Objectives: to analyze the performance of nurses in the Bed Management service of a public teaching hospital. Methods: descriptive, qualitative research inspired by Dubois theoretical model. 32 participants from the bed management unit and care units of a public hospital were interviewed from February to May 2018. Observations and data records from the Bed Management service complemented data collection. Theme/Category-Based Content Analysis was used. Results: the performance of nurses was described in three analysis matrices, represented by the categories: acquisition, implementation and maintenance of nursing resources; transformation of nursing resources into nursing service and results of the work of the nurse in Bed Management. Final Considerations: understanding the performance of nurses in bed management contributes to the scenario of new practices and different roles that favor visibility and strengthening of the nurse’s identity.
Phimosis is classically characterized by the impossibility of completely withdrawing the foreskin and exposing the glans. A distal preputial narrowing occurs, which may be congenital or acquired. Excess foreskin and the presence of balanopreputial adhesions may be components of this spectrum. Circumcision corresponds to foreskin excision, one of the most commonly performed surgeries in boys, whether for medical or religious reasons. Such a procedure is considered sacred by many peoples around the world as a symbol of faith or even as a ritual of tribal emancipation. The appearance of the procedure in several places and times allowed the development of the surgical technique, today adapted to minimize complications and provide evident medical benefits. We present fundamental physiological and histological concepts, classically described, knowing the natural history of a potential disease. We discuss the emergence and development of surgical techniques still used today and identify factors that interfere with the disease and influence the treatment.
Objective: to compare the postoperative esthetic and healing aspects of postectomy performed by different surgical techniques, based on the evaluation of different specialty expert professionals. Methods: prospective and randomized clinical trial enrolling 149 preschool children with a medical indication for circumcision, divided into three groups: postectomy with the hemostatic device Plastibell® (PB group), conventional technique (CV group) and conventional with subcuticular stitches (SC group). Pictures were taken from patients at pre-defined angles on the 30th and 60th postoperative days. Photos were evaluated by three specialists (dermatologist, pediatrician and plastic surgeon), who assigned scores from 1 to 5 regarding the esthetic and healing features at each moment. Grades 4 or 5 from all specialists characterized “best result”. Data were analysed to compare the used surgical techniques, the judgments from specialties and postoperative complications. Results: most of the patients obtained the “best result” regarding healing (70%) and esthetics (56%). The final overall result showed the PB group as the best for healing (p=0.028) and the SC group as the best for esthetics (p=0.002). For the dermatologist, on the 60th postoperative day, the CV group presented the worst aesthetic result, whereas for the pediatrician and the plastic surgeon, the PB group presented the best healing result and the SC group had the best esthetic result. There was no difference between the groups regarding the presence of complications. Conclusion: the most common surgical techniques used to perform postectomy in children were differently assessed regarding healing and esthetic features by distinct medical professionals. The analysis of these two parameters among experts from related areas diverged among them and over time.
HighlightsThe most common mechanism of urethral injury in children is trauma.Urethral trauma in children most commonly is due to pelvic fractures from car accidents.Urethral trauma can present in many forms.Possible options for management of urethral injuries are presented.The surgeon must keep in mind different techniques for urethral reconstruction.
Objetivo: Descrever a configuração da Rede de Cuidados às Doenças Crônicas não Transmissíveis em um Distrito Sanitário na perspectiva da integração. Métodos: Trata-se de estudo qualitativo desenvolvido em um Distrito Sanitário, no qual foram realizadas entrevistas com 34 participantes (coordenadores e enfermeiros assistenciais) com experiência na gestão e no cuidado. Resultados: Os resultados evidenciaram, em termos gerais, que é possível descrever a Rede de Cuidados a partir de uma inter-relação entre as dimensões da integração, destacando-se as interações profissionais, a organização do cuidado e processos logísticos relacionados aos fluxos assistenciais com facilitadores e impeditivos para a atenção às pessoas com Doenças Crônicas não Transmissíveis. Conclusão: Destaca-se como um facilitador na configuração da Rede a capacidade gerencial dos coordenadores em integrar as unidades de saúde e os profissionais na organização do cuidado; e, dentre os percalços para a conformação da Rede o não apontamento teórico dos princípios e diretrizes do SUS, choque nas relações profissionais, falhas operacionais na logística de fluxos assistenciais, sistema de informação não totalmente interligado, fragilidade quanto ao sistema de financiamento e falta de parcerias ou opiniões ambíguas referentes aos processos de trabalho adotados em cada unidade.
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