Technologies During the COVID-19 Pandemic: Teleconsultation in Care Management for Patients Undergoing Liver Transplant.

BACKGROUND: The aim of this study was to identify home care management strategies for patients undergoing liver transplant, through teleconsultation, during the COVID-19 pandemic for maintenance and improvements in treatment adherence. METHODS: This was a qualitative, exploratory, and descriptive research study. Participants included patients who underwent liver transplant between 2020 and 2021. Through a semistructured script, data were analyzed according to the recommendations of content analysis and then simple statistics were applied. RESULTS: Twenty-two people participated in the study. Two analysis categories were developed, which resulted in 7 strategies and 22 care actions. The care strategy with the highest adherence involved actions related to the prevention of COVID-19. CONCLUSIONS: Teleconsultation is an excellent tool to manage and supervise post-liver transplant care of patients. Considering that teleconsultation has presented strategies and care actions, which were developed by the patients, the patients have a direct effect on treatment adherence despite pandemic impositions.

Validating potential organ and tissue donors in the middle of the COVID-19 pandemic: Scoping review and recommendations construction.

OBJECTIVE: To identify the available information to support registered nurses' clinical decisions in assessing and validating potential organ and tissue donors during the COVID-19 pandemic. METHOD: This is a scoping review developed in six stages. The sixth stage was developed with registered nurses who work in the Brazil Organ Donation System. To consolidate the information and prepare all assumptions, the legislation in force in Brazil was followed. RESULTS: Recommendations from 19 articles identified in the literature were analyzed; additionally, 52 professionals who work at Brazil Organ Donation System participated in the research. Four care assumptions were formed: investigation of community transmission, investigation of clinical situations, screening for COVID-19 signs and symptoms, and investigation of alterations presented in the physical examination. Such assumptions are formed by 34 care guidelines. DISCUSSION: Care assumptions were prepared to guide and support registered nurses during assessment and validation of potential organ and tissue donors. From this perspective, assumptions certainly promote safety, effectiveness and quality in the service offered during the organ and tissue donation process in the midst of the COVID-19 pandemic, in addition to empowering registered nurses in this scenario. Quality and bio-surveillance through the donation stages have been discussed extensively in recent times, to improve donation and transplantations by valuing care, safety, and quality of life of recipients. CONCLUSION: The care assumptions presented in this study support and subsidize the daily practice of registered nurses who work in assessing and validating potential organ and tissue donors, enabling these professionals to make decisions based on secure information.

Care bundle for family interview for pediatric organ donation.

PURPOSE: to develop a care bundle for best practices in conducting the family interview for organ and tissue donation with the families of children and adolescents. DESIGN AND METHODS: methodological study, with a qualitative approach, developed in Brazil, in three stages: literature review, qualitative study with professionals and family members, and development of the care bundle. RESULTS: Nine studies were selected and 17 health professionals and nine family members were interviewed. With this data, the care bundle was developed in three categories: communication of death, emotional support and information about organ and tissue donation. The recommendations were evaluated by five external professionals and all of them assessed the bundle as having the highest possible quality. CONCLUSIONS: the care bundle was built following the stages of integrative literature review and interviews with professionals working in this scenario and family members who have already gone through a family interview for organ and tissue donation of children and adolescents. PRACTICE IMPLICATIONS: the use of this material is seen as an important resource to support the professional during the conduction of the family interview in a scenario as sensitive and challenging as the care to family members facing death and the decision of organ and tissue donation of children and adolescents. Furthermore, the care bundle can increase the quality of family interviews and impact the reduction of family refusals. DESCRIPTORS: Practice Guideline as Topic. Tissue and Organ Procurement. Patient Care Team. Nursing. Pediatrics. Communication.

Validating potential organ and tissue donors in the middle of the COVID-19 pandemic: Scoping review and recommendations construction / Validación de los donantes potenciales de órganos y tejidos en medio de la pandemia de COVID-19: revisión del alcance y construcción de recomendaciones

Objective: To identify the available information to support registered nurses’ clinical decisions in assessing and validating potential organ and tissue donors during the COVID-19 pandemic.Method: This is a scoping review developed in six stages. The sixth stage was developed with registered nurses who work in the Brazil Organ Donation System. To consolidate the information and prepare all assumptions, the legislation in force in Brazil was followed.Results: Recommendations from 19 articles identified in the literature were analyzed; additionally, 52 professionals who work at Brazil Organ Donation System participated in the research. Four care assumptions were formed: investigation of community transmission, investigation of clinical situations, screening for COVID-19 signs and symptoms, and investigation of alterations presented in the physical examination. Such assumptions are formed by 34 care guidelines.Discussion: Care assumptions were prepared to guide and support registered nurses during assessment and validation of potential organ and tissue donors. From this perspective, assumptions certainly promote safety, effectiveness and quality in the service offered during the organ and tissue donation process in the midst of the COVID-19 pandemic, in addition to empowering registered nurses in this scenario. Quality and bio-surveillance through the donation stages have been discussed extensively in recent times, to improve donation and transplantations by valuing care, safety, and quality of life of recipients.Conclusion: The care assumptions presented in this study support and subsidize the daily practice of registered nurses who work in assessing and validating potential organ and tissue donors, enabling these professionals to make decisions based on secure information.

