Percepção dos enfermeiros sobre os resultados dos indicadores de qualidade na melhoria da prática assistencial Percepción de enfermeros sobre resultados de los indicadores de calidad para mejora de la práctica profesional Nurses' perception on the results of quality indicators for the improvement of professional practice

As estratégias de controle da qualidade assumem um significado importante para os enfermeiros, tornando-os mais envolvidos e competentes para aperfeiçoarem a qualidade do cuidado prestado. Esse estudo teve como objetivo diagnosticar a percepção dos enfermeiros de um hospital privado sobre os processos de qualidade em enfermagem aplicados à melhoria da assistência. É um estudo descritivo-exploratório cuja amostra foi de19 enfermeiros. Resultados demonstraram que os mesmos consideraram a utilização dos resultados dos indicadores um instrumento estratégico, e que sua percepção corrobora a prática de melhoria assistencial por meio da utilização de ferramentas e indicadores de qualidade com ênfase no registro de falhas no processo como possíveis sugestões de melhoria da qualidade.<br>Las estrategias de control de la calidad asumem un significado importante para los enfermeros, los vuelvendo más involucrados e capacitados para perfeccionarem la calidad del cuidado prestado. El objetivo fue diagnosticar la percepción de los enfermeros sobre los procesos de cualidad en enfermería aplicados a la mejora de la asistencia. Es un estudio descriptivo-exploratório cuya muestra fue compuesta por 19 enfermeros. Resultados demonstraran que ellos consideran la utilización de los resultados de los indicadores un instrumento estratégico, y que la percepción corrobora la práctica de mejora asistencial por medio de la utilización de herramientas y indicadores de cualidad con énfasis en el registro de fallas en el proceso como posibles sugerencias de mejora de la cualidad.<br>The quality control strategies plays an important role to nurses as they become more involved and qualified to improve the care provided. The purpose of this study was to diagnose the perception of nurses at a private hospital on the nursing quality processes applied to care improvement. This is a descriptive-exploratory study whose sample was composed by 19 nurses from care units. Results demonstrated that nurses considered the use of results from indicators to be a strategic tool for the institution, and their perceptions have confirmed the validity of care improvement practices using quality tools and indicators, emphasizing that follow up of process flaws can be a possible suggestion towards quality improvement

Genetic and developmental disorders of the oral mucosa : epidemiology; molecular mechanisms; diagnostic criteria; management

A large number of disorders may affect the oral cavity, including genetic diseases, infections, cancers, blood diseases, skin diseases, endocrine and metabolic disorders, autoimmune and rheumatologic diseases, local lesions, to name a few. Oral mucosa shows a considerable variation in its normal structure and a wide range of conditions may affect it. Such conditions are often harmless or minor and could be primary or secondary to systemic disease. Several of them are quite rare and, hence, the diagnosis is not easy. Clinically, lesions may appear as ulcers, discoloration of the oral mucosa and alterations in size and configuration of oral anatomy. Genetic disorders have specific manifestations and can be caused by a derangement of one or more components of the tissue. Many of them follow the skin or systemic signs of the underlying genetic disease, but in a few cases oral signs could be the first manifestation of the disorder. Among them genodermatoses are prominent. They are inherited disorders characterized by a multisystem involvement. This review describes chondro-ectodermal dysplasia, dyskeratosis congenita, Ehlers-Danlos syndrome, hereditary benign intraepithelial dyskeratosis, keratosis follicularis, lipoid proteinosis, multiple hamartoma syndrome, pachyonychia congenita, Peutz-Jeghers syndrome, tuberous sclerosis and white sponge nevus. Other genetic disorders not included in the genodermatosis group and reported in the present review are: acanthosis nigricans, angio-osteo-hypertrophic syndrome, encephalotrigeminal angiomatosis, familial adenomatous polyposis, focal dermal hypoplasia, focal palmoplantar and oral mucosa hyperkeratosis syndrome, gingival fibromatosis, Maffucci's syndrome, neurofibromatosis (type 1) and oro-facial-digital syndrome (type 1). Disorders during embryonic development might lead to a wide range of abnormalities in the oral cavity; some of them are quite common but of negligible concern, whereas others are rare but serious, affecting not only the oral mucosa, but also other structures of the oral cavity (ie palate, tongue and gingiva). Fordyce's granules, leukoedema, cysts of the oral mucosa in newborns, retrocuspid papilla, geographic tongue, fissured tongue, median rhomboid glossitis, hairy tongue, lingual varices and lingual thyroid nodule are described. This review may help dentists, dental hygienists, but also general internists and pediatricians to diagnose different disorders of the oral mucosa, to understand the pathogenesis and to schedule a treatment plan