The Good, The Bad and Drug Shortages.

It doesn’t take a rocket scientist to know that when you don’t have enough of a good thing, bad things can happen. This is the case with the on-going drug shortages and the resulting potential issues that affect the care we provide and patient safety concerns.

The ISMP (Institute for Safe Medication Practices) recently released the results of a national survey of more than 1,800 healthcare practitioners regarding drug shortages. Many stated a high level of frustration and that the drug shortage problem has risen to the level of a national public health crisis. According to ISMP, survey participants were alarmed by the ever-increasing volume of critically important medications in short supply (FDA Drug shortage list) and the resulting use of less desirable, unfamiliar alternative drugs where available. They felt that shortages have significantly increased the potential for errors and patient harm caused by absent or delayed treatment or preventable adverse drug events associated with alternative drugs or dosage forms.

The Bad… I have to admit that most of the time (and not until I used Twitter), as an infusion nurse, I never paid attention to drug shortages. Just like most nurses, I think it’s not my problem, it’s the pharmacy’s problem. Perhaps that is the reason why I don’t hear much about the drug shortages, because pharmacy takes care of it and as long as I have something in my hand to administer to my patient at the designated time; it’s all transparent to me. I have done my job and that makes me a happy nurse!  Wow, that was selfish and short sighted on my part. This is not just pharmacy’s problem, it’s a health care problem and that includes nursing.  Yes, I know, nurses are already swamped with many other responsibilities, we’re understaffed and now, we have to worry about drug shortages too. Well, truth is, we all need to be concerned and as nurses, perhaps we should think about the following:

  • Do you take the time to check a drug reference when alternative products, if available are substituted? Often, these products appear in our medication cabinets and we have never seen or given that drug before.
  • Do you take the time to double check the dosage, concentration, and preparation of an alternate product? Just because the drugs belong in the same category, the recommendation may not be the same as the original drug.
  • Do you take extra precautions to monitor and assess patients when an alternative product is administered? Particularly when the patient received an original medication that now is on the drug shortage list.
  • Do you know what your organization’s plan of action is regarding drug shortages?  Is there even a plan? What if your pharmacy isn’t 24/7? Would you know what to do?
  • Love your pharmacists – the drug shortage is not their fault and they are working diligently to get what we need.
  • Be assured that several professional and national organizations are trying to get a handle on this issue, no solution yet so we still need to be prepared.

The Good…well, there’s nothing really good about drug shortages, unless according to USA Today… you’re a prisoner with an execution order!