Objetivo: Identificar la información disponible para respaldar las decisiones clínicas de las enfermeras tituladas en la evaluación y validación de los donantes potenciales de órganos y tejidos durante la pandemia de COVID-19.Método:Se trata de una revisión del alcance, desarrollada en seis etapas. La sexta etapa se efectuó con las enfermeras tituladas que trabajan en el Sistema de Donación de Órganos de Brasil. Para consolidar la información y preparar todos los supuestos, el estudio se adaptó a la legislación vigente en Brasil.Resultados: Se analizaron las recomendaciones de 19 artículos identificados en la literatura; además, 52 profesionales que trabajan en el Sistema de Donación de Órganos de Brasil participaron en el estudio. Se formaron cuatro supuestos de cuidados: estudio de la transmisión comunitaria, estudio de las situaciones clínicas, cribado de los signos y síntomas de la COVID-19, y estudio de las alteraciones presentadas en el examen físico. Dichos supuestos están formados por 34 directrices sobre cuidados.Discusión: Se prepararon supuestos sobre cuidados para orientar y respaldar a las enfermeras tituladas durante la evaluación y validación de los donantes potenciales de órganos y tejidos. En esta perspectiva, los supuestos promovieron ciertamente la seguridad, efectividad y calidad del servicio ofrecido durante el proceso de donación de órganos y tejidos en medio de la pandemia de COVID-19, además de empoderar a este grupo de profesionales en este escenario. En los últimos tiempos, se ha debatido ampliamente sobre la calidad y bio-vigilancia a través de las etapas de la donación, a fin de mejorar esta y los trasplantes, valorando los cuidados, la seguridad y la calidad de vida de los receptores.Conclusión: Los supuestos sobre cuidados presentados en este estudio respaldan y subsidian la práctica diaria de las enfermeras tituladas que trabajan en la evaluación y validación de los donantes potenciales de órganos y tejidos,

Validating potential organ and tissue donors in the middle of the COVID-19 pandemic: Scoping review and recommendations construction.

OBJECTIVE: To identify the available information to support registered nurses' clinical decisions in assessing and validating potential organ and tissue donors during the COVID-19 pandemic. METHOD: This is a scoping review developed in six stages. The sixth stage was developed with registered nurses who work in the Brazil Organ Donation System. To consolidate the information and prepare all assumptions, the legislation in force in Brazil was followed. RESULTS: Recommendations from 19 articles identified in the literature were analyzed; additionally, 52 professionals who work at Brazil Organ Donation System participated in the research. Four care assumptions were formed: investigation of community transmission, investigation of clinical situations, screening for COVID-19 signs and symptoms, and investigation of alterations presented in the physical examination. Such assumptions are formed by 34 care guidelines. DISCUSSION: Care assumptions were prepared to guide and support registered nurses during assessment and validation of potential organ and tissue donors. From this perspective, assumptions certainly promote safety, effectiveness and quality in the service offered during the organ and tissue donation process in the midst of the COVID-19 pandemic, in addition to empowering registered nurses in this scenario. Quality and bio-surveillance through the donation stages have been discussed extensively in recent times, to improve donation and transplantations by valuing care, safety, and quality of life of recipients. CONCLUSION: The care assumptions presented in this study support and subsidize the daily practice of registered nurses who work in assessing and validating potential organ and tissue donors, enabling these professionals to make decisions based on secure information.

Communication of Death in the Context of Infant-Child Donation: Best Practices for Creating Family Interview for Organ and Tissue Donation.

OBJECTIVE: To analyze evidence capable of supporting best practices available in the literature to create dialogues about organ and tissue donation with parents of deceased children and adolescents. METHODS: An integrative literature review performed using Scopus, Cochrane, PsycINFO, PubMed/MEDLINE, Web of Science database, and SciELo electronic libraries from November of 2013 to November of 2018, using keyword syntax for each database. The categories were developed using the Alicante model. RESULTS: A total of 745 articles were identified, with 7 selected for analysis. The information obtained was grouped into 3 categories: death communication, which indicates the importance of using simple and clear words; emotional support, which reveals the need to respect family time and the importance of empathy and compassion; and donation information, which punctuates the importance of dissociating communication about the death from that regarding organ donation. CONCLUSIONS: Evidence shows that best practices are the use of simple language, respect for the family during the grieving process, and the importance of establishing different situations in which to communicate about the death and the donation process.

