Vizient’s Conservation Strategies for Potential IV Fluid Supply Disruption

On October 7, Vizient shared a press release with Healthcare Purchasing News regarding the potential IV fluid supply disruption caused by Hurricane Helene:

Due to the impact to the Baxter International, Inc. North Cove facility in Marion, N.C. from Hurricane Helene, Vizient has published a conservation guide for adult and pediatric IV push medications. Baxter's North Cove plant is a major producer of large volume IV fluid bags used for patient care in the U.S. The guide includes detailed information for providers, which will help conserve inventories during this time of potential supply disruption while maintaining the delivery of safe patient care.

"Vizient has been closely monitoring the situation since the storm hit and we are in communication with officials at Baxter as they assess the impact to the facility and their employees," said John Thompson, senior vice president, med/surg, lab and capital equipment for Vizient. "Because this facility is a significant producer of large volume IV fluids for the U.S., which includes saline, dextrose and lactated ringers, we are encouraging healthcare providers to take immediate action to manage their inventory and implement conservation strategies to help mitigate the risk of shortages."

Strategies 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.

"IV fluids are a foundational component of basic medication preparation and compounding for hundreds of drugs. Immediately implementing conservation strategies will be important to help minimize supply disruptions as the supply chain works to recover," said Mittal Sutaria, PharmD, senior vice president, pharmacy contract and program services for Vizient. "This guide gives providers a list of medications that can be administered as IV push or slow IV injection in instances of bulk IV fluid shortages."

Conservation strategies for IV fluids in general include:

• Actively review patients on IV fluids or IV medications to assess discontinuation or the ability to switch to an alternative route of administration, as clinically appropriate.
• Utilize oral rehydration in place of IV fluids when able.
• In instances where oral medication administration is not feasible, consider intramuscular or IV push administration, to conserve fluids, as appropriate based on the medication.
• Consider preparing and dispensing medications that may be administered via IV push in ready-to-administer concentrations packaged in syringes.
• Increase the infusion time of IV fluids wherever applicable.
• Consider discontinuing practice of standing orders to keep infusion lines open and use intermittent line flushing to maintain patency.
• Review ASHP recommendations for management and conservation of Small- and Large-Volume Fluids.

Additionally, Vizient is encouraging all manufacturers of IV fluids to increase production and inventory levels to help ensure providers have access to these solutions that are critical to safe and effective patient care.

The Adult and pediatric IV push medication reference guide can be accessed here.