Brachiobasilic arteriovenous fistula with superficialisation and transposition the basilic vein in a one stage surgical technique. Five years of single experience. / Fístulas arteriovenosas nativas humerobasílicas con superficialización y trasposición en un solo acto quirúrgico. Revisión de cinco años de experiencia.

BACKGROUND: The basilic vein is a deep vein which usually requires superficialisation and surgical transposition. MATERIAL AND METHODS: This is a retrospective study of 119 BBAVF-ST in patients with stage 5D chronic kidney disease who received an implant with a one-stage surgical technique (2011-2015). The percentage of primary (PP), assisted primary (APP) and secondary (SP) permeabilities were assessed, as well as the related complications. We analysed the permeabilities using Kaplan-Meier survival curves and a univariate Log Rank analysis (Mantel-Cox). P values less than or equal to 0.05 were considered as significant. RESULTS: The mean age of the study group was 67.9years, with 63.8% of the subjects being male. A total of 57 complications were detected during the follow-up period: 24 stenosis (42.1%), 11 thrombosis (19.2%), 7 vascular access steal syndromes (12.2%), 7 upper limb oedemas (12.2%), 6 post-puncture haematomas (10.5%) and 2 infections (3.5%). The percentages of PP obtained at 1, 6, 12 and 24months were 92.4%, 79.8%, 66.3% and 52%; APP: 94.1%, 87.3%, 80.4% and 65.6%, and SP: 95%, 89.1%, 84% and 67.5%, respectively. Diabetic patients presented with significantly worse permeabilities than vascular or idiopathic patients: (P=.037, .009 and .019, respectively). CONCLUSIONS: According to the results obtained in our study, the one-stage surgical implementation of BBAVF-ST presents high permeability rates and a small number of related complications. Diabetes mellitus is a factor related to a worse surgical prognosis. Some of the biggest advantages are the greater optimisation of health resources and a shorter time in which the central venous catheter needs to remain in the body.

Contribuição da etnometodologia para avaliação do cuidado de enfermagem no centro cirúrgico / Contribution of ethnomethodology to evaluation of nursing care in the operating room / Contribución de la etnometodología para la evaluación de la atención de enfermería en el centro quirúrgico

A etnometodologia se caracteriza em compreender a realidade social de um determinado grupo ou instituição social. Para tanto, os objetivos deste estudo foram: caracterizar os discursos dos usuários do centro cirúrgico e analisar o cuidado de enfermagem evidenciado nesses discursos. Estudo etnometodológico, exploratório, desenvolvido com 18 usuários de um hospital estadual do Rio de Janeiro. Os dados foram coletados em 2013, por meio de observação participante e entrevista semiestruturada; em seguida, submetidos à análise de conteúdo, emergindo a categoria: Análise do cuidado de enfermagem no centro cirúrgico. O medo do desconhecido gerou desconforto, ansiedade e nervosismo nos usuários, reverberados nas falas, nos códigos, nos símbolos e no imaginário, que levam à profusão de ideias. Conclui-se que a etnometodologia contribui para a investigação dos fenômenos emergentes do cotidiano, viabilizando acesso às informações necessárias sobre o significado da experiência dos usuários, potencializando a subjetividade humana e as dimensões do cuidado, para o exercício de uma prática mais humanizada.

Ethnomethodology seeks to understand the social realities of a given social group or institution. This exploratory ethnomethodological study aimed to characterize the discourse of operating room users and analyze the nursing care evidenced by that discourse. Data were collected from 18 users at a state hospital in Rio de Janeiro in 2013 by participant observation and semi-structured interview. Content analysis revealed the category: analysis of nursing care in the operating room. Fear of the unknown generated user unease, anxiety and nervousness, which reverberated in the statements, codes, symbols, imagery, which lead to a profusion of ideas. It was concluded that ethnomethodology contributes to investigating everyday emergent phenomena, allowing access to the necessary information about the meaning of the user experience, and leveraging human subjectivity and the dimensions of care towards more humane care practices.

La etnometodología se caracteriza por comprender la realidad social de un determinado grupo social o institución. Para eso, los objetivos de este estudio fueron: caracterizar los discursos de los miembros de la sala de operaciones y examinar el cuidado de enfermería destacado en los discursos de los usuarios. Estudio exploratorio etnometodológico llevó a cabo con 18 miembros de un hospital del Estado de Río de Janeiro - Brasil. Los datos fueron recogidos en 2013, a través de observación participante y entrevista semiestructurada; después, fueron sometidos al análisis de contenido, emergiendo la categoría: Análisis de la atención de enfermería en la sala de operaciones. El miedo del desconocido ha generado malestar, ansiedad y nerviosismo en los usuarios, reverberados en las declaraciones, códigos, símbolos, imágenes que traen una gran cantidad de ideas. En conclusión, la etnometodología contribuye para la investigación de los fenómenos emergentes de la vida cotidiana, lo que permite el acceso a la información necesaria sobre el significado de la experiencia del usuario en la sala de operaciones que aprovechan la subjetividad humana y las dimensiones de la atención para ejercer una práctica más humana.