Health Needs of Patients Undergoing Liver Transplant From the Context of Hospital Discharge.

OBJECTIVE: To identify the health needs of the patient and family facing the perspectives of discharge, health care, and adaptation to the new reality at home. METHODS: This was a quantitative and qualitative, exploratory, descriptive study conducted at a reference hospital for liver transplantation. The participants were patients undergoing liver transplant in this hospital unit from 2011 to June 2019. A semistructured interview script was used for data collection, and data were analyzed according to guidelines proposed for content analysis. RESULTS: Twenty patients participated, with a mean age of 40.2 years; 76% were men. The interview data enabled the development of 3 categories: daily health care, warning signs, and adaptation to the new health care routine. The data obtained from the categories showed that the main health needs include difficulties in blood glucose management, insulin administration, the importance of awareness of the warning signs, and obtaining support from the health care team to deal with food restrictions and high doses of medication. CONCLUSION: The health needs are focused on identifying strategies to develop daily care, in addition to seeking better strategies to adapt to the new reality. The study showed the need for individualized discharge planning by the health care team, based on the health needs of each patient.

Simulação realística como ferramenta de ensino na comunicação de situação crítica em cuidados paliativos / Simulación realista como herramienta de enseñanza en comunicación de situaciones críticas en cuidados paliativos / Realistic simulation as a teaching tool in critical situation communication in palliative care

RESUMO Objetivo Identificar a percepção, habilidades e competências dos estudantes de enfermagem frente à comunicação da situação crítica em cuidados paliativos por meio da simulação realística. Método Estudo descritivo quali-quantitativo, desenvolvido com 41 estudantes do Curso de Graduação em Enfermagem de uma universidade do sul do Brasil. Pesquisa realizada no laboratório de práticas simuladas, entre março e maio de 2019. Resultados A média de idade dos estudantes era 23,4 anos. Quanto à percepção deles sobre comunicação da situação crítica: 39% pontuam como difícil; 75,6% nunca participaram de uma comunicação em situações críticas e; 36,60% se sentem bastante estressados nesse contexto. Da análise dos dados qualitativos, emergiram duas categorias: Sentimentos e dificuldades do estudante frente à comunicação de situações críticas em cuidados paliativos e; Principais competências adquiridas por meio da ferramenta de ensino-simulação. Conclusão e implicações para a prática da enfermagem A simulação clínica é importante ferramenta no processo ensino-aprendizagem, faz emergir a observação e torna os estudantes confiantes na habilidade de manter diálogos interprofissionais e com a família. Implica, desta maneira, na prática profissional no tocante às tomadas de decisão, na comunicação de más notícias.

RESUMEN Objetivos Identificar la percepción, habilidades y competencias de los estudiantes de enfermería con respecto a la comunicación de la situación crítica en los cuidados paliativos a través de la simulación realista. Método Estudio descriptivo cuali-cuantitativo, desarrollado con 41 estudiantes universitarios de enfermería de una universidad del sur de Brasil. Investigación realizada en el laboratorio de prácticas simuladas, entre marzo y mayo de 2019. Resultados El edad promedio de los estudiantes era 23,4 años. En cuanto a su percepción de comunicar la situación crítica: el 39% califica como difícil; el 75,6% nunca participó en la comunicación en situaciones críticas y; el 36,6% se siente bastante estresado en este contexto. Del análisis de datos cualitativos, surgieron dos categorías: Sentimientos y dificultades del alumno frente a la comunicación de situaciones críticas en cuidados paliativos y Competencias principales adquiridas a través de la herramienta de enseñanza-simulación. Conclusión e implicaciones para la práctica de enfermería La simulación clínica es una herramienta importante en el proceso de enseñanza-aprendizaje, hace emerger la observación y hace que los estudiantes confíen en la capacidad de mantener diálogos interprofesionales y familiares. Implica, de esta manera, en la práctica profesional sobre la toma de decisiones, en la comunicación de malas noticias.

ABSTRACT Objectives To identify the perception, skills and competencies of nursing students regarding the communication of the critical situation in palliative care through realistic simulation. Method Qualitative and quantitative descriptive study, developed with 41 undergraduate Nursing students from a university in southern Brazil. Research conducted in the laboratory of simulated practices, between March and May 2019. Results The average age of students was 23.4 years. Regarding their perception about communication of critical situation: 39% scored it as difficult; 75.6% never participated in communication in critical situations and; 36.6% feel quite stressed in this context. From the analysis of qualitative data, emerged two categories: Feelings and difficulties of the student facing the communication of critical situations in palliative care and; Main competences acquired through the teaching-simulation tool. Conclusion and implications for nursing practice Clinical simulation is an important tool in the teaching-learning process, brings about observation and makes students confident in the ability to maintain interprofessional and family dialogues. It implies, in this way, in professional practice regarding decision making, in the communication of bad news.