Background: 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. Materials and Methods: 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. Results: 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. Conclusions: 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.

Background Enhancing the quality of obstetric triage services requires a clear perception of the current situations and problems, this issue gained more importance during the COVID-19 pandemic. The purpose of this study was to explore the obstetric and gynecological service providers’ and recipients’ perception and experience of the quality of obstetric triage services during the COVID-19 pandemic. Methods This research was a qualitative study carried out using conventional content analysis. Participants were selected through purposive sampling, and data collection was conducted using in-depth semi-structured interviews. Data were analyzed using MAXQDA software and conventional content analysis. Validity of the data was approved based on four criteria: credibility, dependability, conformability and transferability. Results Five themes emerged through analysis: “unpreparedness to deal with the COVID-19 resulting in disorganized triage”, “threat to the physical and mental health of personnel during the COVID-19 pandemic”, “degradation of the quality of services due to improper triage structure during the COVID-19 pandemic”, “communicating with patients which is neglected during the COVID-19 pandemic” and finally “accountability required to improve the provision of services during the COVID-19 pandemic. Conclusion Obstetrics and gynecology service providers and recipients faced formidable challenges in the triage department during this pandemic caused by the complex and ambiguous nature of the Coronavirus. Identifying the problems, barriers and challenges in providing services to patients in this situation especially in triage, can lead to an improvement in the outcome of services.

BACKGROUND: The ultimate goal in educating medical students is to train skilled workforce who by obtaining the required knowledge of the discipline, personal and professional skills, and attitudes to enter the national health-care system. This study was conducted with the goal of designing a comprehensive clinical competency test of operating room technology student using the Delphi technique, and then, the clinical skills of the operating room technology students of the paramedical school were assessed using the CIPP evaluation model. MATERIALS AND METHODS: The present study was conducted in the University of Medical Sciences to evaluate clinical skills with Delphi technique and CIPP evaluation model. This was a mixed methods study. Purposive sampling method was employed in the qualitative stage, and a census was conducted in the quantitative part. A comprehensive clinical competency test was designed in this research using the Delphi technique and was conducted with 18 students. Then, clinical skills evaluation was performed by descriptive-analytical statistical tests and evaluator's observation using the CIPP model. RESULTS: The comprehensive clinical competencies test of the surgical technology students was designed in four sections: content, evaluation method, test conditions, and the criteria for passing the comprehensive test. The results in the implementation stage showed that the operating room technology students had a range of excellent to weak performances in exhibiting basic skills at different levels. CONCLUSIONS: The results of the present study showed that the comprehensive test, designed based on the Delphi technique of experts, and using the CIPP model can be a good criterion for the evaluation of the operating room technology students before entering the clerkship.

Background & Aims: Caring for patients with the diagnosis of brain death is one of the heaviest duties for nurses. The importance of organ donation is one of the biggest challenges of nursing in the intensive care unit. This qualitative research aimed to investigate the experience of nurses in care for brain death patients. Materials & Methods: The study was qualitative research using a content analysis method. Purposive sampling started with in-depth semi-structured interviews with 20 participants and continued until the data saturation stage. Data were analyzed using conventional qualitative content analysis. Results: Qualitative analysis of data content led to the extraction of themes reflecting the research of nurses’ experiences in the care of the brain dead patients and including “organ donation; a distinct care element” and “’facing increased tensions and conflicts.” Finally, the main themes of “Care stress resonance following a distinct donation situation; a distinct care element” were abstracted. Conclusion: Due to the importance of maintaining the health of donation organs, nurses’ experiences have shown that they face many challenges while caring for brain death patients. But the issue of organ donation is one of the significant issues affecting the care of organ donors, so managers can take practical proceedings by identifying nurses’ challenges in this field to improve the quality of care for these patients.