To validate the quality assessment and performance improvement instrument of US transplant programs to the Brazilian reality.
Methodological study developed for semantic validation and cultural ...adaptation of the Quality assessment and Performance Improvement instrument in the following steps: 1) translation; 2) synthesis; 3) back translation; 4) review by expert committee; 5) pretest and 6) content validation. To evaluate the agreement between the five judges, the Kappa coefficient was used and for content validation, the content validation index.
Kappa coefficient showed the agreement of the judges for semantic, idiomatic, cultural and conceptual equivalences. Content validation index values for relevance and item sequence of at least 0.80 for all blocks.
The instrument of Quality Evaluation and Performance Improvement of Transplantation Programs proved to be valid and reliable. This instrument will contribute to the development of quality assurance programs for transplant teams in Brazil.
The role of nurses in cardiothoracic transplantation has evolved over the last 25 years. Transplant nurses work in a variety of roles in collaboration with multidisciplinary teams to manage complex ...pre- and post-transplantation issues. There is lack of clarity and consistency regarding required qualifications to practice transplant nursing, delineation of roles and adequate levels of staffing.
A consensus conference with workgroup sessions, consisting of 77 nurse participants with clinical experience in cardiothoracic transplantation, was arranged. This was followed by subsequent discussion with the ISHLT Nursing, Health Science and Allied Health Council. Evidence and expert opinions regarding key issues were reviewed. A modified nominal group technique was used to reach consensus.
Consensus reached included: (1) a minimum of 2 years nursing experience is required for transplant coordinators, nurse managers or advanced practice nurses; (2) a baccalaureate in nursing is the minimum education level required for a transplant coordinator; (3) transplant coordinator-specific certification is recommended; (4) nurse practitioners, clinical nurse specialists and nurse managers should hold at least a master's degree; and (5) strategies to retain transplant nurses include engaging donor call teams, mentoring programs, having flexible hours and offering career advancement support. Future research should focus on the relationships between staffing levels, nurse education and patient outcomes.
Delineation of roles and guidelines for education, certification, licensure and staffing levels of transplant nurses are needed to support all nurses working at the fullest extent of their education and licensure. This consensus document provides such recommendations and draws attention to areas for future research.
Ensuring a comprehensive hand off from inpatient nurses to the outpatient transplant coordinators is a key performance measure for most transplant programs. A scorecard must be developed for each ...organ system within a transplant hospital. ...if a hospital performs liver, kidney, pancreas, heart, and lung transplants, there will be five different scorecards monitoring each phase of transplant. In addition to monitoring performance measures, transplant programs must have a process to review adverse events such as the death of a patient or a patient's graft loss within the first year. Based on the findings of a root cause analysis, a corrective action plan is developed and a performance improvement project is designed and implemented to address the root cause(s) identified in the analysis. Each week transplant programs submit data to the United Network for Organ Sharing (UNOS). The methodologies used in research are more complex and provide us with evidence whereas...
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