Interprofessional work in health in the context of the COVID-19 pandemic: a scoping review / Trabajo interprofesional en salud en el contexto de la pandemia del COVID-19: revisión del alcance / O trabalho interprofissional em saúde no contexto da pandemia de COVID-19: revisão de escopo

ABSTRACT Objective: to map the scientific production on interprofessional relationships in health in the first year of the COVID-19 pandemic. Method: this is a scoping review performed in PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar and Science Direct databases, covering the period of publication in 2020, using the acronym PCC (Population = health professionals; Concept = interprofessional relationships; Context = health services) and respective search strategies. Results: fourteen scientific articles were selected and the content discussed in the manuscripts was standardized, analyzed and organized into categories of affinities and similarities of their results: 1 - Interprofessional collaboration; 2 - Collaborative practice; 3 - Interprofessional work; 4 - Interactive and interprofessional learning. Conclusion: the pandemic demanded quick and effective responses that were only possible through collaboration and interprofessionalism dimensions. Interprofessional work in health during the first year of the COVID-19 pandemic confirms the importance of interprofessional work and its dimensions for the provision of more comprehensive, resolute and safer health services.

RESUMEN Objetivo: mapear la producción científica sobre las relaciones interprofesionales en salud en el primer año de la pandemia del COVID-19. Método: revisión del alcance, realizada en las bases de datos PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar y Science Direct, cubriendo el período de publicación 2020, utilizando las siglas del PCC (Población = profesionales de la salud; Concepto = relaciones interprofesionales; Contexto = salud servicios) y las respectivas estrategias de búsqueda. Resultados: se seleccionaron 14 artículos científicos y el contenido discutido en los manuscritos fue estandarizado, analizado y organizado en categorías de afinidades y similitudes de sus resultados: 1 - Colaboración interprofesional; 2 - Práctica colaborativa; 3 - Trabajo interprofesional; 4 - Aprendizaje interactivo e interprofesional. Conclusión: la pandemia exigía respuestas rápidas y eficaces que solo eran posibles a través de las dimensiones de la colaboración y la interprofesionalidad. El trabajo interprofesional en salud durante el primer año de la pandemia COVID-19 confirma la importancia del trabajo interprofesional y sus dimensiones para la prestación de servicios de salud más integrales, decididos y seguros.

RESUMO Objetivo: mapear a produção científica sobre relações interprofissionais em saúde no primeiro ano da pandemia de COVID-19. Método: revisão de escopo, realizada nas bases PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar e Science Direct, abrangendo o período de publicação do ano de 2020, utilizando o acrônimo PCC (População = profissionais de saúde; Conceito = relações interprofissionais; Contexto = serviços de saúde) e respectivas estratégias de busca. Resultados: foram selecionados 14 artigos científicos e o conteúdo discutido nos manuscritos foi uniformizado, analisado e organizado em categorias de afinidades e semelhanças de seus resultados: 1 - Colaboração interprofissional; 2 - Prática colaborativa; 3 - Trabalho interprofissional; 4 - Aprendizagem interativa e interprofissional. Conclusão: a pandemia demandou respostas rápidas e eficazes que só foram possíveis através das dimensões da colaboração e da interprofissionalidade. O trabalho interprofissional em saúde durante o primeiro ano de pandemia de COVID-19 confirma a importância do trabalho interprofissional e suas dimensões para a oferta de serviços de saúde mais integrais, resolutivos e seguros.

Centro cirúrgico: recomendações para o atendimento de pacientes com suspeita ou portadores de COVID-19 / Surgical Center: recommendations for the care of patients with suspected or confirmed COVID-19 / Centro quirúrgico: recomendaciones para el cuidado de pacientes con COVID-19 sospechado o confirmado

Objetivo: Apresentar as recomendações para reorganização do centro cirúrgico no atendimento a pacientes com suspeita ou confirmação de COVID-19. Método: Revisão crítica da literatura, com publicações dos anos de 2019 e 2020 relacionadas à produção científica, a normas técnicas, às diretrizes e recomendações de sociedades, para o gerenciamento do centro cirúrgico na assistência a pacientes durante a pandemia do novo coronavírus. Resultados: A gestão dos recursos humanos e materiais é primordial para: atender à demanda assistencial perioperatória; reorganizar os procedimentos cirúrgicos; garantir a segurança dos profissionais de saúde; organizar a sala cirúrgica com materiais necessários; planejar a recuperação pós-anestésica do paciente; e realizar limpeza e desinfecção da sala cirúrgica. Conclusão: As recomendações apresentadas direcionam os enfermeiros a aplicar as melhores práticas no atendimento aos pacientes, em consonância com evidências científicas recomendadas por instituições de referência, para promoção de assistência segura e de qualidade aos pacientes e profissionais.

