At my hospital the nursing UI of Epic is absolutely horrid. It's cluttered and confusing with multiple places to document everything.
Epic is completely customizable, but the people who make the decisions in nursing management aren't always the same people using the software. That and funding to make the changes.
If you want to see really bad software take a look at Meditech it defaults 800x600 (!), and doesn't resize well at all.
Ah yes, I am still forced to use Meditech's telnet interface today. I asked our IT guy if we can please change the font to a smoothed, non-raster font. I think it took all his willpower to not burst out laughing lol
The indiegogo funded camect is pitched as a private 'cloud optional' recorder. The beta unit I have is cloud connected but the final release has the option to be fully local. It has a lot of neat features like identifying people/ups trucks/cars/etc.
It only has a webbased client, but I kind of like it and the beta version has been way better than any of the cheap dvr trash that big box stores sell.
It is absolutely criminal that a <$20 drug can be sold for $4500... Auto-injectors have been a solved problem for decades, and there is nothing special about naloxone vs any other drug. Treating auto-injecting tech as different for each drug only helps drive up prices and keep out competition by making FDA approval very expensive.
I hope you are successful getting a generic auto-injector approved, but I don't think your biggest hurdle will be design or engineering.
>(3) In the Emergency treatment of anaphylactic reactions Guidelines for healthcare providers the preferred needle length is 25 mm for adrenaline injectors to access muscle in most people. I heard during expert evidence that Epipen needle length was 16mm - suitable according to the UK Resuscitation Council for “pre-term or very small infants”. The use of needles which access only subcutaneous tissue and not muscle is in my view inherently unsafe. An alternative autoinjector, Emerade has a 24 mm needle.
>(4) The dose of adrenaline in Epipen is 300mcg. The UK Resuscitation Council recommends a standard emergency dose of 500mcg. Emerade contains a dose including 500mcg. The combination of what my expert told me was an inadequate dose of adrenaline for anaphylaxis and an inadequate length needle raises serious safety concerns.
-Depending on her weight 300mcg may be an appropriate dose for US guidelines (listed at 0.01mg/kg).
The listed issues may be from a company taking a 'one-size-fits-most' approach. They also do not update their product with respect to new guidelines and recommendations (new doses, new needle lengths, etc) Possibly to avoid further FDA approval processes? With such large profits and so little competition there is no incentive to innovate/update.
they are completely different. Where I work in cali nurses are full time working 3 or 4 twelve hour shifts a week. Overtime optional and highly compensated.
medical residents will routinely do back to back 24 hour shifts with no sleep and even the ICU attendings will do a week of every other day 24 hour shifts.
The 16 hour rule only applies to interns. Once you reach second year the rule is 80 hours a week averaged over four weeks. This means that 100 hour weeks still do happen.
I was forced to do 100 hours a week for a company that had a sadistic culture of over work, you never get anything done, under those kind of hours unless you're doing stimulant drugs your brain just shuts down. I wonder how many doctors are also drug addicts just to make this kind of work intensity physically possible even?
I'm surrounded by doctors and I don't know any that abuse drugs, other than alcohol and maybe weed. I believe they are just so busy and so overworked that they are constantly moving around / doing paperwork. The demands of the job keep them going.
In my experience, you are absolutely correct. I dated a nurse for a while and later married a doctor, and it was completely different. Physician training is absolutely, terrifyingly demanding.
CURES works but at the cost of completely negating any type of privacy protection on medical records. Pretty much anyone (prescriber, dispenser, law enforcement) can pull up CURES reports knowing a persons last name and birthdate.
What is the point of HIPAA and medical privacy if anyone can log in and see what scheduled drugs you're taking? From the drugs you take I can pretty much derive your medical history. I consider this a much larger problem than the 'war on drugs'.
Absolutely, though I'd argue that this is simply one consequence of the war on drugs rather than separate larger issue.
The war on drugs is a masterful play. It's a free pass for law enforcement to circumvent your rights, to search your vehicle (via warrant dog), to enter your home (via anonymous tip), to review your doctor's records, to surveil your activities, to seize your cars, cash or real estate without due process. It's the master key for an authoritatian police state and the selective targeting of undesirables.
Or maybe you aren't a doctor and shouldn't be judging if your father needed abx based on a few google searches.
Get a second opinion from a professional if you think your dads doc is over prescribing.
While colds are not dangerous for the young -- they can be very dangerous for the elderly and easily progress to a pneumonia that can kill. Pneumonia used to be called 'old mans best friend' because it caused such a swift and painless death.
So what is 'just a cold' for you isnt for others and that isn't even taking into account that the elderly often have baseline lung disease.
There may have been things lavished on doctors in the past, but as of a few years ago docs effectively can't get anything free unless it is under $10 an instance and less than $100/year.
$10/instance and $100/year are only the threshold for reporting, not the threshold for banning. Plenty of doctors are still getting lots of perks from the pharmaceutical industry.
In some circles, most notably in academia, doctors even consider it a mark of prestige to get expensive perks from multiple pharmaceutical companies. "Pfizer just asked me to speak at their conference in the Bahamas. Too bad I already agreed to attend Novartis's event in France!" The Sunshine Act does nothing to curb their corruption and only fuels their pride.
Vancomycin is used routinely (at least in the three hospitals I work in) and it is far from a last ditch drug. That has shifted to Linezolid and Daptomcyin. In the three hospitals I work at, medicine doctors must consult Infectious Disease doctors for approval to place patients on those therapies.
The parent post was referring to GPs, which at least in the U.S. aren't often operating in hospitals, and certainly don't get ID consults.
Vancomycin is the drug of choice for several major infections that are of a concern to hospitals (MRSA, C. difficile) because there's already pretty established resistance mechanisms. There are definitely some "more last ditch" drugs, but Vancomycin is kind of the first of the "Now we bring out the big guns" antibiotics.
Partially because it's a PITA to give to patients, and has some toxicity problems.
"Last ditch" is a poor choice of words. The point I was trying to make is that if you come to you doc with the sniffles, it's unlikely you're going to get an Rx for vancomycin.
Epic is completely customizable, but the people who make the decisions in nursing management aren't always the same people using the software. That and funding to make the changes.
If you want to see really bad software take a look at Meditech it defaults 800x600 (!), and doesn't resize well at all.