臺灣器官移植協調師角色定義與工作範疇

Abstract

器官移植協調師是串聯移植流程的一線人員。隨著臺灣器官移植醫學的進步, 器官移植協調師也漸受重視,但在角色發展上仍較歐美晚了近 20 年。民國 100 年 爆發愛滋器官誤植事件,更突顯器官移植協調師在角色發展上模糊的工作範疇與 定位。本研究遵循 Bucher 於 1988 年提出的 Natural History Framework 中新健康照 護角色發展步驟,透過德菲法研究設計,調查器官移植領域各層級專家意見,藉 以歸納現今臺灣器官移植協調師的角色定義、核心工作範疇,及角色背景期待。 研究結果顯示,81 位器官移植各層級專家在臺灣器官移植協調師的核心工作範疇 上,有高度的一致性。本研究根據其共識,將器官移植協調師的角色定義為『健 康照護人員,負責器官捐贈者與受贈者資料的確認、統整建檔與文件的取得;協 助醫療團隊提供器官捐贈家庭及受贈家庭之術前術後照護;協調院內移植團隊與 其他科部間之移植業務,擔任院際移植器官的分配、轉運的聯絡人;辦理醫院及 社區的器官捐贈宣導活動,並於其專業上積極自我成長』。本研究寄望藉由明確的 工作範疇與具體的角色定義,以促進器官移植協調師角色的永續發展。

Organ transplant coordinator is a front-line practitioner who facilitates patient care throughout all phases of transplantation. However, a lack of consensus on role definition, essential job functions, and licensure and education preparation of these important practitioners results in role confusion. This role confusion was evident from the event of HIV-infected organs mistakenly transplanted into five patients in Taiwan back to year 2011. Based on Bucher’s framework on the natural history of health care occupation, this study aimed to survey the viewpoints on role definition, essential job functions, and licensure and education preparation of organ transplant coordinator from field experts, using a Delphi survey design. The results show that the survey participants (n=81) have a high consensus on essential job functions and licensure and educational preparation of organ transplant coordinator. Based on the findings, we defined the role of organ transplant coordinators as 'health care practitioners, responsible for obtaining, verifying, and completing necessary documentation for the transplant patients including donors and recipients; assisting multidisciplinary team members to provide care of the transplant patients and their family pre-transplant or post-transplant; coordinating transplantation process when a donor is available including communication between physicians, organ procurement organization, patient/families and the medical team involved including ER, OR, and histocompatilbility labs; organizing educational activities about transplantation and organ donations for the hospital system and local community; and enhancing the professional competences through self-learning and growth. We hope by delineating the role of organ transplant coordinator in Taiwan, public discussion and rigorous research can be initiated leading to a pathway for professional role development.