Objective: To present the recommendations to reorganize surgical center in the care of patients with suspected or confirmed COVID-19. Method: Critical literature review of the literature, with publications from 2019 and 2020 related to scientific production, technical standards, guidelines and recommendations of societies for managing the surgical center in the care of patients during the new coronavirus pandemic. Results: The management of human and material resources is essential to meet the perioperative care demand; reorganize surgical procedures; ensure the safety of health professionals; organize an operating room with required materials; plan the patient's post-anesthetic recovery; and perform cleaning and disinfection of the operating room. Conclusion: The recommendations direct nurses to apply best practices in patient care, in line with scientific evidence recommended by reference institutions, to promote safe and quality care for patients and professionals.

Objetivo: presentar las recomendaciones para la reorganización del Centro Quirúrgico en la atención de pacientes con COVID-19 sospechado o confirmado. Método: Revisión crítica de la literatura, con publicaciones de los años 2019 y 2020, relacionadas con producción científica, estándares técnicos, Guías y Recomendaciones de Sociedades, para el manejo del CQ en la asistencia a pacientes durante la pandemia del nuevo coronavirus. Resultados: La gestión de los recursos humanos y materiales es fundamental para atender la demanda de cuidados perioperatorios, reorganizar los procedimientos quirúrgicos; garantizar la seguridad de los profesionales de la salud; organizar el quirófano con los materiales necesarios; planificar la recuperación postanestésica del paciente y realizar la limpieza y desinfección del quirófano. Conclusión: Las recomendaciones presentadas a enfermeras directas para aplicar las mejores prácticas en la atención al paciente, en línea con la evidencia científica recomendada por las instituciones de referencia, para promover una atención segura y de calidad a pacientes y profesionales.

Conflictos del cirujano: ¿La vocación quirúrgica está en crisis? / Conflicts of surgeons: is surgical vocation in crisis?

RESUMEN Introducción: En los últimos años vemos un aumento de bibliografía que se refiere a problemas perso nales y psicológicos del cirujano, a la deserción en residencias de cirugía y a la falta de especialización de individuos jóvenes. Este aumento se observa sobre todo en revistas de jerarquía como Lancet o JAMA. ¿Pero cuál es la situación en la Argentina? ¿Consideramos que nos están pagando adecua damente por nuestra práctica? ¿Pensamos en abandonar nuestra especialidad? ¿Cuántos conflictos tenemos con pacientes por mes? Estimamos necesaria la realización de un trabajo regional que lo plasme. Objetivo: conocer la situación socioeconómica actual de los cirujanos. Material y métodos: estudio de corte transversal. Resultados: de 73 cirujanos encuestados de la provincia de Santa Fe, se recibió respuesta en un 57,5 %. El 87,8 % fueron hombres y 56,1% estaba dentro del grupo de edad adulto intermedio/mayor al momento del estudio. El 97,6 % de los cirujanos concordó en que sus ingresos no se corresponden con el tiempo invertido en la práctica. Consideraron abandonar su práctica diaria en el último año en un 26,2 %; la causa económica es el principal problema para el 72,7%. Discusión: la incomodidad del cirujano frente a su salario (97,6 %), la discrepancia de porcentajes en tre cirujanos y cirujanas (87,8% vs. 12,2%), la falta de cirujanos jóvenes (43,9%) y la alarmante cifra de cirujanos graduados por año (35 por año) son cuatro puntos clave que consideramos deberían abordar de manera urgente los entes políticos y, sobre todo, las Asociaciones de Cirugía.

ABSTRACT Background: In recent years we have witnessed more publications about personal and psychological issues affecting surgeons, residents quitting surgery residencies, and lack of specialization of young in dividuals. This growth can be observed especially in high-impact journals such as The Lancet or JAMA. But what is the situation in Argentina? Do we think that we are receiving adequate payment for our practice? Do we consider quitting our specialty? How many conflicts do we have with patients each month? We think that a regional work is necessary to reflect this situation. Objective: The aim of this study is to determine the current socioeconomic situation of surgeons. Material and methods: We conducted a cross-sectional study. Results: A total of 73 surgeons from the province of Santa Fe were contacted and 42 answers were received (response rate 57.5%): 87.8% were men and 56.1% corresponded to middle/older adulthood. Almost all surgeons (97.6%) agreed that their income did not reflect the time spent in practice. Up to 26.2% of survey respondents considered quitting their daily practice in the last year due to eco nomic reasons, which is the main problem for 72.7% of them. Discussion: Surgeons' discomfort with their salaries (97.6%), the discrepancy in percentages between male and female surgeons (87.8% vs. 12.2%), the lack of young surgeons (43.9%) and the alarming number of surgeons graduated per year (35 per year) are 4 key issues which we believe should be urgently addressed by political bodies and, especially, by surgery associations.

