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

To provide an overview of the challenges that Intensive Care Unit nurses experience during the organ donation process and identify recommended support models or strategies that may assist them when caring for potential organ donors and their families during the organ donation process.

A scoping review was conducted in accordance with JBI methods.

Cochrane Library, MEDLINE (via Ovid), Embase (via OVID), APA PsycINFO (via OVID), Scopus, OVID Emcare, Web of Science and CINAHL (via EBSCO) were searched from the first available start date of the individual database to December 2023.

Eligible studies included peer-reviewed empirical quantitative, qualitative and mixed method studies exploring the challenges experienced by Intensive Care Unit nurses during the organ donation process in adult intensive or critical care settings. Reviewers used Rayyan systematic review software to screen titles, abstracts and full-text articles. Data were gathered using an adapted JBI data extraction tool for scoping reviews.

Twenty-eight papers were included that were published between 1983 and 2023. Most studies (71.4%) used a qualitative approach. Seven key challenges were identified: direct patient care, care for the next of kin, concept of brainstem death, ethical challenges, emotional challenges, challenges around communication and organisational challenges. Several support models were identified including debriefing, training and education, and availability of local or national protocols and guidelines for organ donation.

This scoping review provides an increased understanding of the challenges that Intensive Care Unit nurses experience during the organ donation process. Appropriate support models or strategies may potentially improve nurses' care experience during the organ donation process.

Improved understanding of the nature of challenges during the organ donation process can facilitate the implementation of supportive strategies that may ultimately improve quality of care, consent rates and nurses' and donors' family experiences.

A public representative with family experience of organ donation was involved in developing the protocol and search strategy.