[Nursing Competence Mapping for Organizational Development: a national analysis of nurses involved in the Donation and Transplantation Process]. / Mappatura delle competenze Infermieristiche per lo sviluppo organizzativo: analisi nazionale degli Infermieri coinvolti nel Processo di Donazione e Trapianto.

The constant evolution of the health care system has led to a thorough reorganization of the system itself and an improvement in terms of the quality of treatment provided. Many articles in the literature confirm that the answer to increased quality of standards and efficient levels of organization are undoubtedly due to true and efficient team work, without any of the professionals involved having to change their area of expertise. This rapid evolution of the treatment process has required the improvement and definement of technical-specialist skills on the part of the nursing staff; personnel who have proved to be the real link in the technical-communicative processes. In relation to this important aspect, it has become essential to design, at present based on more than ten-years of experience, a profile of "job description" skills for the nursing staff engaged in the world of donations and transplants, in order to give companies objective and measurable elements on the skills profile that can be identified for this specific area and a clear recognition of the profession itself.

Rare Disease Patients as Potential Organ Donors.

BACKGROUND: Rare diseases (RDs) are a heterogeneous group of pathologies, which, when present in a donor, with their anatomic or functional deficiencies, may put the recipient at risk. The aim of our work is to analyze the incidence of RDs in our donors to support transplant experts in the evaluation of these organs. METHODS: We retrospectively assessed the incidence of RDs in donors from July 2017 to June 2019, along with the risk attributed, the number of transplanted organs, and the follow-up results of the recipients. RESULTS: Over a 24-month period, we had 19 donors with RDs. Of those, the organs of 4 donors were rejected before the risk assessment, the organs of 4 other donors were deemed an unacceptable risk, the organs of 4 more donors were rejected by transplant centers, and the organs of 7 donors were accepted with 16 organs ultimately transplanted (2 hearts, 3 livers, and 11 kidneys). Three of the recipients died of causes not related to the RDs. Thirteen of the recipients are still alive with a functioning organ with an average follow-up of 9 months. CONCLUSIONS: Although the evaluation of the results is influenced by the limited follow-up period, the use of donors with RDs has proved safe. One of the critical issues encountered in the evaluation process was the impossibility of carrying out genetic and histologic investigations for each organ in urgency. Moreover, the heterogeneity of RDs and the lack of solid literature data require, for the purpose of assessing the level of risk, a specific assessment of individual cases. To overcome these limitations, a group of experts was set up at the Superior Health Council, who drafted a reference document, which allowed for the assessment of the suitability and risk level of donors with the most frequent RDs.