IV Infusion Supply and Finding the Light in the Uncertainty

Hospitals and clinics are overwhelmed with surges in covid and influenza patients as they continue to manage the impact of the global supply chain crisis with many critical IV infusion supplies on shortage. After starting winter with rampant IV fluid bag and diluent vial shortages, the newest victim in the cascade of IV infusion supply shortages are dedicated ambulatory pump tubing sets. The National Home Infusion Association released Guidance for Addressing Shortages of Administration Sets for Ambulatory Infusion Pumps directing Clinicians to utilize alternative infusion solutions like elastomeric infusion pumps and gravity infusion with flow-regulators whenever possible. Facilities are turning to these classic infusion modalities to safely deliver IV infusion therapies and are discovering new patient and operational benefits along with upgraded device and manufacturing technologies, enabling them to continue to deliver exceptional care amid revolving supply disruptions.

Kaiser Health News reported on the healthcare supply crisis, with procurement experts predicting challenges will continue for another 18 to 24 months. Clinicians are preparing for lingering IV infusion supply shortages by evaluating their medication distribution practices, embracing alternative technologies and relying on traditional infusion solutions to deliver therapies ranging from antibiotics and chemotherapy to monoclonal antibody infusions.

Elastomeric pumps have been a formidable competitor to mechanical pumps for decades, offering a cost-effective and safe infusion solution. With the dedicated ambulatory pump tubing sets in short supply, clinicians are relying on SMARTeZ elastomeric pumpsthat are individually calibrated for accuracy to fill the gap.

Elastomeric Opportunities:

• Elastomeric pumps provide a cost-effective and safe infusion solution
• Long history of use in the home infusion and long-term care settings
• Provide intermittent & continuous medication delivery including antibiotics, electrolytes and chemotherapy
• Offer an extensive collection of flow rates and fill volumes
• Silent, light-free, discreet functioning without batteries or IV poles

Today pharmacies across the country are reviewing SMARTeZ elastomeric pumps for monoclonal antibody infusions. When considering elastomeric pumps, the drug reservoir composition, data supporting safe medication storage and compatibility, and accuracy should be reviewed. Not all elastomerics share the same safety, design or manufacturing technologies. Outpatient infusion centers, home infusion, and long-term care pharmacies appreciate the fixed flow-rate disposable elastomeric pumps that eliminate complicated pump programming and exhausting inventory management.

It was not too far in the past that gravity infusions with integrated dial-calibrated flow-regulators were one of the most common infusion modalities, allowing for cost-effective controlled medication delivery. Ambulatory mechanical pumps and elastomeric pump technologies introduced new options for medication delivery, but simple flow-regulators are still commonly used for thousands of medication doses. Pharmacies, infusion centers and physicians are turning to this cost-effective infusion solution for monoclonal antibody infusions in the treatment of COVID-19 infections, utilizing flow-regulators with integrated 0.2 micron low-protein binding in-line filters. Amid the ambulatory infusion set shortage, many clinicians are turning to traditional gravity infusion with PMI Flow-Regulators to deliver antibiotics, hydration, immune globulins, monoclonal antibodies and other medication types.

PMI Flow Regulator Opportunities:

• They help to reduce the risk of free flow and air bolus
• Available with easy to read and smooth adjusting rate flow dial
• Available in needle-free Y-site configuration for secondary infusion
• Options include 0.2 micron and 1.2 micron low-protein binding in-line filter

When confronting IV infusion supply shortages, the review of alternative sources, modalities, and therapy options can be a complicated and exhausting task. The level of operational, economic and clinical value that these medical devices deliver will ultimately determine their staying power when alternative supplies stabilize. Comprehensive education and training, ease-of-use, safety and accuracy are critical considerations when selecting an infusion modality, and availability should never be the only factor when making these changes in practice.

Sourcing alternatives to critical IV infusion supplies and drugs has become an unfortunate reality in pharmacy and the last year has seen unprecedented demands on our healthcare system and its finite resources, but facilities are embracing the opportunity to learn and adapt in the face of constant adversity and disruption. With nearly two years of the turbulent pandemic behind us and likely another couple of years of aftershocks in supply disruptions ahead, finding the light in the uncertainty can be difficult but is not impossible. Reviewing medication distribution practices, considering alternative infusion solutions and modalities or distribution models can be daunting but is the hallmark of this years’ resilient healthcare organizations.