So far, all Knoxville hospitals say they've been able to avoid canceling surgeries or forgoing medications patients need, but it's taken some creative planning in some cases.
Covenant Health, which operates nine area acute-care hospitals, has a multi-hospital pharmacy task force looking at ways to deal with the shortage.
"Over the past couple of months, Covenant Health hospitals have managed existing IV resources, shared supplies throughout our health system and found alternative manufacturers to help cover any delivery gaps," said Dr. Mark Browne, senior vice president and chief medical officer for the hospital system. "We have used different medication delivery procedures as needed, such as having nurses administer antibiotics directly into an IV line rather than using a bagged IV solution. As a result, our patients have continued to receive all medications without interruption, and Covenant Health has not experienced any cost increase."
"Pushing" antibiotics through an IV line can be more time-consuming for nurses, but it's an alternative in some cases. Some hospitals also are using the larger saline IV bags, typically used to give fluids, in place of the smaller ones typically used to give medication diluted in a saline solution.
East Tennessee Children's Hospital continues to track daily inventory of the supplies but so far hasn't had to postpone surgeries or withhold needed treatment from patients, said Erin Estep, public relations manager for the hospital.
Dr. Jerry Epps, senior vice president and chief medical officer for University of Tennessee Medical Center, said the regional trauma center and teaching hospital is dealing with shortages "by working with team members to change practices and prescribing habits that in turn help preserve the products we have for those who clinically have no other alternatives."
Both Epps and Russell Marriott, vice president of marketing and development for Tennova Healthcare hospitals in East Tennessee, said their hospitals are working to find other FDA-approved suppliers for the products.
Baxter International Inc., whose plants in Puerto Rico produce 44 percent of the IV bags used by U.S. hospitals, sustained major damage from Hurricane Maria. The FDA said last week production at the plants — which now have intermittent power and back-up generators — is still "fragile" but should improve over the next two months. Manufacturer B. Braun Medical Inc., which produces another 10 percent of bags used in the United States, also is facing production issues, some of which predated the hurricane.
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