Indicadores clínicos para o diagnóstico de enfermagem Síndrome do equilíbrio fisiológico prejudicado para doadores de órgãos

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.

Nursing Diagnosis for Potential Organ Donors: Accuracy Study

The objective was to analyze the diagnostic accuracy of Impaired physiological balance syndrome in potential brain-dead organ donors. It is a study of diagnostic accuracy. Data was retrospectively collected from 145 medical records through the filling out of an instrument containing 25 indicators of the nursing diagnosis (ND). Descriptive and inferential statistics were used. The prevalence of the ND was 77 (53.1%). The indicator with the best measures of accuracy was altered heart rate. Therefore, it has the best predictive capacity for determining the ND. It was identified that the absence of the indicators altered heart rate, hyperglycemia, and altered blood pressure is associated with the absence of the ND, while the presence of the indicators hyperthermia, hypothermia, and altered heart rhythm is associated with the presence of the ND. Accurate indicators will assist in diagnostic inference and the interventions and results will have greater chances of targeting and effectiveness.

Development of a nursing outcome for a percutaneous procedure

OBJECTIVES

To develop a nursing outcome, consistent with the standardized format of outcomes within the nursing Outcomes Classification (NOC). This outcome will include an outcome label, an outcome definition, and clinical indicators. The proposed use for this outcome is to evaluate the access site of a percutaneous procedure.

METHODS

Concept analysis with a scoping review. Initially, content experts were recruited to validate the indicators of the proposed outcome in order to complete a consensus validation. After consensus validation, a review of the proposed outcome and its indicators was completed by two of the editors of the NOC team to confirm that the outcome label, definition, and indicators were consistent with the NOC taxonomy. During this review, edits were made on the label name and definition.

FINDINGS

After a series of reviews, the initial outcome of Vascular Status: Percutaneous Procedure Access was changed to Tissue Injury Severity: Percutaneous Procedure. In addition, the original definition of the condition of an access site for percutaneous procedure by venous or arterial puncture and health of surrounding tissues was edited to: Severity of complications from a needle-puncture access through the skin and into deeper tissues. The outcome has 11 indicators to be used to formulate a target rating for use in the clinical setting. The indicators were not edited over the course of the reviews.

CONCLUSION

The proposed outcome will assist nurses in evaluating the access site of percutaneous procedures and in identifying possible complications.

IMPLICATIONS FOR THE NURSING PRACTICE

This research contributes to the refinement of the NOC taxonomy by having a new outcome that meets clinical practice needs.

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.