yazdan abdolmohammadi

One of the most important barriers to organ transplantation and the consequent mortality of people on the waiting list for transplants in most countries is family refusal. As a result, recognizing the effective factors in family consent will provide a bridge to increase the rate of supply of organs needed for transplantation. Due to the various factors affecting organ donation, including cultural, religious, scientific, social, moral, religious, and legal dimensions, there is a need for comprehensive and up-to-date studies in this field. Therefore, in this narrative review article, we gathered and summarized the major and influential causes of family refusal among the next of kin of brain death cases It is suggested that some ceremonies and social activities be considered to familiarize the community with brain death and the process of organ donation. Also, it is necessary to organize meetings with religious authorities to present the humanitarian aspects of organ donation.

Donor detection is the first step of organ procurement for transplantation, and about 50% of all potential donors are not detected.

The present study aimed to evaluate the facilitators and barriers to donor detection based on hospital characteristics and staff opinions.

In this cross-sectional study, a 16-item questionnaire was prepared to clarify medical staff opinions about facilitators (10 items) and barriers (6 items) to potential donor detection. The questionnaire was distributed on social networks, and all medical staff members were invited to participate in the study.

A total of 230 medical staff participated in this study. From their point of view, the main facilitator was active detection via regular daily phone calls (150, 65.2%), which had the most advocators among medical staff of public (64.1%) and private hospitals (74.5%). Detection by donor coordinators or inspectors tanked the second (103, 44.8%). Moreover, private hospitals highly agreed with detection by donor coordinators and inspectors in 66.7% and 60.8% of cases, respectively. Donor detection by an in-hospital-coordinator was recommended by 42.6% of all 230 participants, with most advocators among those affiliated with an organization (65.4%). Staff opinions about donor selection and care to donor families were important barriers according to 53.5% and 46.1% of subjects, respectively.

To identify all potential donors, different strategies are necessary according to hospital characteristics. In public hospitals, daily calls; in private ones, active visits; and in an-organization-related hospitals, in-hospital coordinators could be effective.

COVID 19 pandemic and the confusion of the world at the beginning of the epidemic affected many aspects of the life and health care. In this regard, organdonation as a vital approach for life saving in patients on the waiting list was influenced too. This essential treatment requires the provision of vital organs from the brain death cases, which is a sensitive, accurate and lengthy process. This process begins with the identification of Glasgow Coma Scale (GCS) cases less than 5 and is followed by organ harvesting and assignment to waiting list patients.Organ donation and factors related to its process have been fluctuated during three specific time periods, including the first and second year of the epidemic with the year before the epidemic. This decrease in the number of donations has been felt worldwide and it has been reported that this number has decreased significantly even in the amount of blood donation.Numerous barriers to the treatment system during the epidemic, limitations of surgeries except in emergencies, asymptomatic patients, and many unknown aspects of the disease have shown that the policies and approaches of procurement centers need to be changed to continue efforts in this situation. New protocols (according to the needs of these days) should be developed and implemented according to the conditions ahead.

In our organ procurement unit, based on empirical evidence, the chance of turning a potential donor into an actual one is less than 30 percent and nursing plays a crucial role in this regard.

We aimed to clarify nursing viewpoints and probe limitations that affect the organ donation process.

In this cross-sectional study, a self-constructed 28-item questionnaire including information regarding hospital characteristics, nursing attitudes, and level of knowledge was prepared. Our study population was all nurses who consented to fill in the questionnaire using the Quota sampling method. After content validity, the questionnaire was circulated in cyberspace and the nursing society was invited to complete it. After onemonth, the response rate was 46 percent andthe completed forms were analyzed.

The majority of participants had not attended any organ donation training program (67%). Also, only 30% of nurses were aware of their crucial role in the donation process. In total, 61.7% of the participants had a high level of knowledge regarding brain death definition and donor maintenance. A positive attitude was observed in 59.1% of nurses with a significant difference in the high record of services(p=0.04).It was also, significantly higher in whom with the experience of working in private hospital (64% vs. 54%, p=0.05); hospitals with neurosurgery-ward (67.7% vs. 54.7%, p=0.01), transplant ward (67.4% vs. 54.9%, p=0.03). Attending training programs had a considerable impact (67.7% vs. 50.8%, p=0.03) but, being in ICU didn't affect nursing attitudes.

Hospital characteristics affect the nursing attitude toward organ donation and transplantation. It is recommended that all health staff obtain appropriate working experience in transplantation wards of the hospitals.

Nowadays, the basis of competition haschanged and the success of organizations dependson the degree of attention to knowledge. In this era,the mainadvantage islied within the knowledge properties of the organizations. Accordingly, the world's largest organizationshave earned their superiority by the processes accompanied with knowledge,nottheir financial assets.Theseorganizationshavedeveloped knowledge management systems, in orderto applyit,as best as they can.Knowledge managementincludes all the ways that organizationsmanagetheirknowledge assets, comprisingcollection,storage,transfer,applying,updating and creating knowledge. Due to some especial characteristics like wide range of employees, variation in services (which based on up-to-date sciences and experiences), wide geographical distribution in towns and villages, dealing with the public and community health,being rich in information, etc.;the health organizations are among the most important establishments whichrequire implementation of knowledge management.The Covid-19 pandemic has showed importance of the role of knowledge management in providing information to decision-makers in the proper time.Knowledge management inhealthcare has several purposes. This study tries to express the goals,applications and implementation of knowledge management in national health management system and evaluatethe challenges and opportunities ahead; especially during the Covid-19 pandemic.

It is currently fulfilling the needs and expectations of patients and providing their satisfaction from the main goals of the organization of health services. Because awareness of patients chr('39') perceptions and expectations plays an important role in providing better and more quality health care services, this study aimed to compare expectations of patients with their perceptions of health care quality among educational hospitals in Neyshabur city using the servqual model.

A recent cross-sectional study was conducted on 271 patients admitted to Hakim hospitals and 22 Bahman Neyshabur hospitals from 2017 to 2018. A Systematic random sampling method and 22-Question SERVQUAL Questionnaire was used to collect data. Data were analyzed by SPSS software ver 17 and using descriptive and inferential statistics (Independent t, Paired t, Pearson correlation, one-way ANOVA).

The results showed that there is a significant difference between the quality of services provided and the expectations and perceptions of patients in all aspects of the five dimensions (p<0.05). The difference between expectation and perception was related to the dimensions of reliability (-6.57) and responsiveness (-5.27) and the lowest gap was related to the dimension of empathy (-2.94).

The quality analysis of services has led to the awareness of authorities in the areas of patient dissatisfaction and the use of procedures and reduces the distance between expectations and perceptions of patients.