Non-technical skills in organ procurement: a preliminary approach to communicative and emotional problems in the intensive care unit

SUMMARY- To prevent the risk of errors in complex working environments, skills not directly relat-ed to expertise in a specific profession but crucial in determining efficacy and safety have been defined “non-technical skills ” (NOTECHS). The Intensive care unit is a complex system where technical and operating aspects interact with non-tech-nical skills. All these factors are correlated and able to influence each other, causing crises and/or errors in the organization, in the management of relationships and in clinical care. Inadequate awareness of tasks and roles, non-adherence to guidelines, mistakes in written or oral communi-cation and high levels of environmental and personal stress may have devastating clinical consequences. In the donation process, besides possible errors in evaluation of suitability and treatment of the potential donor, non-technical skills may influence the efficiency, efficacy and personal well-being of doctors and nurses. A hierarchical taxonomy of abilities has been identified in anaesthesia, the “ANTS ” system (Anaesthetist Non-Technical Skills), including four behavioural markers: “Task Management”, “Team Working”, “Situation Awareness ” and “Decision-Making”. Most of these principles can be extended to the Intensive Care Unit (ICU) and to organ and tissue procurement that is a specific sector of intensive care. To check the suitability of such a model in organ procurement a research-action project has been set up