YazdiMoghaddam Hamideh, Manzari Zahra-Sadat, Mohammadi Eesa
Iranian Research Center on Healthy Aging, Operating Room Department, Faculty of Paramedices, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Nurs Midwifery Res. 2020 Jun 17;25(4):265-272. doi: 10.4103/ijnmr.IJNMR_226_18. eCollection 2020 Jul-Aug.
Caring for brain dead patient is one of the most troublous duties of an Intensive Care Unit (ICU) nurse. This study aimed to determine nursing challenges based on recent literature and identify the strategies to overcome these challenges.
In this systematic review, the standard systematic review guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used with articles published in PubMed, Science Direct, Scientific Information Database (SID), and Google Scholar databases during 2000-2018 on the keywords "brain dead OR brain death" and "nurses OR nursing." After the primary search, 212 articles were found. Eventually, 21 articles were selected for the final evaluation.
According to the results, the challenges included the concept and diagnosis of brain death, religious, and cultural beliefs opposing organ donation, lack of knowledge about the care process, interactions with the families. The proposed strategies were providing medical and nursing interventions to maintain a brain dead patient for organ donation, providing working conditions that maintain nurses' health, and increase the quality of care.
Nurses play an important role in the care process of brain dead patients; therefore, recognizing their challenges can be thefirst step in increasing holistic care and maintaining organ vitality for transplantation. It is suggested that nursing authorities commence special educational programs with the aim to increase the knowledge of nurses about the care process of brain dead patients.
护理脑死亡患者是重症监护病房（ICU）护士最棘手的职责之一。本研究旨在根据近期文献确定护理挑战，并找出克服这些挑战的策略。
在这项系统评价中，采用了系统评价与Meta分析的首选报告项目（PRISMA）的标准系统评价指南，检索了2000年至2018年期间发表在PubMed、Science Direct、科学信息数据库（SID）和谷歌学术数据库上的关键词为“脑死亡或脑死亡”以及“护士或护理”的文章。初步检索后，共找到212篇文章。最终，选取21篇文章进行最终评估。
根据结果，挑战包括脑死亡的概念和诊断、反对器官捐赠的宗教和文化信仰、对护理过程缺乏了解、与家属的互动。提出的策略包括提供医疗和护理干预以维持脑死亡患者用于器官捐赠、提供维护护士健康的工作条件以及提高护理质量。
护士在脑死亡患者的护理过程中发挥着重要作用；因此，认识到他们面临的挑战可能是加强整体护理和维持器官移植活力的第一步。建议护理管理部门开展专项教育项目，以增加护士对脑死亡患者护理过程的了解。
