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Survey of drug shortages on academic obstetric anesthesiology floors
Abstract Number: F-31
Abstract Type: Original Research
Introduction: Drug shortages may result in patient harm1. No current evidence exists whether suggested strategies to deal with drug shortage actually reduce the number of shortages or improve patient safety2. The goal of our study is to survey academic obstetric anesthesiology unit directors to determine how drug shortages are being managed.
Methods: A survey was generated which addressed the impact of drug shortages as well as the mechanisms being used to manage these shortages. A list of academic obstetric anesthesiology directors was created and verified (93 total). The survey was distributed electronically ( September 2014). Descriptive statistics were used to categorize survey responses.
Results: Sixty participants responded (response rate 65%). Fifty five percent of respondents indicated their unit was experiencing a shortage at the time of the survey and 76.3% indicated they had experienced a shortage in the last year. While 27.6% of directors indicated that at least one medication was being restricted to use on the obstetric floor, 11.9% indicated that there were medications that were restricted to other units. In order to conserve drug supply, 37.3% indicated that single dose medications were being divided for use on multiple patients and 11.9% responded this was being done by the anesthesiologists on the floor and not under sterile conditions. Medication errors/ near misses linked to drug shortages were reported by 15.3% of units. Anesthesiology consultation prior to drug changes by pharmacy was reported by 15.3% of respondents. Only 62.7% reported there was a mechanism in place to alert anesthesiologists of any changes in drugs manufacturers or concentration, , with e-mail notification being the most common mode of communication.
Conclusion: Drug shortages remain a concern for most obstetric units, with over 75% of respondents indicating that their unit experienced a drug shortage in the last year. In addition to medication errors, reported hazards included near-misses, the division of single dose vials for administration to multiple patients by anesthesiologists under non-sterile conditions, and the widespread practice of drug substitutions without anesthesiology consultation or notification.
1. ISMP Canada Safety Bulletin. March 20 2012;12(3).
2.Fox ER,. Am J H Syst Phar, Aug 1 2009;66(15):1399-1406.