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In this PSNet Annual Perspective, we worked with co-authors Dr. Jacqueline C. Stocking, a quality improvement and critical care specialist, and Dr. Christian Sandrock, a patient safety professional and emerging infectious diseases specialist, to provide a look at news and research related to the impact of the COVID-19 pandemic on patient safety.

Alexander GC, Qato DM. JAMA. 2020;324:31-32.
The COVID-19 pandemic has raised concerns about the pharmaceutical supply chain, from overseas manufacturing to medication distribution within the United States. This commentary presents several emergency response and preparedness measures for policymakers, pharmaceutical distributors and pharmacies to prepare for drug shortages and demand surges. Suggested measures include developing an “essential medicines” strategy, using allocation strategies that prevent stockpiling and drug shortages and expanding capacity for mail-order and home delivery.
Alpert A, Jacobson M. Clin Pharmacol Ther. 2019;106:415-421.
Drug shortages have become more frequent and may lead to delays in treatment or failure to deliver the appropriate drug, an error of omission. This secondary data analysis examined how oncology drug shortages affected use of chemotherapy medications among patients with newly diagnosed cancer as measured by Medicare claims data. The changes in utilization varied by medication; overall, drug shortages had only a modest impact on the delivery of these drugs to patients with newly diagnosed cancer. This finding contrasts with a prior study showing patient harm related to drug shortages, and the authors recommend further study to understand how to identify and mitigate clinically relevant drug shortages. A WebM&M commentary discussed strategies for preventing or minimizing adverse events associated with drug shortages.
A 1-month-old preterm infant in the NICU receiving the standard 500 mL bag of 0.45% sodium chloride (NaCl) with heparin at low rates developed hyponatremia. Clinicians recognized the need to deliver a more concentrated sodium solution and ordered that the IV fluid be changed to a 500 mL bag of 0.9% NaCl with heparin. However, due to a natural disaster affecting the supply chain for IV fluids, 0.9% NaCl 500 mL bags were in short supply, and the order was modified to use 100 mL 0.9% NaCl bags, which were available.
Fox ER, McLaughlin MM. Am J Health Syst Pharm. 2018;75:1742-1750.
Drug shortages are a persistent threat to safe patient care. These guidelines provide a structured approach for care teams to develop an action plan to reduce risks when faced with drug shortages in their work. Recommendations include conducting operational assessments, establishing a drug shortage team, and communicating with patients and providers when a shortage occurs.
University of Utah Drug Information Service; ASHP; American Society of Health-System Pharmacists.
Efforts to limit the availability of opioids has led to a shortage of needed medications. This fact sheet provides strategies for organizations who seek to improve management of injectable opioids while taking into account both safety and supply availability.
Institute for Safe Medication Practices; ISMP.
Drug shortages can contribute to treatment delays and complications that lead to patient harm. This survey sought insights from hospital directors of pharmacy regarding their experiences with drug shortages over the past 6 months. 
Geneva, Switzerland: World Health Organization; 2015.
Drug shortages have the ability to affect the patient safety in emergency departments, oncology services, and pediatrics. This report discusses the consequences of drug shortages, approaches different countries are taking to reduce their occurrence, and strategies such as proactive identification of potential supply limitations and collective agreements to manage shortages.
Fink S. New York Times. January 29, 2016.
Drug shortages have become a routine challenge in medicine. Reporting on the impact of medication shortages on care delivery and decision making, this newspaper article discusses processes in place to manage patient care as safely as possible and ethical dilemmas health care providers have faced in light of the reduced availability of medications.