Communication with Families Regarding Organ and Tissue Donation after Death in Intensive Care (COMFORT): A multicentre before-and-after study

Potter, JE; Perry, L; Elliott, RM; Aneman, A; Brieva, JL; Cavazzoni, E; Cheng, ATH; O’leary, MJ; Seppelt, IM; Herkes, RG

Communication with Families Regarding Organ and Tissue Donation after Death in Intensive Care (COMFORT): A multicentre before-and-after study

Potter, JE

Perry, L

Elliott, RM

Aneman, A Brieva, JL Cavazzoni, E Cheng, ATH O’leary, MJ Seppelt, IM Herkes, RG

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Publication Type:: Journal Article
Citation:: Critical Care and Resuscitation, 2018, 20 (4), pp. 268 - 276
Issue Date:: 2018-12-01

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Field	Value	Language
dc.contributor.author	Potter, JE https://orcid.org/0000-0002-6347-6597	en_US
dc.contributor.author	Perry, L https://orcid.org/0000-0002-8507-1283	en_US
dc.contributor.author	Elliott, RM https://orcid.org/0000-0002-9239-7126	en_US
dc.contributor.author	Aneman, A	en_US
dc.contributor.author	Brieva, JL	en_US
dc.contributor.author	Cavazzoni, E	en_US
dc.contributor.author	Cheng, ATH	en_US
dc.contributor.author	O’leary, MJ	en_US
dc.contributor.author	Seppelt, IM	en_US
dc.contributor.author	Herkes, RG	en_US
dc.date.issued	2018-12-01	en_US
dc.identifier.citation	Critical Care and Resuscitation, 2018, 20 (4), pp. 268 - 276	en_US
dc.identifier.issn	1441-2772	en_US
dc.identifier.uri	http://hdl.handle.net/10453/130512
dc.description.abstract	© 2018, Australasian Medical Publishing co. All rights reserved. Objective: To implement a best-practice intervention offering deceased organ donation, testing whether it increased family consent rates. Design: A multicentre before-and-after study of a prospective cohort compared with pre-intervention controls. Setting: Nine Australian intensive care units. Participants: Families and health care professionals caring for donor-eligible patients without registered donation preferences or aged ≤ 16 years. Intervention: A multicomponent intervention including offers of deceased organ donation from specially trained designated requesters using a structured conversation separate to end-of-life discussions. Main outcome measure: Proportion of families consenting to organ donation. Results: Consent was obtained in 87/164 cases (53%) during the intervention period compared with 14/25 cases (56%) pre-intervention (P = 0.83). The odds ratio (OR) of obtaining consent during the intervention period relative to pre-intervention was 1.13 (95% CI, 0.48–2.63; P = 0.78). During the intervention period, designated requesters obtained consent in 55/98 cases (56%), compared with 32/66 cases (48%) in which the medical team managing patient care raised donation (P = 0.34). Factors independently associated with increased consent were: family-raised organ donation (OR, 4.34; 95% CI, 1.79–10.52; P = 0.001), presence of an independent designated requester (OR, 3.84; 95% CI, 1.35– 10.98; P = 0.012), and multiple donation conversations per case (OR, 3.35; 95% CI, 1.93–5.81; P < 0.001). Consent decreased when patients were of non-Christian religion (OR, 0.18; 95% CI, 0.04–0.91; P = 0.038) and end-of-life and donation meetings were separate (OR, 0.38; 95% CI, 0.16–0.89; P = 0.026). Conclusion: Implementation of a multicomponent intervention did not increase consent rates for organ donation, although some components of the intervention exerted significant effect.	en_US
dc.relation.ispartof	Critical Care and Resuscitation	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Death	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Communication	en_US
dc.subject.mesh	Family	en_US
dc.subject.mesh	Professional-Family Relations	en_US
dc.subject.mesh	Decision Making	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Intensive Care Units	en_US
dc.subject.mesh	Tissue and Organ Procurement	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	Communication with Families Regarding Organ and Tissue Donation after Death in Intensive Care (COMFORT): A multicentre before-and-after study	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	20	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Students
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	20	en_US

Abstract:

© 2018, Australasian Medical Publishing co. All rights reserved. Objective: To implement a best-practice intervention offering deceased organ donation, testing whether it increased family consent rates. Design: A multicentre before-and-after study of a prospective cohort compared with pre-intervention controls. Setting: Nine Australian intensive care units. Participants: Families and health care professionals caring for donor-eligible patients without registered donation preferences or aged ≤ 16 years. Intervention: A multicomponent intervention including offers of deceased organ donation from specially trained designated requesters using a structured conversation separate to end-of-life discussions. Main outcome measure: Proportion of families consenting to organ donation. Results: Consent was obtained in 87/164 cases (53%) during the intervention period compared with 14/25 cases (56%) pre-intervention (P = 0.83). The odds ratio (OR) of obtaining consent during the intervention period relative to pre-intervention was 1.13 (95% CI, 0.48–2.63; P = 0.78). During the intervention period, designated requesters obtained consent in 55/98 cases (56%), compared with 32/66 cases (48%) in which the medical team managing patient care raised donation (P = 0.34). Factors independently associated with increased consent were: family-raised organ donation (OR, 4.34; 95% CI, 1.79–10.52; P = 0.001), presence of an independent designated requester (OR, 3.84; 95% CI, 1.35– 10.98; P = 0.012), and multiple donation conversations per case (OR, 3.35; 95% CI, 1.93–5.81; P < 0.001). Consent decreased when patients were of non-Christian religion (OR, 0.18; 95% CI, 0.04–0.91; P = 0.038) and end-of-life and donation meetings were separate (OR, 0.38; 95% CI, 0.16–0.89; P = 0.026). Conclusion: Implementation of a multicomponent intervention did not increase consent rates for organ donation, although some components of the intervention exerted significant effect.

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http://hdl.handle.net/10453/130512