Challenges and Support Strategies for Intensive Care Unit Nurses in the Organ Donation Process: A Scoping Review.

Area of Science:

• Nursing
• Organ Donation
• Critical Care Medicine

Background:

• Organ donation is a critical process within intensive care settings.
• Intensive Care Unit (ICU) nurses play a pivotal role in managing potential organ donors and their families.
• Understanding the unique challenges faced by these nurses is essential for optimizing the donation process.

Purpose of the Study:

• To comprehensively review the challenges encountered by ICU nurses during the organ donation process.
• To identify and recommend effective support models and strategies for nurses involved in organ donation.

Main Methods:

• A systematic scoping review was conducted following JBI methodology.
• Searches were performed across multiple databases (Cochrane, MEDLINE, Embase, PsycINFO, Scopus, Emcare, Web of Science, CINAHL) up to December 2023.
• Included studies were peer-reviewed empirical research (quantitative, qualitative, mixed-methods) focusing on ICU nurses' challenges in adult critical care settings.

Main Results:

• Twenty-eight studies published between 1983 and 2023 were included, predominantly qualitative (71.4%).
• Seven primary challenge categories were identified: direct patient care, family care, understanding brain death, ethical dilemmas, emotional distress, communication barriers, and organizational issues.
• Support strategies identified include debriefing, specialized training, and the implementation of clear local/national protocols and guidelines.

Conclusions:

• This review enhances understanding of the multifaceted challenges ICU nurses face in organ donation.
• Targeted support models and strategies can significantly improve nurses' experiences and care delivery during the organ donation process.
• Improved support can lead to better quality of care, higher consent rates, and more positive experiences for both nurses and donor families.