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Intravenous amino acid shortage
By Sarah Gloeckner, Clinical Nutrition supervisor
Salem Health has been out of stock of IV amino acids used for parenteral nutrition (PN) for adults since Monday, Dec. 4. We are currently compounding PN without amino acids for adult patients. This stock issue is due to a nationwide shortage precipitating from ongoing IV medicine shortages, exacerbated by hurricanes affecting manufacturing locations of IV nutrition products.
Pharmacy has been pursuing alternate products and sources. Pharmacists and dietitians have been preparing to use whichever IV amino acid products are procured. We are also considering ethics and evidence in triaging product use. Supply may change on a day-to-day basis.
If you are considering initiation of PN for a patient, the best first action is to communicate with a dietitian to consider supply available and oral/enteral nutrition options whenever possible. Unit-assigned dietitians may be contacted via WebXchange Dietitian Staffing Lists or via Care Team listed in a patient’s EPIC chart. It is also important to consider timing – resources are managed most effectively during a shortage when these standards are followed:
- MD Consult to Nutrition Support Team be entered in EPIC by 1000.
- Dietitian works with Provider and Pharmacy to determine initiation plan & formulation by 1200.
- TPN bags are administered to patients around 1800 daily. If a patient is to be discharged from the hospital or you are considering stopping PN for a patient, please communicate with a dietitian and or pharmacist as soon as possible (by 1200) so that compounding can be held and product preserved for other patients.
Please contact Sarah Gloeckner, Clinical Nutrition supervisor, with further questions 503-814-0542.