The meaning of care to brain dead potential donors involves understanding the complexity of this patient who can save somebody's life through organ donation.

Objectives: to demonstrate the scientific knowledge developed on lean thinking in health, highlighting the impact and contributions in health care and nursing. Method: an integrative literature review in the PubMed, CINAHL, Scopus, Web of Science, Emerald, LILACS and SciELO electronic library databases, from 2006 to 2014, with syntax keywords for each data base, in which 47 articles were selected for analysis. Results: the categories were developed from the quality triad proposed by Donabedian: structure, process and outcome. Lean thinking is on the rise in health surveys, particularly internationally, especially in the USA and UK, improving the structure, process and outcome of care and management actions. However, it is an emerging theme in nursing. Conclusion: this study showed that the use of lean thinking in the context of health has a transforming effect on care and organizational aspects, promoting advantages in terms of quality, safety and efficiency of health care and nursing focused on the patient.

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RESUMO: Objetivou-se apresentar aspectos inovadores para a prática profissional do enfermeiro, no que se refere ao diagnóstico de morte encefálica no processo de doação e transplante de órgãos e tecidos, abordando as interfaces entre a gerência do cuidado e a segurança do paciente. Enfatiza-se a padronização de processos, utilizada para promover agilidade, redução das perdas por parada cardíaca com aumento concomitante das doações reais, e diminuição do tempo entre o primeiro exame clínico e o explante. Permite que a equipe reconheça as anormalidades e faça as correções necessárias em tempo hábil. Assim, vislumbra-se que a segurança do paciente deve subsidiar as tomadas de decisão e intervenções de gestão, de modo a qualificar a prática de cuidado. DESCRITORES: Gerência; Cuidados de enfermagem; Segurança do paciente; Obtenção de órgãos e tecidos; Transplantes. SEGURANÇA DO PACIENTE NO PROCESSO DE DOAÇÃO E TRANSPLANTE DE ÓRGÃOS E TECIDOS PATIENT SAFETY IN THE PROCESS OF ORGAN AND TISSUE DONATION AND TRANSPLANTABSTRACT: This article aims to present innovative aspects for the professional practice of the nurse, regarding the diagnosis of brain death in the process of donation and transplantation of organs and tissues, addressing the interfaces between the care management and patient safety. Emphasis is placed on the standardization of processes, used to promote speed, reduction in losses from cardiac arrest with a concurrent increase in actual donations, and reduction of time between the first clinical examination and harvesting of the organ. It allows the team to recognize abnormalities and make the necessary corrections in time. Thus, it is seen that patient safety should be a basis for management's decision-making and interventions, so as to make the care practice of adequate quality. DESCRIPTORS: SEGURIDAD DEL PACIENTE EN EL PROCESO DE DONACIÓN Y TRASPLANTE DE ÓRGANOS Y TEJIDOSRESUMEN: Estudio cuyo objetivo fue presentar aspectos innovadores para la práctica profesional del enfermero acerca del diagnóstico de muerte encefálica en el proceso de donación y trasplante de órganos y tejidos, considerándose las relaciones entre la administración del cuidado y la seguridad del paciente. Se destaca la estandarización de procesos, utilizada para promover agilidad, reducción de pérdidas por parada cardíaca con aumento concomitante de las donaciones reales, así como disminución del tiempo entre el primer examen clínico y el explante. Eso posibilita que el equipo reconozca las anormalidades e haga las correcciones necesarias en tiempo hábil. De ese modo, se constata que la seguridad del paciente debe subsidiar las decisiones e intervenciones de gestión, a fin de calificar la práctica de cuidado.

Objectives: to identify information that can support creating good practice assumptions to develop family interview for organ and tissue donation. Methods: this scoping study, conducted in two Brazilian hospitals in the southern, between April and December 2017, included integrative review and consultation with 15 families who experienced interview for organ donation. For data analysis, thematic content analysis was used. Results: three categories emerged: communication of death, which shows the need to know the history of hospitalization of patients; emotional support, the team must have mastery of the stages of mourning; information about donation, professionals need to know the stages of the donation process and respect families’ time. Final Considerations: good practice assumptions point to the need for team training, respect for family time and the use of simple language.