The Ripple Effect 

In recent months, we’ve helplessly watched as not one, but three successive events left our East and Gulf Coasts reeling, sending waves throughout our supply chain and across the country. Two hurricanes caused extensive injury and loss of life, along with major damage to homes, business, factories, and infrastructure while a port strike, tucked in between Hurricanes Helene and Milton, temporarily halted the flow of goods in and out of American ports on the East Coast.  

Hurricane Helene forced the temporary closure of the Baxter facility in Marion, North Carolina, and that closure led to a supply disruption that most of you are already feeling. According to the U.S. Department of Health and Human Services, “The Baxter facility provides a significant portion of IV solutions, irrigation fluids, and peritoneal solutions to the U.S. medical system. There are currently shortages of normal saline IV fluids, normal saline irrigation fluid, sterile water irrigation, and dextrose 5% IV fluids that pre-date Hurricane Helene. The hurricane-related supply disruption at the Baxter facility will likely lead to further constraints for IV fluids.”¹ 

Making the Most of What You Have 

Many of us are already seeing our supply shelves looking less full than before, and we’re feeling the effects of this critical shortage. Knowing that IV fluids are critical for our surgical patients, but hearing about a shortage and seeing shelves empty can lead to feelings of worry, fear, and anxiety. But rather than being crippled by fear, there are things that all of us can do, despite the shortage, to make the most of the fluids that we do have to maximize their reach.  

Conserve 

This is so important. Do you need to hang two bags for that knee scope you’re about to do? Instead of spiking both, start with one. Communicate with your team to let them know you will only be hanging one bag at a time. This way, you can avoid opening bags that won’t be used. The same is true for other IV and irrigation fluids. Start with one. If a second (or more) is needed, then open it, but start with one and determine necessity prior to opening more.  

Also, make sure that IV and irrigation bags are used completely before changing them out. When using irrigation, none of us want to hear a surgeon telling us they ran out of fluid, but we do want to let those bags run all the way out before starting the next one. 

Chart Correctly

Your coworkers in Supply Chain/Materials Management depend on your charting for accurate data. The preference card that is loaded into your EMR may or may not accurately reflect the supplies that you have used for your case, including fluids. Not only do we need to make sure that our charting accurately reflects everything that was done for the patient, but also what was used; this is to ensure accurate billing for the patient and accurate planning by Supply Chain.  

 Without accurate data, Supply Chain cannot demonstrate proper usage of supplies. If they can’t accurately predict how much a department will need, they can have deficits in availability. And while IV fluids are currently on allocation, allocation is still based on usage. Charting is the best way for Supply Chain to get up-to-date, accurate data on how much product is being used, so let’s make sure they’re getting good numbers.   

Stay Informed! 

New information and updates related to the IV fluid shortage are coming out regularly. Stay up to date on what’s happening at your facility by paying attention to the guidance provided by hospital leadership related to fluid usage and conservation. Know what fluids you have available in your department, and what substitutes have been approved.  This is often discussed in your morning huddles, team meetings, and staff meetings, so make sure to attend and pay attention! 

You can also review AORN’s Periop Nurse Emergency Resource Center for resources and information  on planning for supply disruptions.  

Above all, don’t panic. Resources may be strained, but this is a time for resourcefulness and teamwork. We can adapt, and by working together we can still provide the safe, high-quality patient care that we provide every single day.  

Reference 

1. Letter to Health Care Leaders and Stakeholders on Impacts of Hurricane Helene from Secretary Becerra. News Release. U.S. Department of Health and Human Services. October 9, 2024. Accessed December 8, 2024. https://www.hhs.gov/about/news/2024/10/09/letter-health-care-leaders-stakeholders-impacts-hurricane-helene-secretary-becerra.html