SURGICAL/CTRITICAL CARE pharmaceutical manufacturing plant in
Daytona Beach, FL. The site will produce 0.9% sodium chloride for injection available in B. Braun’s Excel Plus IV Bags in 1,000 mL and 500 mL sizes.19
This was followed just two months later in
March 2022, by B. Braun’s announcement of voluntary recall of five lots of . sodium
Infusion therapy scheduling in the face of supply and staffing shortages
The complex model of scheduling patients for infusion therapy has become even more challenging as infusion centers face both staff and supply shortages, according to Obehi Ukpebor, Director of Customer Suc- cess for Infusion Centers, LeanTaaS. “It is almost impossible for infusion
centers to predict demand,” said Ukpebor. “Someone is going to walk in tomorrow, get a cancer diagnosis and for the next eight weeks will need treatment. If you don’t have the right personnel, with the right equipment, in the right room, at the right time, with the right patient, you can’t perform that service at that time.” Ukpebor says today most infusion appointments are made through an open calendar or block-based scheduling where patients are scheduled on a first-come, first-served basis. There is no supply versus demand logic behind it; therefore, centers cannot effectively balance patient needs with clinician and equipment/supply availability. Complicating the scheduling are factors
such as variability in the type and duration of treatment required by patients at each appointment and matching patient needs to clinician skill set so staff members are practicing at the top of their licenses. From a supply perspective, infusion centers must consider the number of pharmacy techs they have available to prepare drugs for infusion, and whether this meets patient demand on any given day. Ukpebor says LeanTaaS applies machine learning and predictive analytics to help infu- sion centers achieve the correct balance of patients, services, staffing and supplies. By providing projections of scheduled and predicted volume, centers can better plan resources to meet demand. His advice to infusion centers: “Listen to your nurses. They know a
lot more about what is happening on the floor and are a lot closer to the patients’ needs. Talk to them to make sure the data makes sense.”
chloride for injection USP 250ML in Excel due to fluid leakage or low fill volume of the respective containers.”20
At the time this article was written (September 2022), the FDA listed shortages of sodium chloride 0.9% injection bags across 52 different products from six manufactur- ers (B. Braun Medical, Baxter Healthcare, Fresenius Kabi USA, Hospira, ICU Medical and Laboratorios Grifols) citing reasons including demand increase and manufac- turing delays.21
Medical plastics shortages add more sup- ply pressures
It is not only IV solutions in short supply, but also medical plastics that are key to the production of IV administration prod- ucts, including IV tubing, catheters, and syringes. These shortages were spurred by the COVID-19 pandemic and further aggravated by a February 2021 winter storm that shut down oil fields and refineries in Texas that produce petrochemical prod- ucts used in plastic products, including medical products. Supply costs in general, whether in
short supply or not, have skyrocketed for healthcare organizations since the pandemic began. In its Fall 2022 report, The Current State of Hospital Finances, KaufmanHall notes how expenses for supplies are pro- jected to grow by $11 billion in 2022, primar- ily due to inflationary pressures.22 Group purchasing organization (GPO) Premier also predicts that the Russia/ kraine war will impact the global supply and pricing of plastics due to “disruption to crude oil and natural gas production and flow in Eastern Europe or ussia. n the 2022 Premier Supply Chain Report on mpacts of ussiakraine Conflict, the GPO states,” Both natural resources are used in the production of plastics, which in turn, are used to manufacture multiple healthcare products such as trays, syringes, specimen bottles, pill containers, sharps containers, and much more.”23
What is the path forward? HPN reached out to IV saline solutions manufacturers to understand the challenges facing healthcare organizations because of shortages and obtain their recommenda- tions on how providers can maintain con- sistent and effective IV therapy to patients. BD offered its response. “No industry is immune to current supply chain volatility,” said Rian Seger, Vice President and General Manager, Medication Delivery Solutions, U.S. Region at BD.
16 November 2022 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
“Hospitals are no exception, and we recog- nize the critical role BD plays in maintaining supply for products that are needed for undisrupted patient care like those for therapy. We also understand that healthcare organizations are feeling pressures from labor
Rian Seger
challenges, reimbursement, supply disrup- tions and inflation, to name a few. “BD is committed to helping overcome
these challenges – and it’s why we continue to invest in innovation, supply continu- ity and capacity for these essential medical devices,” Seger continued. “This includes building redundancies to source raw mate- rials, engaging policymakers to prioritize medical supply production and expand- ing U.S. manufacturing capacity. In fact, BD has increased supply of these devices to help overcome other challenges in the market, and we will continue to turn on new capacity.”
“We have dedicated teams at BD that
can provide support on product capacity and innovation, as well as training and education, clinical assessments and more, to help healthcare organizations make the right choices for their patient needs,” Seger added.
Resources for healthcare providers Given continued IV supply disruptions, ongoing spread of COVID-19, and experts predicting a severe flu season for - based on flu levels in the outhern Hemisphere, it is in the best interest of .. healthcare providers to keep abreast of shortages and alternatives. Here are a few of the industry resources available online. Earlier this year, the U.S. Food and Drug Administration (FDA) published a letter to healthcare personnel on its website (www.
fda.gov) with prefilled saline flush syringe conservation strategies24
The Institute for Safe Medical Practices (ISMP) has guidance on its website (www.
ismp.org) for both pharmacy personnel and nurses on managing shortages of 0.9% sodium chloride, sterile water for injection, and EPINEPHrine.25
The ASHP Drug Shortages Database, accessible on its website (
www.ashp.org), provides an up-to-date list of shortages, reasons for them, and available products.26 The National Home Infusion Association (NHIA) has compiled product shortage recommendations to help clinicians man- age patient care and conserve prefilled 0.9% sodium chloride syringe supplies,
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60
