RESUMEN
Nationwide abortion restrictions resulting from the Dobbs v Jackson Women's Health Organization (2022) decision have generated confusion and uncertainty among healthcare professionals, with concerns for liability impacting clinical decision-making and outcomes. The impact on pediatric surgery can be seen in prenatal counseling for fetal anomaly cases, counseling for fetal intervention, and recommendations for pregnant children and adolescents who seek termination. It is essential that all physicians and healthcare team members understand the legal implications on their clinical practices, engage with resources and organizations that can help navigate these circumstances, and consider advocating for patients and themselves. Pediatric surgeons must consider the impact of these changing laws on their ability to provide comprehensive and ethical care and counseling to all patients.
Asunto(s)
Cirujanos , Humanos , Femenino , Embarazo , Estados Unidos , Cirujanos/psicología , Salud Reproductiva , Aborto Legal/legislación & jurisprudencia , Aborto Legal/ética , Toma de Decisiones Clínicas/ética , Aborto Inducido/legislación & jurisprudencia , Aborto Inducido/éticaRESUMEN
Foreign bodies aspirated into the airway or ingested with retention in the esophagus are common in infants and children. Both can cause life-threatening complications and must be approached with expeditious diagnosis and definitive treatment. Pediatric surgeons should be familiar with diagnosis, treatment, operative management, complications, and outcomes of aerodigestive tract foreign bodies.
Asunto(s)
Manejo de la Enfermedad , Esófago , Cuerpos Extraños/cirugía , Sistema Respiratorio , Procedimientos Quirúrgicos Operativos/métodos , Niño , HumanosRESUMEN
BACKGROUND: The aims of this study were to characterize obstacles affecting current sign-out practices and to evaluate the potential impact of standardized sign-out guidelines. METHODS: In June 2011, detailed guidelines for transitions of care were implemented, and a 29-item multiple-choice survey was developed to assess sign-out practices, attitudes, and barriers to effective communication. Surveys were administered to residents and nurses at 3 time points. Comparisons between time points were assessed using t tests and χ(2) tests (α = .05). RESULTS: Guideline implementation achieved nonsignificant improvements in satisfaction with sign-outs, perceptions of patient safety, adequacy of information provided in sign-out, and patient knowledge by on-call residents. On follow-up, concerns surfaced regarding less complete sign-out processes due to new duty-hour restrictions. CONCLUSIONS: Guideline implementation mildly improved perceptions of safety and adequacy of sign-out; however, persistent barriers to continuity of care remain. Sign-out standardization may not adequately ensure patient safety, and further efforts to improve handoff processes are in need.