MANAGEMENT OF NURSE CARE IN THE ORGAN AND TISSUE DONATION PROCESS

Nurse Specialist in the Organ and Tissue Donation Process with Coordination Role: A Scoping Review

Background/Objectives: In recent years, the introduction of specialist nurses, such as donation coordinator nurses, has been proposed as a potentially effective strategy to increase the number of donations and improve the quality of the process. However, experiences in this field are still limited. The aim of this study was to evaluate the impact of the inclusion of this professional in health systems, both in quantitative and qualitative terms. Methods: A scoping review was performed. Studies published from 1990 to 2024 were included regardless of the study design. The bibliographic search was performed on the databases MedLine, Web of Science, Scopus, CINAHL, and PsycInfo and on the search engines EBSCOhost, ProQuest, and Google Scholar. The search strings included keywords such as organ donation, transplant, procurement, and nursing role. The extraction and selection of articles were conducted in accordance with the PRISMA-ScR guidelines and with the methodology of the Joanna Briggs Institute for scoping reviews. The protocol study was prospectively registered with the Open Science Framework database on 3 December 2023, with registration number osf.io/wzxr3. Results: From the included studies, it emerged that the involvement of a nurse coordinator in the donation process is significantly associated with an increase in the number of organ donors and higher rates of family consent to donation. Additionally, the studies highlighted enhanced effectiveness in identifying potential donors and improvements in the training and preparedness of healthcare staff. Conclusions: The nurse coordinator in the donation process can have positive effects both on the management of the process and on the increase in the number of organ and tissue donations.

Interventions to Improve the Quality in the Organ and Tissue Donation Process

BACKGROUND

Map Interventions is capable of supporting the multidisciplinary team that works in organ and tissue donation to disseminate quality in this process.

METHODS

A scoping review study that was conducted through the steps proposed by the Joanna Briggs Institute.

RESULTS

Fifty-six studies made up the sample. 2018 (no. 07, 12.5%) had the highest number of publications. The country that published the most was the United States (no. 16, 28.56%). The database with the most publications was the Cumulative Index to Nursing and Allied Health Literature - CINAHL (no. 15, 26.78%). The most used interventions, which had the most significant impact on the improvement of results and quality, were the use of indicators in all stages of the organ and tissue donation process; the use of real goals that can be achieved; frequent audits, validation of instruments to track opportunities for improvement; as well as methodologies to implement quality and education among professionals who work in this process. Such interventions reveal important changes in the organ donation process, especially in the notification of potential and effective donors, as well as providing an opportunity for safety in the stages of the organ and tissue donation process.

CONCLUSION

The interventions tracked suggest the implementation of a set of actions formed by the continuous use of auditing, indicators, continuing education with the team that works in the process of organ and tissue donation, combined with the management of the results obtained through the indicators, where it is generated from these data, actions that have a direct impact on the weaknesses identified.

Care actions in obtaining tissues and organs during the COVID-19 pandemic: a mixed methods study

OBJECTIVE

to map health care actions in the organ and tissue donation process in Brazilian regions during the COVID-19 pandemic.

METHODS

a mixed methods study. Data collection was performed simultaneously through an online questionnaire with 72 nurses. Descriptive statistical analysis and content analysis.

RESULTS

a total of 34.7% of professionals work in the state of São Paulo. The largest number of responses was from the Southeast region. Four categories emerged. The first addresses triage care actions; the second involves guidelines for SARS-CoV-2 prevention in potential donors; the third relates to the epidemiological screening of professionals; the fourth presents the scenario of donation training in pandemic times.

CONCLUSION

care actions are aimed at tracking the path taken until arrival at the hospital, assessing temperature and saturation curves, in addition to screening for signs and symptoms for SARS-CoV-2 contamination among professionals.

MORTE ENCEFÁLICA: VIVÊNCIA DA EQUIPE DE SAÚDE JUNTO AOS PAIS DE CRIANÇAS E ADOLESCENTES

RESUMO Objetivo: compreender a vivência da equipe de saúde junto aos pais de crianças e adolescentes durante as etapas do protocolo de morte encefálica. Método: pesquisa exploratória de abordagem qualitativa desenvolvida em duas instituições de saúde de alta complexidade e referência no atendimento a crianças e adolescentes com politrauma. Os participantes foram profissionais de saúde das unidades de pacientes críticos. A coleta de dados ocorreu entre os meses de outubro e dezembro de 2019 por meio de entrevistas semiestruturadas. Para análise de conteúdo, utilizou-se como apoio o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados: participaram do estudo 21 profissionais (médicos, enfermeiros e técnicos de enfermagem). O corpus geral foi constituído por 21 textos, separados em 123 segmentos, emergindo quatro classes. O estudo mostra sentimentos de apoio e compaixão em todas as etapas do protocolo de morte encefálica. Na etapa da abertura do protocolo, as emoções da equipe estão voltadas às ações de clarificar e transparecer informações deste processo. Além de apontar a necessidade de a equipe detalhar o passo a passo dos exames a serem realizados. Na etapa da comunicação da morte, a sensação de estar, cuidar e acolher a família se conecta com outros sentimentos experimentados por eles. Conclusão: o estudo revela que a equipe de saúde vivencia sentimentos únicos durante o protocolo de morte encefálica na realidade de crianças e adolescentes. Revela também a preocupação de a equipe em estar com a família, atentar e cuidar ante a dor da perda.

BRAIN DEATH: HEALTH TEAM’S EXPERIENCE WITH PARENTS OF CHILDREN AND ADOLESCENTS

ABSTRACT Objective to understand the health team’s experience with parents of children and adolescents during the brain death protocol stages. Method a qualitative and exploratory research developed in two health institutions of high complexity and reference in the care of children and adolescents with polytrauma. Participants were health professionals from critical patient units. Data collection took place between October and December 2019 through semi-structured interviews. For content analysis, we used the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires as support. Results twenty-one professionals (physicians, nurses and nursing technicians) participated in the study. The general corpus consisted of 21 texts, separated into 123 segments, with the emergence of four classes. The study shows feelings of support and compassion at all brain death protocol stages. In the protocol opening stage, the team’s emotions are focused on the actions of clarifying and revealing information in this process, in addition to pointing out the need for the team to detail the step by step of the exams to be performed. In the communication of death stage, the feeling of being, caring for and welcoming the family relates to other feelings experienced by them. Conclusion the study reveals that the health team experiences unique feelings during the brain death protocol in the reality of children and adolescents, revealing the team’s concern with being with the family, paying attention and caring for the pain of loss.