Cirurgia abdominal de alta complexidade: classificação e escolha dos equipamentos pela equipe multiprofissional / High-complexity abdominal surgery: classification and choice of equipment by the multi-professional team / Cirugía abdominal de alta complejidad: clasificación y elección del equipo quirúrgico por el equipo multiprofesional

Introdução: Os procedimentos de alta complexidade são caracterizados pelo uso da alta tecnologia. A classificação e a escolha dos equipamentos são um desafio para os profissionais envolvidos. Objetivo: Comparar a classificação das cirurgias abdominais de alta complexidade e a escolha dos equipamentos pela equipe multiprofissional entre duas instituições hospitalares. Método: Pesquisa descritiva, quantitativa, transversal e comparativa, com questionários estruturados sobre a opinião dos cirurgiões, anestesiologistas e enfermeiros. Resultado: A classificação dos procedimentos é semelhante quando levados em conta equipamentos (P<1,0) e estrutura física (P=0,172) diferenciados. Discussão: A classificação dos procedimentos mais complexos tem concordância entre os profissionais comparado à legislação, mesmo não englobando o porte anestésico, tipo de procedimento e condições clínicas na sua classificação; a escolha dos equipamentos é do profissional que os utiliza, incluindo amplas salas de operações, sendo a cirurgia robótica dispensável aos cirurgiões. Conclusão: Há diferenças entre instituições de saúde em relação à escolha, à disponibilidade de equipamentos e aos tipos de cirurgias abdominais.

Introduction: High-complexity procedures are characterized by the use of high-technology. The classification and choice of equipment are challenging for the professionals involved. Objective: To compare the classification of high-complexity abdominal surgeries and the choice of equipment by the multi-professional team between two hospital institutions. Method: Descriptive, quantitative, transversal and comparative research, with structured questionnaires on the opinion of surgeons, anesthesiologists and nurses. Results: The classification of procedures is similar when considering differentiated equipment (P<1.0) and physical structure (P=0.172). Discussion: The classification of more complex procedures is in agreement between professionals when compared to the legislation, even if not encompassing anesthetic dimensions, type of procedure or clinical conditions in their classification; the equipment is chosen by the professional who uses them, including operating rooms, with robotic surgeries being expendable to surgeons. Conclusion: There are differences between the choices made by health institutions, the availability of equipment and the types of abdominal surgeries.

Introducción: procedimientos de alta complejidad se caracterizan por el uso de alta tecnología. La clasificación y elección de los equipos son un desafío para los profesionales. Objetivo: comparar la clasificación de cirugías abdominales de alta complejidad y la elección del equipo por parte del equipo multiprofesional entre dos instituciones hospitalarias. Método: investigación descriptiva, cuantitativa, transversal y comparativa, con cuestionarios estructurados sobre la opinión de cirujanos, anestesiólogos y enfermeras. Resultados: la clasificación de los procedimientos es similar cuando se consideran equipos diferenciados (P<1,0) y estructura física (P=0,172). Discusión: la clasificación de procedimientos más complejos está de acuerdo entre los profesionales en comparación con la legislación, incluso si no abarca dimensiones anestésicas, tipo de procedimiento o condiciones clínicas en su clasificación; el equipo es elegido por el profesional que los utiliza, incluidos los quirófanos, y las cirugías robóticas son dispensables para los cirujanos. Conclusión: hay diferencias entre las elecciones realizadas por las instituciones de salud, la disponibilidad de equipos y los tipos de cirugías abdominales.

Survey on the job satisfaction among the staff in the dilution situation of the hospital staffing management / 国际中医中药杂志

To explore the status of the job satisfaction of the authorized and contract staff in a university affiliated hospital in the dilution situation of the hospital staffing management, and to discuss the key factors and reasons affecting the satisfaction difference. The questionnaire was developed based on Minnesota Satisfaction short form with extra items covering “the comprehensive satisfaction evaluation”. According to the hospital population of staff, the cluster random sampling method was used, and survey was conducted on the spot. Both authorized staff and the contract staff showed high degree of satisfaction. But the contract staff showed higher degree of satisfaction of leadership and their own responsibility sense than the authorized staff. The contract female staff showed higher degree of overall satisfaction than the authorized female staff. The discussion based on the results showed that new human resource management mode, new mechanism of flexible management of staff, targeted staff with targeted management.

The utility of live video capture to enhance debriefing following transcatheter aortic valve replacement.

Background: The surgical and procedural specialties are continually evolving their methods to include more complex and technically difficult cases. These cases can be longer and incorporate multiple teams in a different model of operating room synergy. Patients are frequently older, with comorbidities adding to the complexity of these cases. Recording of this environment has become more feasible recently with advancement in video and audio capture systems often used in the simulation realm. Aims: We began using live capture to record a new procedure shortly after starting these cases in our institution. This has provided continued assessment and evaluation of live procedures. The goal of this was to improve human factors and situational challenges by review and debriefing. Setting and Design: B‑Line Medical’s LiveCapture video system was used to record successive transcatheter aortic valve replacement (TAVR) procedures in our cardiac catheterization/laboratory. An illustrative case is used to discuss analysis and debriefing of the case using this system. Results and Conclusions: An illustrative case is presented that resulted in long‑term changes to our approach of these cases. The video capture documented rare events during one of our TAVR procedures. Analysis and debriefing led to definitive changes in our practice. While there are hurdles to the use of this technology in every institution, the role for the ongoing use of video capture, analysis, and debriefing may play an important role in the future of patient safety and human factors analysis in the operating environment.