Here & Now

Wisconsin Still Struggles With IV Bag Shortage

Frederica Freyberg:

Now for a closer look at a Wisconsin story that has its roots in Puerto Rico. Specifically, the damage done in Puerto Rico in the wake of Hurricane Maria last fall. That’s when major manufacturers of IV bags were destroyed, halting the export of those medical supplies from Puerto Rico to the U.S. and the world. Supplies are still limited. State hospitals are taking steps to conserve IV solution. The Wisconsin Hospital Association reports that some health care facilities are now rationing IV solutions bags. Ann Zenk is an RN and the association's vice-president of workforce and clinical practice. Thanks for being here.

Ann Zenk:

Thanks for having me.

Frederica Freyberg:

This hurricane happened in September and there have been shortages ever since then, presumably getting worse by the day. What is it like right now?

Ann Zenk:

Right now hospitals are continuing to be able to cope in Wisconsin without it impacting directly on patient care. But that means they’re having to make a lot of conservation efforts.

Frederica Freyberg:

And so it’s described as conservation efforts and rationing. We kind of take it for granted that hospitals are going to have all of the medical supplies that are needed. But have hospitals ever seen anything like this?

Ann Zenk:

We've seen medication and IV fluid shortages in the past. I think the difference in this shortage is it’s been of such long duration.

Frederica Freyberg:

Has the flu season made things worse?

Ann Zenk:

It has the potential to. It hasn’t seemed to have impacted it yet. But just like this duration has been — this shortage has been going on for a long duration, if flu season is extended, that could also impact it.

Frederica Freyberg:

The conserving. What are hospitals doing as alternatives to IV solutions?

Ann Zenk:

The original shortage started with IV mini bags, those little bags you see hanging from the IV pole that we put the medication in. Hospitals aren’t using those. They’re using syringes instead or they’re using bigger bags.

Frederica Freyberg:

And so what is that like for both the providers and the patients?

Ann Zenk:

Sure. So for the providers, it’s much more labor-intensive. Instead of hanging a bag and then going to check on other patients, perhaps a nurse has to remain by the bedside. For patients then they would experience it as staff being at their bedside for longer periods. Maybe if you’re a cancer patient who’s getting continued care, instead of the nurse coming in and hanging the bag, you may have questions about why are you doing with a syringe instead?

Frederica Freyberg:

It's got to be very difficult in busy hospital care centers where the nurses and staff are really having to spend so much more time. What’s that like on the floor?

Ann Zenk:

Yeah. On the floor what we’ve experienced is that, you know, nurse managers maybe have to schedule differently, schedule more nurses on a shift. In our pharmacies, the pharmacy technicians and the pharmacist may have to work longer hours, use different supplies. It’s really been labor-intensive and supply-intensive.

Frederica Freyberg:

Has it gotten to the point where people have to reschedule procedures or go to different hospitals or facilities?

Ann Zenk:

No. I think our hospitals have done a great job of the conservation efforts preventing that from happening.

Frederica Freyberg:

Yet what are they saying?

Ann Zenk:

The hospitals?

Frederica Freyberg:

Yeah.

Ann Zenk:

What they're saying is boy, we sure hope this is over soon. The conservation strategies — and that’s part of the reason that we did do this survey. We wanted to make sure that our health care professionals are being able to cope with those shortages without having to delay treatment or reschedule care. And so far we’ve been able to cope.

Frederica Freyberg:

Meanwhile, what can be done about this?

Ann Zenk:

Right. Right. At a local level, at the bedside level, we are going to continue those conservation strategies to make sure patients get the care they need with the supplies they need. Kind of at the next level up, we’re going to continue doing what we always do in Wisconsin, and that’s help our neighbors. So hospitals share supplies between themselves to make sure that lasts.

Frederica Freyberg:

What about the Food and Drug Administration at the federal level? Are they doing enough, in your mind?

Ann Zenk:

Right. The FDA controls the IV supplies and who can manufacture them. And we are seeing kind of the end in sight because the FDA has approved additional manufacturers outside of Puerto Rico and now those manufacturers either as we speak or very soon are going to start shipping those supplies.

Frederica Freyberg:

Couldn’t come soon enough, I'm assuming. So what happens if the shortage gets worse?

Ann Zenk:

As the shortage gets worse, I think that we’re going to see hospitals continue to be creative. Hospitals and health care professionals continue to be creative about the mitigation strategies that they use. I think that in that case, you know, we may urge additional actions by the FDA to not just solve this current shortage, but also we need to stabilize this for the future and make sure that we have, you know, in the great health care that we have in Wisconsin, that we also have ready supplies in a reliable fashion.

Frederica Freyberg:

Absolutely. All right. Ann Zenk, thanks very much.

Ann Zenk:

Thank you for having me.