Guideline adherence to an expert panel predefined care set in brain death (DBD) donor management proved moderate leaving substantial room for improvement. An importance-performance analysis can be used to improve implementation and documentation of guidelines. A total of 296 patients were included. Thirty-five of 67 KIs had a high level of adherence congruent to a high expert panel rating of importance. Nineteen of 67 KIs had a low level of adherence in spite of a high level of importance according to expert consensus. This observational, cross-sectional multicenter study was performed in 21 Belgian ICUs.

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