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Mira J.J.,University Miguel Hernandez | Lorenzo S.,Fundacion Hospital Universitario Alcorcon | Vitaller J.,University Miguel Hernandez | Guilabert M.,University Miguel Hernandez
Gaceta Sanitaria | Year: 2010

Objectives: To analyze hospital and primary care physicians' knowledge of certain patients' rights recently modified by Spanish Law 41/2002 (law of patient autonomy). Material and methods: We performed a voluntary survey of hospital and primary care physicians who were presented with three problem situations drawn from court decisions and the law of patient autonomy. Results: Among interviewed physicians, 78% were familiar with the law of patient autonomy. Fifty-three percent knew how to explain what advance wills are. Eighty-eight percent responded correctly to the problem situation concerning the right to privacy. Fifty-seven percent knew the legal age of consent for healthcare. Seventy percent correctly applied patients' right not to be informed. Only 38% responded correctly to all three problem situations. Correct responses were more frequent (odds ratio: 2.4-3.4) among physicians who were familiar with the law of patient autonomy. Conclusions: At least one out of every 10 physicians could be legally compromised by lack of knowledge of the law of patient autonomy. Patients' rights were most likely to be jeopardized in patients aged between 16 and 18 years old. Prior information on the law of patient autonomy contributes to greater compliance. © 2009 SESPAS. Source

Jimenez-Almonacid P.,Fundacion Hospital Universitario Alcorcon | Lasala M.,Fundacion Hospital Universitario Alcorcon | Rueda J.A.,Fundacion Hospital Universitario Alcorcon | Gruss E.,Fundacion Hospital Universitario Alcorcon | And 9 more authors.
Nefrologia | Year: 2010

Introduction: The increase of prevalent haemodialysis patients is a challenge for surgery units. Vascular access related complications are the main cause of hospital admissions in many dialysis units. Outpatient surgery could decrease waiting lists, cost related and complications associated to vascular access. Material and methods: We have performed a prospective study of the vascular access related surgery in a ten years period. Outpatient surgery was included with the rest of the activity in a general surgery unit and was performed by not exclusive dedicated surgeons. Results: Since 1998 to December 2009 we performed 2,413 surgical interventions for creating and repairing arteriovenous fistula in 1,229 patients, including elective and emergency surgery (74.8% and 25.2% respectively). Outpatient procedures were performed in 82% of cases (89% in elective and 60% in emergency surgery). There were unexpected admissions secondary to surgical complications in 6% of patients. There wasn't postoperative mortality. The rate of admissions were 0.09 episodes and 0.2 days per patient/year. Conclusions: Outpatient surgery is possible in a high percentage of patients to perform or to repair an arteriovenous fistula, including emergency surgery. Vascular access surgery can be included in ordinary activity of a surgical unit. Outpatient vascular access surgery decreases unnecessary hospital admissions, reduces costs and nosocomial complications. © 2010 Revista Nefrología. Source

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