.5%

• Detection, identification and donor criteria

• Death diagnostic

• Donor maintenance

Organ and/or tissue donor recovered

1.6% → 9.1%

• Organ and tissue viability studies

• Family interview, requesting consent

• Organ sharing, allocation and preservation

• Transplant ethics and legislation

Niday, Painter, Peak et al. (2007); United States

To implement and evaluate a scripted information about organ and tissue donation for hospice inpatient on admission

Nurses

Educational:

6 months

• Provide instruction

Review of death records

Organ and/or tissue donor recovered (corneal rates)

6.3% → 20.6%

(n = 12)

• Scripted instruction to prompt nurses to introduce the subject of donation

Organ and/or tissue donor recovered (tissue rates)

0.0% → 0.0%

Organizational:

• Give tissue donation information upon admission as part of the normal admission process and then repeated at the time of death.

Shafer, Durand, Hueneke, et al. (1998); United States

To determine whether donors could be produced from non-donor hospitals

Nurses and hospital staff

Educational:

17 months

• Intervention not described

Monthly death records audit

Referred potential donor (organ)

24 → 139 (donors)

(n = 25 hospitals)

• Training activities

• Education programs and materials

Referred potential donor (tissue)

202 → 3,931 (donors)

Organizational:

• Develop in-house coordinators

Organ donor recovered

8 → 44 (donors)

Tissue donor recovered

154 → 423 (donors)

Stark, Wikoren and Martone (1994); United States

To develop and pilot an organ donation program that focuses on the collaborative efforts of the entire health care team, hospital administration and organ procurement agency

Physicians, nurses and hospital personnel (n = not mentioned)

Educational:

24 months

• Provide information on consequences

Not mentioned

Detected potential donor

45.7% → 92.0%

• Partners in organ donation program

o Promote positive attitudes toward donation (awareness)

• Provide instruction

Obtained donation consent

17.1% → 56.0%

o Recognize potential donor

o Offering the option of donation

o Support the grieving of donor families

Organizational:

• Develop nurse requestor role

Taylor, Young and Kneteman (1997); Canada

To describe the development of a program to cross-train critical care nurses as organ procurement coordinators

Intensive care units nurses (n = not mentioned)

Educational:

Not mentioned

• Provide instruction

Not mentioned

Donation rates

18 donors per million population → 31 donors per million population (72% increase rate)

• Classroom instruction

• Preceptor clinical experience

Van Gelder, Van Hees, de Roey, Monbaliu, Aerts, Coosemans et al. (2006); Belgium

To measure the impact of an intervention plan designed to optimize the donor detection process and donor referral patterns

Departments of neurology, neurosurgery, anesthesiology, intensive care medicine and abdominal transplant (n = not mentioned)

Educational:

48 months

• Provide instruction

Not mentioned

Organ and/or tissue donor recovered

230 → 301 (donors) (P < .05)

• Provide feedback on performance

• Information on donor criteria

• Communication between donor and transplant centers

Organizational:

• Facilitation of procedure

Tissue donor recovered

66 → 180 (donors) (P < .001)

Wight, Cohen, Roels and Miranda (2000); United Kingdom

To evaluate the immediate (6 months), short-term (1 year) and sustained (2 years) effects of the Donor Action program on donation rates in different countries

Intensive care units staff (n = not mentioned)

Educational:

12 months (United Kingdom)

• Provide instruction

Medical records review

Organ donor recovered (United Kingdom.)

122% increase (6 months)

• Educational program on:

24 months (Spain)

• Provide feedback on performance

o Family care and communication

40% increase (12 months)

o Donor maintenance

• Prompt practice

o Organ retrieval

Organizational:

• Forming a Donor Action committee

Have referred potential donor (Spain)

16% increase (24 months)

Organ donor recovered (Spain)

33% increase (24 months)