Thursday, July 19, 2007

Announcing the July case

The July 2007 issue of the Journal of the Medical Library Association is now available in PubMed Central, and it includes the next installment in our case study series.

This month's case "Organ preservation in a brain dead patient: information support for neurocritical care protocol development," explores a role for the librarian in shaping the organ donation and procurement process.

An excerpt from the case:

You serve as the liaison to your hospital's [Neurocritical Care Unit] committee, which is charged with identifying and implementing guidelines to assist care providers in using appropriate management strategies for patient care in the unit. This multidisciplinary team also includes physician intensivists, critical care nurses, pharmacists, respiratory therapists, ethicists, and hospital epidemiologists. Given the complexity of the organ donation process, the NCU committee turns its attention to verifying and implementing best practices for organ donor management.

The main concerns during the committee's initial discussion of organ procurement practices center around standardizing different aspects of donor care, including appropriate interventions to maintain organs prior to removal for transplant and to ensure effective and timely communication with family members. The team's goal is to achieve appropriate management of the body from the point at which brain death is perceived to be imminent to the time when organs are removed for transplantation. They hope that by optimizing the unit's practices, they will also ultimately increase the number of viable organs available for transplant. Discussion among group members during the first meeting also indicates that no one is aware of guidelines or studies examining the recommended methods to ensure organ preservation in a brain dead patient.

During the discussion, the team comments that organ preservation in this setting may need to be addressed by literature that evaluates medical, family-based, or staff training strategies to increase the number of successful transplants or improve quality of the organs removed from potential donors. Noting the daunting potential volume and complexity of literature that is needed to guide them in developing a care protocol for brain dead cadaver care, they ask you, as the group's librarian, to aid them in identifying, summarizing, and appraising guidelines and articles addressing these issues.

Reference: Todd PM, Jerome RN, Jarquin-Valdivia AA. Organ preservation in a brain dead patient: information support for neurocritical care protocol development. J Med Libr Assoc. 2007 July; 95(3): 238–245.

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