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Scarce Resources

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Scarce Resources Article Nurses depend on a variety of resources every day that affect patient care. Staffing issues and supply shortages are sometimes daily battles. A growing concern is drug shortages to hospitals, clinics, and doctor’s offices. Drug shortages can affect drug therapy, postpone medical procedures, and result in medication errors. An article published in the American Journal of
Nursing in November 2011 discussed the national impact of the drug shortage on health systems.
Since 1996 the problem of drug shortages has steady increased. As of 2011 there were 232 drugs on the national drug shortage list. “The areas most commonly reported shortages were surgery and anesthesia, emergency care, cardiovascular care, gastrointestinal and nutritional care, and pain management. Thirty-five percent of hospitals reported that the shortages had resulted in adverse outcomes” (Carter, 2011, p. 14). One specific example is the propofol shortage. Propofol is used for sedation during procedures and ventilated patients. Alternative medications are more difficult to titrate resulting in under or over sedation (Carter, 2011).
There are several factors that contribute to the national drug shortage. The lack of available raw or bulk materials has a significant impact on drug shortages. “Raw material shortage can result from a number of factors, including a sole source manufacturer that ceases operation, suboptimal quality of the raw material, and wars that disrupts importation” (Brown, Gu, Shaya, & Wertheimer, 2011, p.1) . Natural disasters may also affect the drug shortage by affecting the availability of raw materials needed to produce the drug. The majority of raw materials are obtained from foreign markets; therefore a disaster in that region as a direct affect on the ability to manufacture medications. An unexpected demand secondary to a disease outbreak can affect the drug shortage. Lack of notification of drug discontinuations to the Food and Drug Administration (FDA) adversely affects the drug shortage. Currently “manufacturers are not obligated to inform FDA about product discontinuation plans unless their product is the only medication to treat a life-threatening condition or debilitating disease” (Brown, Gu, Shaya, & Wertheimer, 2011, p. 1) . Last, there is a lack of communication and awareness among facilities about impending drug shortages. The most significant consequence of not addressing the problem is that patients are dying. A reported 15 deaths have occurred in 2012 secondary to errors associated with the recent medication shortage (Ellman, 2012). In the instance of cancer treatments, patients are denied treatment options secondary to the shortage. Perhaps the biggest challenge of this dilemma is that there does not seem to be a solution to the crisis. The most practical solution to this complex problem is allocation of resources. This is a difficult process and requires interdisciplinary cooperation among pharmacy, medical, and nursing staff. The current medication supply should be allocated to those patients in greatest need, with alternative medications utilized for other patients. One study suggested that an estimated $216 million was spent annually to manage drug shortages across the nation (Faloon, 2012, p. 2). The lay public can get involved by political involvement in legislation that both the Senate and House of Representatives are considering in regards to the national drug shortage.
Improvement in the drug shortage crisis requires the collaboration of those involved in medication administration and delivery. In October 2011, the President joined the crusade to resolve the drug shortage issue by signing an executive order helping the FDA to initiate efforts to relieve the drug shortages. Communication between the FDA, manufactures, and health care delivery systems is essential to resolving this crisis.

References
Brown, B., Gu, A., Shaya, F., & Wertheimer, A. (2011). Drug Shortages in the US-Causes, Impact, and Strategies. Innovations in Pharmacy, 2(4), 1-8.
Carter, D. (November 2011). Drug Shortage Crisis Affects Patients and Nurses. AJN, 111(11), 14.
Ellman, G. (June 2012). Drug Shortages: Your 20-step guide to Survival. EMSWorld, 41(6), 26-32.
Faloon, W. (April 2012). Lethal Shortages. Life Extension. Retrieved from http://www.lef.org.…...

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