Pediatric critical care nurses?? perceptions, knowledge, and attitudes regarding organ donation after cardiac death*

Mathur, Mudit; Taylor, Shelley K.; Tiras, Kathyrne; Wilson, Michèle; Abd-Allah, Shamel

doi:10.1097/pcc.0b013e31816c6ff9

Cited by 37 publications

(37 citation statements)

References 13 publications

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“…Previous studies agree with these assumptions, having found that most of the studied populations did not accept brain death as death. (4)(5)(6)(7)(8)(9)(10) In Brazil, the diagnosis of brain death in patients with clinical signs of brain death is confirmed by two clinical exams and one complementary test, which are part of care delivery for patient and their families. A major conflict reported by the nurses in our study concerns withdrawing therapeutic support for non-donor patients with a diagnosis of brain death.…”

Section: Discussionmentioning

confidence: 99%

Conflitos éticos vivenciados por enfermeiros no processo de doação de órgãos

Araújo¹,

Massarollo²

2014

Acta paul. enferm.

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Objective: To determine ethical conflicts experienced by nursing during the organ donation process. Methods: This qualitative study used the content analysis approach developed by Bardin. We interviewed eleven nurses who had cared for potential donors of organs for transplantation. Four questions were used to guide the interview. Results: After analysis, five categories emerged: difficulty in accepting brain death; non-acceptance of the multidisciplinary team for withdrawing mechanical ventilation of the non-donor patient after brain death; difficulty of the multidisciplinary team during the organ donation process; and situations that can interfere with the organ donation process and decision making in ethical conflicts. Conclusion: Ethical conflicts experienced by nurses during the organ donation process were difficulty of health care professionals in accepting brain death as the death of the individual, non-acceptance of withdrawing mechanical ventilation in non-donor patients after brain death, lack of knowledge to perform the brain death protocol, lack of commitment, negligence in care for potential donors, scarcity of human and material resources, religion, and lack of communication. ResumoObjetivo: Conhecer os conflitos éticos vivenciados pelos enfermeiros no processo de doação de órgãos. Métodos: Pesquisa qualitativa utilizando a análise de conteúdo de Bardin. Foram entrevistados onze enfermeiros, com experiência na assistência a potenciais doadores de órgãos para transplante. Foram utilizadas quatro questões norteadoras. Resultados: Emergiram cinco categorias: dificuldade em aceitar a morte encefálica; não aceitação da equipe multiprofissional de desconectar o ventilador mecânico do paciente em morte encefálica não doador de órgãos; dificuldades da equipe multiprofissional durante o processo de doação de órgãos; situações que podem interferir no processo de doação de órgãos e Tomada de decisão frente a conflitos éticos. Conclusão: Os conflitos éticos vivenciados pelos enfermeiros no processo de doação de órgãos foram: a dificuldade do profissional em aceitar a morte encefálica como morte do individuo, a não aceitação em desconectar o ventilador mecânico do paciente em morte encefálica e não doador de órgãos, o desconhecimento para a realização do protocolo de morte encefálica, a falta de comprometimento, o descaso no cuidado com o potencial doador a escassez de recursos humanos e materiais a crença religiosa e a falha na comunicação.

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Section: Discussionmentioning

confidence: 99%

Conflitos éticos vivenciados por enfermeiros no processo de doação de órgãos

Araújo¹,

Massarollo²

2014

Acta paul. enferm.

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“…Previous investigators 16,17 targeted select groups who worked with DCD systems or multidisciplinary teams in the design of theoretical DCD protocols. In contrast, our survey targeted the entire multidisciplinary team in the PICU-physicians, nurses, respiratory therapists, social workers, and a chaplain-and we compared their acceptance, perceptions, and opinions of DBD and DCD after implementation of the DCD protocol.…”

Section: Discussionmentioning

confidence: 99%

“…20 Some care providers fear that in the operating room a change may occur in that model, because support and reaction to the death of a patient may be different than in the PICU. 16 Our protocol maintains the PICU team as the primary caregivers until the actual time organ recovery begins. Multiple survey respondents remarked in written comments that this practice has provided a smooth transition for patients' families and yet maintained the "feel" generally provided in the PICU.…”

Section: Discussionmentioning

confidence: 99%

“…Centers remain hesitant to implement a program of DCD by children because of a possibly negative dying experience for patients' families, the potential emotional burden of the process on health care providers, and the ethical and emotional issues of obtaining consent from parents, [15][16][17] resulting in marked variation in the existing pediatric DCD protocols. 18 Despite these concerns, families of children who donate organs after cardiac death have overwhelmingly positive views of DCD.…”

mentioning

confidence: 99%

“…Research [15][16][17][18][19] on the implementation of protocols for DCD by children has revealed that the process needs to support the concerns of both the children's parents and the staff members of the pediatric intensive care unit (PICU). Centers remain hesitant to implement a program of DCD by children because of a possibly negative dying experience for patients' families, the potential emotional burden of the process on health care providers, and the ethical and emotional issues of obtaining consent from parents, [15][16][17] resulting in marked variation in the existing pediatric DCD protocols.…”

mentioning

confidence: 99%

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Organ Donation After Cardiac Death in Children: Acceptance of a Protocol by Multidisciplinary Staff

Cowl

Cummings

Yager

et al. 2012

American Journal of Critical Care

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Background Organ donation after cardiac death is increasingly implemented, with outcomes similar to those of organ donation after brain death. Many hospitals hesitate to implement a protocol for donation after cardiac death because of the potential negative reactions among health care providers. Objectives To determine the acceptance of a protocol for donation after cardiac death among multidisciplinary staff in a pediatric intensive care unit. Methods An anonymous, 15-question, Likert-scale questionnaire (scores 1–5) was used to determine the opinions of staff about donation after brain death and after cardiac death in a pediatric intensive care unit of a tertiary-care university hospital. Results Survey response rate was 67% (n = 60). All physicians, 89% of nurses, and 82% of the remaining staff members stated that they understood the difference between donation after brain death and donation after cardiac death; staff supported both types of donation, at rates of 90% and 85%, respectively. Staff perception was the same for each type of donation (ρ = 0.82; r = 0.92; P < .001). The 20 staff members who provided care directly to patients who were donors after cardiac death considered such donation worthwhile. However, 60% of those providers offered suggestions to improve the established protocol for donation. Conclusions The multidisciplinary staff has accepted organ donation after cardiac death and has fully integrated this kind of donation without reported differences from their acceptance of donation after brain death.

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Controlled Donation After Cardiac Death in Pediatrics

Paquette¹,

Frader²

2016

Ethical Issues in Pediatric Organ Transplantation

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Pediatric critical care nurses?? perceptions, knowledge, and attitudes regarding organ donation after cardiac death*

Cited by 37 publications

References 13 publications

Conflitos éticos vivenciados por enfermeiros no processo de doação de órgãos

Conflitos éticos vivenciados por enfermeiros no processo de doação de órgãos

Organ Donation After Cardiac Death in Children: Acceptance of a Protocol by Multidisciplinary Staff

Controlled Donation After Cardiac Death in Pediatrics

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