Organ Chart Qa Checklist - Organ Donation Alliance Page 2
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2Organ Chart QA Checklist
T#
REF#
UNOS#
Donor:
ODC
Serologies/Cultures
Comments:
All donors:
Urine culture
Blood Culture
Lung donors:
Sputum gram stain
EKG/Echo/Cath
Comments:
Heart donors:
12 Lead ECG
Echocardiogram or Cardiology consult
CXR/Bronch/ABGs
Comments:
All donors:
Chest X-Ray
ABGs
Donor Mgmt Flowsheet
Comments:
Intraoperative Info
Comments:
Kidney Anatomy
Comments:
Biopsy
Vessels
Pumped
Liver Anatomy
Comments:
Biopsy
Vessels
Ht/Lung/Panc/Int Anatomy
Comments:
Organ Disp/Recipient Info
Comments:
Med-Soc UNOS
Comments:
DARTS
Darts data entry completed?
UNET
Feedback completed with appropriate disposition codes?
PTR Completed?
DDR Completed? Full audit ______ Partial audit ______
Comments:
Serologies verified in DonorNet and Tiedi
CDS Form #706
Revision Date: 4/29/10
Effective Date: 5/17/10
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