While manufacturers are working to increase production, healthcare providers should take steps to help mitigate the risk of shortages, industry stakeholders urge.
Hurricane Helene forced the temporary closure of a manufacturing plant critical to the IV fluid supply in the United States. As a result, several major healthcare organizations quickly released recommended conservation strategies for healthcare providers to help mitigate the potential IV fluid supply disruption.
Because the facility is a significant producer of large volume IV fluids for the U.S., which includes saline, dextrose and lactated ringers, Vizient was encouraging healthcare providers to take immediate action to manage their inventory and implement conservation strategies to help mitigate the risk of shortages, said John Thompson, senior vice president, med/surg, lab and capital equipment for Vizient.
Strategies Vizient recommended for inventory management include:
- Evaluate IV fluid supplies on a health system-wide basis and redeploy solutions to areas of greatest need.
- Minimize unit stock of large-volume bags to the extent possible or stock product only in critical care areas where fluids are an essential component of emergency supplies.
- Ensure smaller volume bags are stocked in other supply areas, especially pediatric areas.
- Ensure purchasing agents have active backorders in place to help ensure your facility is obtaining allocations as available.
The Food and Drug Administration (FDA) announced temporary policies for 503A pharmacy compounders and 503B outsourcing facilities that may support their efforts to address fluid shortages. Details of the flexibilities are included on FDA’s Hurricane Helene resource page.
The ASHP and the University of Utah also released updated recommendations for managing intravenous fluid shortages and conserving supply. The management and conservation resource, created in 2022, was updated following the hurricane to reflect the current supply status of small- and large-volume intravenous solutions. The document provides operational steps that organizations may consider in conserving inventory and managing fluid shortages. The updated recommendations reflect best practices related to multiple aspects of patient care, including considerations for intravenous hydration and alternate routes of administration.
The general recommendations included:
- Implement an organization-specific action plan to conserve IV fluids where possible. Organizations must be flexible as the status of specific products may vary. Establish policies to allow for interchanges between clinically equivalent products when possible.
- Ensure an interdisciplinary team is making rationing decisions using an ethical framework.
- Communicate changes in shortage status and action plan adjustments to stakeholders as soon as possible.
- Identify vulnerable and populations with specific needs, such as pediatric and neonatal patients, and consider specific policies and practices that reserve or prioritize fluid products for their needs.
For the full list of ASHP recommendations, visit https://www.ashp.org/drug-shortages/shortage-resources/publications/fluid-shortages-suggestions-for-management-and-conservation?loginreturnUrl=SSOCheckOnly.