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View related articlesView Crossmark data Introduction: The management process is an essential and predominant part of nurses' work, regardless of positions or functions assumed by health institutions [1]. The performance of these professionals in the surgical center (SC) has deserved attention because it involves specificities and articulations indispensable to the management of caring of patients with complex needs. However, what is perceived in reality is that nurses have difficulties in understanding this function. In this sense, this work aims to analyze nurses' practices in the management and care on SC. Materials and methods: This is a qualitative and exploratory research performed in surgical centers of four hospitals, two in Rio Grande do Norte and two in Cear a, Brazil. Data were collected through a semi-structured interview, unsystematic observation of the professionals and also appreciation of the nursing records. The data analysis method used was the Content Analysis, idealized by Bardin [2]. This study was approved by the Research Ethics Committee of Universidade Estadual do Cear a, Brazil under statement n 11044791-3. Results: Nine nurses, seven women and two men, aged between 43 and 50 years, were interviewed. All had between 2 and 25 years of service. The anguish of the nurses was identified in the face of the overload of activities and the impotence faced with the lack of good quality materials, medicines and instruments; and the inconsequence of professionals who do not respect norms and routines and, mainly, the lack of planning and systematization of the work that prevents the nurse from providing a direct care to the patient. Discussion and conclusions: In view of the results achieved by the objectives and the method of the study, the research question confirms that in the data collection scenario, there is no delimitation of the margins of the nurses' performance, leading them to assume activities outside their professional responsibility [3]. The overload of activities constitutes an impediment to the practice of direct care to the patient compromising the quality of this. From the point of view of the planning of the activities in the SC, it was observed the inexistence or little importance given to the planning which required of the professionals a process of work based in the situation and condition of improvisation and, consequently, inflicting good practices within the SC generating risks patients.

ObjectiveThe aim of the study was to evaluate risk factors for positive margins on surgical specimens of patients submitted to transformation zone excision (TZE).Materials and MethodsWe conducted a retrospective study evaluating women submitted to TZE in our center, between 2012 and 2020. Our study population included only women with the diagnosis of high-grade intraepithelial lesion (HSIL) in the pathologic examination of the TZE surgical specimen. Positive margins were defined as the presence of HSIL in the endocervical and/or ectocervical margin of the specimen. Factors evaluated included demographic characteristics, pretreatment Pap smear and human papillomavirus test, colposcopic findings, TZE indication, and pathologic features of the surgical specimen. We performed univariate analysis and logistic regression modeling including variables associated with the outcome of positive margins in the univariate analysis.ResultsOur sample included 264 women, with a 15.2% positive margins rate (40 patients). In the univariate analysis, patients with immunocompromised status, HSIL Pap smear, and higher number of quadrants involved in colposcopic examination were more likely to have positive margins. After multivariate analysis, only immunocompromised status was found to be an independent risk factor (odds ratio = 4.94; 95% CI = 1.43–17.15; p < .05).ConclusionsImmunocompromised status was the sole significant predictor for positive margins in TZE surgical specimens. To our knowledge, this is the first report of immunodepression as a risk factor for positive margins in cervical excisional procedures.