title: Care pathways for organ donation after brain death: guidance from available literature?
abstract: OBJECTIVE
  A discussion of the literature concerning the impact of care pathways in the complex and by definition multidisciplinary process of organ donation following brain death.
  
  
  BACKGROUND
  Enhancing the quality and safety of organs for transplantation has become a central concern for governmental and professional organizations. At the local hospital level, a donor coordinator can use a range of interventions to improve the donation and procurement process. Care pathways have been proven to represent an effective intervention in several settings for optimizing processes and outcomes.
  
  
  METHODS
  A discussion paper.
  
  
  METHODS
  A systematic review of the Medline, CINAHL, EMBASE and The Cochrane Library databases was conducted for articles published until June 2015, using the keywords donation after brain death and care pathways. Each paper was reviewed to investigate the effects of existing care pathways for donation after brain death. An additional search for unpublished information was conducted.
  
  
  CONCLUSIONS
  Although literature supports care pathways as an effective intervention in several settings, few studies have explored its use and effectiveness for complex care processes such as donation after brain death.
  
  
  CONCLUSIONS
  Nurses should be aware of their role in the donation process. Care pathways have the potential to support them, but their effectiveness has been insufficiently explored.
  
  
  CONCLUSIONS
  Further research should focus on the development and standardization of the clinical content of a care pathway for donation after brain death and the identification of quality indicators. These should be used in a prospective effectiveness assessment of the proposed pathway.
authors.affiliation: Department of General Internal Medicine, Ghent University Hospital, Belgium.|Faculty of Medicine and Health Sciences, Ghent University, Belgium.|Department of Intensive Care, General Hospital Sint-Lucas, Ghent, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Hoste
authors.affiliation: Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Belgium.|Department of Quality Management, University Hospitals Leuven, Belgium.|European Pathway Association, Kapucijnenvoer, Leuven, Belgium.
authors.forename: Kris
authors.initials: K
authors.lastname: Vanhaecht
authors.affiliation: Surgical and Transplantation ICU, University Hospitals Leuven, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ferdinande
authors.affiliation: Faculty of Medicine and Health Sciences, Ghent University, Belgium.|Department of Transplant Surgery, Ghent University Hospital, Belgium.
authors.forename: Xavier
authors.initials: X
authors.lastname: Rogiers
authors.affiliation: Faculty of Medicine and Health Sciences, Ghent University, Belgium.
authors.forename: Kristof
authors.initials: K
authors.lastname: Eeckloo
authors.affiliation: Faculty of Medicine and Health Sciences, Ghent University, Belgium.|Department of Internal Medicine, Ghent University, Belgium.|Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Stijn
authors.initials: S
authors.lastname: Blot
authors.affiliation: Department of Intensive Care Medicine, Ghent University Hospital, Belgium.|Research Foundation - Flanders (FWO), Egmontstraat, Brussels, Belgium.
authors.forename: Eric
authors.initials: E
authors.lastname: Hoste
authors.affiliation: Department of General Internal Medicine, Ghent University Hospital, Belgium.|Faculty of Medicine and Health Sciences, Ghent University, Belgium.|Department of Internal Medicine, Ghent University, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vogelaers
authors.affiliation: Faculty of Medicine and Health Sciences, Ghent University, Belgium.|Department of Internal Medicine, Ghent University, Belgium.
authors.forename: Koenraad
authors.initials: K
authors.lastname: Vandewoude
mesh_terms: D001926:Brain Death; D006801:Humans; D011446:Prospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement
keywords: care pathways; management; nurses; nursing; organ donation; quality; quality of care