Analysis of the reasons for nurses' confusion in relation to the concept of brain death from clinical and legal points of view
Keywords:
Brain death, Organ donation, Nurse, Care, LegalAbstract
Background: Nurses in intensive care units (ICU) play a key role in taking care of brain dead patients and they
are often in contact with such patients given the high rate of brain deaths. Consequently, they are in a challenging
and stressful condition, which may be aggravated due to the need for increased organ donation, and this may also
affect the quality of care provided for these patients.
Objective: This review analyzes the different studies on the concept of brain death from both medical and legal
points of view. The aim of this study was to identify the challenges the nurses face with the perception of the
concept of brain death and its effects on the care provided for the patients suffering from brain death, as well as
organ donation.
Methods: This Narrative review study summarizes the information obtained from relevant literature through a
targeted search of library texts and electronic resources including Science Direct, PubMed, Google Scholar,
Scientific Information Database (SID), IranMedex, and Magiran databases during 2000-2017 in English and
Persian, on the subject of interest by keywords such as brain death, organ donation, care, legal, regulations and
nursing. Finally, a total of 44 relevant articles were reviewed.
Results: Nurses play an important role in taking care of brain dead patients; therefore, recognizing challenges can
be the first step in taking accurate care of these patients and subsequently maintaining the organs’ health for
transplants. Although there are clinical and legal uncertainties regarding the concept of brain death, nurses have
an important effect on taking care of brain dead patients as well as the rate of organ donation.
Conclusion: Nurses in intensive care units should have a clear understanding of the concept of brain death in
order to be able to take care of brain dead patients by avoiding psychological effects. In this regard, it is
recommended that a comprehensive educational program be designed on the dimensions of brain death.
Therefore, the nurses' awareness of brain death and their ability to clarify this concept to the patients' relatives
would have a great effect on the decrease in the challenges and the stress imposed on the nurses. Also, there
would be an increase in the quality of the care given to brain dead patients and even the rate of organ donation
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