time basis, no less.
"You're at a severe disadvantage if you don't have a dedicated staff
member in charge of constantly ensuring needed medications are on
hand," he says. "Make sure the person understands the critical impor-
tant of the job. If they don't, find someone else who does."
Erin Fox, PharmD, BCPS, FASHP, senior director of drug informa-
tion and support services at University of Utah Health Care in Salt
Lake City, monitors the drug market and updates the list of shortages
posted on the ASHP website.
"Keep constant tabs on your own supply in order to determine how
much product you have on hand and how long that supply will last,"
says Dr. Fox. "It's important to have a plan in place that you can
implement when shortages occur."
3. Stretch your current supply.
Make the most of medications
by investing in prefilled syringes, which limit waste, or split single
vials into multiple doses. Keep in mind, however, that vials labeled by
the manufacturer as "single dose" or "single use" should only be used
for a single patient. And you can't draw up medication from multi-
dose vials in patient treatment areas (the OR, procedure room or
patient bedside). You must draw them up in a room remote from the
procedure room using sterile technique.
Members of your surgical team might have to alter their preferred
practices and find creative ways to achieve desired outcomes. Dr.
Durick, for example, recalls when hyperbaric bupivacaine was on
backorder at his facility, and he struggled to find a viable alternative
for administering spinal anesthesia. Dr. Durick, who generally prefers
to place ultrasound-guided regional blocks, combined an adductor
canal block and iPACK block with injections of Exparel (liposomal
bupivacaine) around the incision site during a medial unicompartmen-
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