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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

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Open Access 01-11-2020 | Care | Reports of Original Investigations

Improving quality of withdrawal of life-sustaining measures in organ donation: a framework and implementation toolkit

Authors: Andrew Healey, MD, Michael Hartwick, MD, James Downar, MD, Sean Keenan, MD, Jehan Lalani, MHA, Jim Mohr, MBA, Amber Appleby, RN MM, Jenna Spring, MD, Jesse W. Delaney, MD, Lindsay C. Wilson, MHA, Sam Shemie, MD, for Canadian Blood Services, the Canadian Critical Care Society, the Canadian Association of Critical Care Nurses, and the Canadian Society of Palliative Care Physicians

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 11/2020

Abstract

Background

Donation after circulatory determination of death (DCD) is responsible for the largest increase in deceased donation over the past decade. When the Canadian DCD guideline was published in 2006, it included recommendations to create standard policies and procedures for withdrawal of life-sustaining measures (WLSM) as well as quality assurance frameworks for this practice. In 2016, the Canadian Critical Care Society produced a guideline for WLSM that requires modifications to facilitate implementation when DCD is part of the end-of-life care plan.

Methods

A pan-Canadian multidisciplinary collaborative was convened to examine the existing guideline framework and to create tools to put the existing guideline into practice in centres that practice DCD.

Results

A set of guiding principles for implementation of the guideline in DCD practice were produced using an iterative, consensus-based approach followed by development of four implementation tools and three quality assurance and audit tools.

Conclusions

The tools developed will aid DCD centres in fulsomely adapting the Canadian Critical Care Society Withdrawal of Life-Sustaining Measures guideline.

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Title: Improving quality of withdrawal of life-sustaining measures in organ donation: a framework and implementation toolkit
Authors: Andrew Healey, MD
Michael Hartwick, MD
James Downar, MD
Sean Keenan, MD
Jehan Lalani, MHA
Jim Mohr, MBA
Amber Appleby, RN MM
Jenna Spring, MD
Jesse W. Delaney, MD
Lindsay C. Wilson, MHA
Sam Shemie, MD
for Canadian Blood Services, the Canadian Critical Care Society, the Canadian Association of Critical Care Nurses, and the Canadian Society of Palliative Care Physicians
Publication date: 01-11-2020
Publisher: Springer International Publishing
Keyword: Care
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 11/2020
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-020-01774-6

At a glance: The STEP trials

Springer Medicine

Improving quality of withdrawal of life-sustaining measures in organ donation: a framework and implementation toolkit

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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