[Lean thinking and brain-dead patient assistance in the organ donation process]. / Pensamento Lean e cuidado do paciente em morte encefálica no processo de doação de órgãos.

Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.

Family Interview Evaluation for Organ Donation: Communication of Death and Information About Organ Donation.

BACKGROUND: The aim of this study was to identify variables related to organ donation that can contribute to the development of best practices in planning and conducting family interviews by health professionals. METHODS: This descriptive and prospective study of quantitative approach was conducted at 2 southern Brazil health institutions referenced in organ donation. Data collection occurred between 2018 and 2019 by health professionals who conduct family interviews using validated instruments that assessed the stages of the interview. Analysis was performed by means of the proportions of the studied variables associated with the donation authorization categories per the χ2 test. The significance level adopted was 0.05. RESULTS: The variables that presented the highest level of significance in the correlation with the prevalence of family authorization for organ donation included the following: communication with the family about the results of each test in the brain death diagnostic protocol; identification of whether the family understood the information about the death; presence of a member of the transplantation commission who had training to communicate information about organ donation; presence of a family member who had power to authorize the donation; and the interval between the communication of death and information about organ donation. CONCLUSIONS: The study presents important gaps that can be filled by health teams and hospitals in order to improve the welcoming and respect for families, as well as the organ donation rates. It is important to understand that each family is unique when facing mourning, and to distance the communication of death from the discussion about organ donation is an act of respect and empathy.

Segurança do paciente no processo de doação e transplante de órgãos e tecidos / Patient safety in the process of organ and tissue donation and transplant / Seguridad del paciente en el proceso de donación y trasplante de órganos y tejidos

Objetivou-se apresentar aspectos inovadores para a prática profissional do enfermeiro, no que se refere ao diagnóstico de morte encefálica no processo de doação e transplante de órgãos e tecidos, abordando as interfaces entre a gerência do cuidado e a segurança do paciente. Enfatiza-se a padronização de processos, utilizada para promover agilidade, redução das perdas por parada cardíaca com aumento concomitante das doações reais, e diminuição do tempo entre o primeiro exame clínico e o explante. Permite que a equipe reconheça as anormalidades e faça as correções necessárias em tempo hábil. Assim, vislumbra-se que a segurança do paciente deve subsidiar as tomadas de decisão e intervenções de gestão, de modo a qualificar a prática de cuidado (AU).

This article aims to present innovative aspects for the professional practice of the nurse, regarding the diagnosis of brain death in the process of donation and transplantation of organs and tissues, addressing the interfaces between the care management and patient safety. Emphasis is placed on the standardization of processes, used to promote speed, reduction in losses from cardiac arrest with a concurrent increase in actual donations, and reduction of time between the first clinical examination and harvesting of the organ. It allows the team to recognize abnormalities and make the necessary corrections in time. Thus, it is seen that patient safety should be a basis for management's decision-making and interventions, so as to make the care practice of adequate quality (AU).

Estudio cuyo objetivo fue presentar aspectos innovadores para la práctica profesional del enfermero acerca del diagnóstico de muerte encefálica en el proceso de donación y trasplante de órganos y tejidos, considerándose las relaciones entre la administración del cuidado y la seguridad del paciente. Se destaca la estandarización de procesos, utilizada para promover agilidad, reducción de pérdidas por parada cardíaca con aumento concomitante de las donaciones reales, así como disminución del tiempo entre el primer examen clínico y el explante. Eso posibilita que el equipo reconozca las anormalidades e haga las correcciones necesarias en tiempo hábil. De ese modo, se constata que la seguridad del paciente debe subsidiar las decisiones e intervenciones de gestión, a fin de calificar la práctica de cuidado (AU).