From: Dima Awad, PharmD, MS, System Director of Pharmacy Services
Date: August 31, 2017
Re: D5W/0.45% NS Shortage
We are experiencing a shortage in D5W/0.45% NS.
Medications including IV fluid shortages keep occurring at great frequency, this situation has been worsening over the past several years due to multiple factors such as fewer suppliers, inability to acquire active ingredients, issues with packaging and more.
Currently, Pharmacy services has a 1 day supply of D5W/0.45% NS. When the current supply of D5W/0.45% NS becomes depleted, a plan for automatic substitution needs to be implemented. This is not a new workflow nor is it a change in practice in case of shortages.
When supply becomes depleted, Pharmacy services will initiate substitution with D5W/0.225% NS, to be administered at same infusion rate that was ordered. Pharmacy services will place “Substituted for D5W/0.45% NS” in the comment section of the Paragon order so that nursing is aware of the change. This substitution has been approved by The Pharmacy and Therapeutics Committee. Pharmacy will also maintain vigil on availability of D5W/0.225%, as we anticipate that increased use will decrease supply.