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Lin MP, Vargas-Torres C, Shin-Kim J, et al. Am J Emerg Med. 2022;53:135-139.
Drug shortages can result in patient harm, such as dosing errors from a medication substitution. In this study, 28 of the 30 most frequently used medications in the emergency department experienced shortages between 2006 and 2019. The most common reasons for shortages were manufacturing delays and increased demand. The COVID-19 pandemic exacerbated pre-existing drug shortages.
Miller FA, Young SB, Dobrow M, et al. BMJ Qual Saf. 2020;30:331-335.
The COVID-19 pandemic has raised concerns about medical product shortages and demand surges, and the resulting effects on patient safety. This viewpoint discusses medical product supply chain vulnerabilities heightened by the COVID-19 pandemic. The authors summarize the evidence on supply chain resilience and medical product shortage, provide examples to illustrate key vulnerabilities, and discuss reactive and proactive solutions for medical product shortage.
Girion L, Levine D, Respaut R. Reuters. 2020;June 9.
The COVID-19 pandemic has disrupted the supply of protective equipment, medical devices and medications. This article discusses how economics contribute to drug shortages and highlights the specific impact on access to the opioids essential for providing safe care for hospitalized patients with COVID-19.

Institute for Safe Medication Practices and US Food and Drug Administration Division of Drug Information. June 23, 2020.

The COVID-19 pandemic response is creating a need for care delivery adjustments that include changes in pharmacy and medication practices. This webinar discussed process alterations that have the potential to impact safe medication administration and provide context for the changes to help ensure they are effectively implemented.
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.
Am J Health Syst Pharm. 2018;75:816-820.
This commentary summarizes the discussion of a multidisciplinary group of experts about drug shortages to highlight successes, opportunities for improvement, trends to consider, and strategies to plan for shortages. The group recommended actions needed to guide prevention and mitigation efforts such as developing best practices for use of high-alert drugs during shortages, increasing manufacturer transparency, and enhancing Food and Drug Administration improvement and communication activities.
National Alert Network. Horsham, PA: Institute for Safe Medication Practices; Bethesda, MD: American Society of Health-System Pharmacists. May 24, 2018.
Drug shortages can necessitate hospitals to find alternative sources for important medications. This alert raises awareness of risks associated with potassium chloride use due to variations in labeling, packaging, or concentration of outsourced medications. Recommendations include use of barcode scanning and communicating with staff regarding drug shortages.
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.
Holcombe B, Mattox TW, Plogsted S. Nutr Clin Pract. 2018;33:53-61.
Shortages of medications and compounding components can lead to diversion from recommended treatment. This review describes problems that can arise due to shortages in parenteral nutrition components. The authors recommend strategies to reduce risks associated with lack of ingredients for parenteral nutrition.

ISMP Medication Safety Alert! Acute Care Edition. January 11, 2018;23:1-4.

Drug shortages are known to disrupt the safety of care. This newsletter article reports the results of a survey exploring the impact of drug shortages on practice and recommends strategies to help organizations safely manage drug shortages, including standardizing processes and raising awareness among clinicians regarding shortages.
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. 
Chen SI, Fox ER, Hall K, et al. Health Aff (Millwood). 2016;35:798-804.
Drug shortages have been a persistent problem for several years and have been shown to affect patient safety. The Food and Drug Administration Safety and Innovation Act of 2012 was intended to address these shortages. This analysis found that while shortages have decreased since the act was passed, problems with drug supply for acute care facilities remain.
Reed BN, Fox ER, Konig M, et al. Am Heart J. 2016;175:130-41.
Patients hospitalized with cardiovascular conditions are particularly vulnerable to medication errors. This review explains how drug shortages associated with cardiovascular medications pose risks to patients and provides recommendations for clinicians, policymakers, and manufacturers to address this problem.
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.