Articles Tagged With:
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Self-Managed Abortion: A Guide to Harm Reduction and Patient-Centered Care
Even before the Dobbs v Jackson Women’s Health Organization decision, access to safe, legal abortion within the formal healthcare system was increasingly restricted. In this context, patients may turn to self-managed abortion (SMA). Clinicians should understand the course of SMA, including its overall safety, rare complications, and potential legal risks to patients.
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Utility of the Simplified Bishop Score in Trial of Labor After Cesarean Success
This study demonstrated that a higher likelihood of vaginal birth after cesarean was associated with a favorable simplified Bishop score on admission. This emphasizes the need for delaying patient counseling on the choice of trial of labor after cesarean delivery until the end of pregnancy to incorporate the cervical exam into decision-making.
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Prevalence of Urinary Incontinence Among Adult U.S. Women Has Increased
The updated prevalence of urinary incontinence using the National Health and Nutrition Examination Survey data is 60% in community dwelling women, which is an increase from prior estimates.
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Can Maternal COVID-19 Vaccination Protect Newborns?
In this case control study, 537 case infants younger than 6 months of age who were admitted to the hospital with COVID-19 were compared to 512 control infants who were hospitalized for other reasons; 16% of the case infants and 29% of the control infants had been born to mothers who had been fully vaccinated against COVID-19 during the pregnancy. The effectiveness of maternal vaccination against infant hospitalization for COVID-19 was 52% overall, 80% during the Delta variant period, and 38% during the Omicron variant period. Effectiveness increased when the vaccine was received after 20 weeks of pregnancy.
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Nurses and Physicians Find Ethics Consults Helpful, But for Different Reasons
Ethicists are challenged to meet the needs of everyone involved during an ethics consult. Now, ethicists can turn to some new data on how those differ.
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Updated Recommendations on Pediatric End-of-Life Care
A report includes a review of essential elements of care for patients and families. The authors covered discussions on goals of care, how to establish end-of-life care goals, advance care planning, and palliative and hospice involvement.
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Encourage Reluctant Clinicians to Contact Ethics
Ethicists can contact department chairs and clinical leadership to express interest in participating in grand rounds or educational forums. Contact nursing leaders to offer in-service training sessions on frequently encountered ethical issues. Join hospital committees to learn more about ethical issues clinicians are encountering. The idea is to gain the support of individual clinicians, the medical staff, and hospital leaders.
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Ethicists Strive to Make Training for Consults More Consistent
Hospital administrators vary in their awareness of the need for training for ethics consultants. They want to believe the committee is doing good work. But as ethics committees often do not capture metrics to measure their work product quality, it is hard for leaders to question the training quality.
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Making Ethical Decisions on Genetic Testing, Precision Medicine
Physicians are obligated to consider the benefits and harms of genetic testing. They must be prepared to engage in discussions with patients, and offer assistance in understanding the risks, benefits, and uncertainties of direct-to-consumer genetic testing. Clinicians must safeguard privacy, security, and confidentiality of patient information.
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Court-Appointed Guardians for Unrepresented Patients
Ethicists are seeing a range of issues arise during consults involving unrepresented patients, including conflicts over how aggressive treatment should be, whether to treat at all, how to discharge, and how to follow up with compliance with treatment. Creating a template for actions to take related to unrepresented persons who present to the hospital is a proactive first step.