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Survey of Drug Shortages on Academic Obstetric Anesthesiology Units
Abstract Number: O2-03
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. In light of the recent increase in drug shortages, the goal of our study was to determine how drug shortages are being managed on academic obstetric anesthesiology units.
Methods: A previously created and administered survey examining the impact and management of drug shortages was electronically administered (SurveyMonkey Jan 2019) to a list of academic obstetric anesthesiology directors (93 total). Descriptive statistics were used to categorize survey responses and was compare to results from its 2014 administration.
Results: Forty-one participants responded (response rate 44%). Fifty-one percent of respondents indicated their unit was experiencing a shortage at the time of the survey and 82% had experienced a shortage in the last year. In order to conserve drug supply, 42.5% of participants indicated that single dose medications were being divided for use on multiple patients and 17.6% reported 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 30.8%. Anesthesiology consultation prior to drug changes by pharmacy was identified as occurring by 23.1% of respondents. Seventy-two percent 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. Comparisons to 2014 data is in Table 1.
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. The presence of a designated anesthesiology drug managers has reportedly increased, while medication errors (including near-misses) and the division of single dose vials via non-sterile technique has reportedly increased. This may indicate a need for drug managers to work closely with pharmacy to provide sterile single dose medications to the unit. More units have alert systems in place to provide more information to obstetric anesthesiology providers, however there is no data available to assess the efficacy of these systems.
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.