ASHP Survey: IV Fluid Bag Shortage Affecting Patient Care

Pharmacists call shortage of small-volume parenteral solutions "severe"

The shortage of small-volume parenteral solutions often supplied in intravenous fluid bags is affecting virtually all U.S. hospitals, according to results of a survey by the American Society of Health-System Pharmacists (ASHP).

Nearly all of the respondents (99.1%) to the informal, nonscientific survey indicated that their hospital has been affected by the shortage. More than 60% called the shortage “severe” and noted that limited inventory of the critical product has required health care providers to adopt new procedures and use alternative therapies to treat patients, ASHP said.

More than three-quarters of the respondents had less than two weeks’ supply of SVPs in inventory at the time of the survey. Survey respondents are taking a variety of steps to mitigate the shortages, including using alternative methods of administration such as intravenous (IV) push, intramuscular injections, or oral dosage forms (84.5%); using nonformulary premixed solutions and/or frozen products (64.4%); and implementing protocols that restrict the use of product (60.1%).

SVPs are solutions of 100 mL or less used in nearly every hospital in the United States to dilute IV medications. The shortages are primarily a result of hurricane-related damage to pharmaceutical manufacturing plants in Puerto Rico.

The shortage of SVPs is the latest in a series of shortages of critical medications, including sodium bicarbonate and epinephrine. Drug shortages pose a significant threat to the safety and quality of patient care in hospitals and other health care settings and may result in delayed treatment and increased risk of adverse reactions and medication errors, ASHP said.

“We strongly believe that the current drug shortage situation is unacceptable and unsustainable,” said ASHP CEO Paul W. Abramowitz, PharmD, ScD (Hon), FASHP. “It threatens harm to patients, wastes valuable health care resources, causes great uncertainty, and disrupts the health care system.”

ASHP works closely with officials in the FDA’s Drug Shortages Program and collaborates with the University of Utah Drug Information Service to track drugs in short supply. The ASHP Drug Shortages Resource Center features recommendations for managing current inventory and, when available, recommendations for alternative therapies.

In November 2017, ASHP initiated a congressional call to action with key stakeholders, asking Congress to take immediate action to address the public health crisis caused by persistent shortages. The association also hosted a roundtable discussion where participants identified 11 recommendations to address the ongoing patient-care challenges associated with drug shortages.

The full text of the ASHP survey report is available here.

Source: ASHP; January 11, 2018.