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dc.contributor.authorColeman, Nicole L
dc.contributor.authorBonner, Ann
dc.date.accessioned2020-12-09T02:28:07Z
dc.date.available2020-12-09T02:28:07Z
dc.date.issued2014
dc.identifier.issn1036-7314en_US
dc.identifier.doi10.1016/j.aucc.2014.04.007en_US
dc.identifier.urihttp://hdl.handle.net/10072/400111
dc.description.abstractBackground: Donation after Cardiac Death (DCD) is one possible solution to the world wide organ shortage. Intensive care physicians are central to DCD becoming successful since they are responsible for making the clinical judgements and decisions associated with DCD. Yet international evidence shows health care professionals have not embraced DCD and are often reluctant to consider it as an option for patients. Purpose: To explore intensive care physicians' clinical judgements when selecting a suitable DCD candidate. Methods: Using interpretative exploratory methods six intensive care physicians were interviewed from three hospital sites in Australia. Following verbatim transcription, data was subjected to thematic analysis. Findings: Three distinct themes emerged. Reducing harm and increasing benefit was a major focus of intensive care physicians during determination of DCD. There was an acceptance of DCD if there was clear evidence that donation was what the patient and family wanted. Characteristics of a defensible decision reflected the characteristics of sequencing, separation and isolation, timing, consensus and collaboration, trust and communication to ensure that judgements were robust and defensible. The final theme revealed the importance of minimising uncertainty and discomfort when predicting length of survival following withdrawal of life-sustaining treatment. Conclusion: DCD decisions are made within an environment of uncertainty due to the imprecision associated with predicting time of death. Lack of certainty contributed to the cautious and collaborative strategies used by intensive care physicians when dealing with patients, family members and colleagues around end-of-life decisions, initiation of withdrawal of life-sustaining treatment and the discussion about DCD. This study recommends that nationally consistent policies are urgently needed to increase the degree of certainty for intensive care staff concerning the DCD processes.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofpagefrom172en_US
dc.relation.ispartofpageto176en_US
dc.relation.ispartofissue4en_US
dc.relation.ispartofjournalAustralian Critical Careen_US
dc.relation.ispartofvolume27en_US
dc.subject.fieldofresearchClinical Sciencesen_US
dc.subject.fieldofresearchNursingen_US
dc.subject.fieldofresearchcode1103en_US
dc.subject.fieldofresearchcode1110en_US
dc.subject.keywordsScience & Technologyen_US
dc.subject.keywordsLife Sciences & Biomedicineen_US
dc.subject.keywordsCritical Care Medicineen_US
dc.subject.keywordsNursingen_US
dc.subject.keywordsGeneral & Internal Medicineen_US
dc.titleExploring Australian intensive care physicians clinical judgement during Donation after Cardiac Death: An exploratory qualitative studyen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationColeman, NL; Bonner, A, Exploring Australian intensive care physicians clinical judgement during Donation after Cardiac Death: An exploratory qualitative study, Australian Critical Care, 2014, 27 (4), pp. 172-176en_US
dcterms.dateAccepted2014-04-22
dcterms.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/en_US
dc.date.updated2020-12-09T02:26:03Z
dc.description.versionAccepted Manuscript (AM)en_US
gro.rights.copyright© 2014 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.en_US
gro.hasfulltextFull Text
gro.griffith.authorBonner, Ann J.


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