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Objetivo: identificar características dos óbitos e sinais clínicos de morte encefálica dos pacientes com lesão neurológica internados em unidades de pacientes críticos, a partir de ferramenta para apoio na busca ativa. Método: estudo descritivo, retrospectivo, realizado de janeiro a agosto de 2017 nas unidades críticas de dois hospitais do sul brasileiro. Os dados foram coletados nos prontuários de pacientes que evoluíram a óbito utilizando-se instrumento da Organização Nacional de Transplantes da Espanha, analisados pela estatística descritiva. Resultados: os sinais clínicos de morte encefálica identificados antes do óbito foram Glasgow três; reflexos de tosse ausente; hipertensão intracraniana presente, pupilas midriáticas e poliúria. Destacase que 14,8% apresentaram todos os critérios para iniciar o diagnóstico de morte encefálica, mas não foram notificados à Central Estadual de Transplante. Conclusão: os profissionais atuantes nessas unidades devem ter conhecimentos dos sinais clínicos de morte encefálica para que ocorra identificação precoce desses pacientes, consequentemente, aumentando as notificações.

Objective: To assess the weaknesses of the teams of the critical care units related to the donation process. Method: A cross-sectional study conducted with 150 health professionals. Data collection took place between 2017 and 2018 in two public hospitals in Santa Catarina, with the aid of a specific instrument on the stages process of organ and tissue donation. Data was analyzed by absolute and relative frequencies, Kolmogorov-Smirnov and Mann-Whitney tests. Results: Hit rates: criteria for starting the diagnosis of brain death 137 (91.3%) and clinical signs of brain death 126 (84%). Weaknesses: criteria that prevent the diagnosis of brain death 36 (24%) and sequence of the stages of the donation process 56 (37%). There was a correlation between the length of professional activity in the unit and the criteria that prevent the diagnosis of Death p=0.039. Conclusion: The results can support actions in the face of the weaknesses, impacting on the improvement of the organ and tissue donation and transplantation process.

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.