IV fluid shortage drives innovation in hospital hydration practices

Editor's Note

A nationwide shortage of intravenous (IV) fluids is forcing hospitals to adopt conservation strategies that could reshape hydration practices long-term, KFF Health News reported November 19.

The shortage was driven by Hurricane Helene’s damage to Baxter International’s North Cove facility, which is responsible for 60% of US IV fluid production. According to the article, the plant has resumed limited production, but normal supply levels may not return until late 2024.

Hospital responses to the shortage cited in the article include:

• Aggressive conservation: Inova Health System has reduced IV fluid usage by 55% since October through conservation measures such as evaluating hydration needs and using "push medications," which administer drugs intravenously without fluid bags.
• Redefining practices: Hospitals are leveraging electronic health records (EHRs) to prompt reassessments of IV fluid orders, encouraging alternative hydration methods like oral fluids for patients able to consume them. Inova's system-wide approach demonstrates the impact of small adjustments, such as limiting unnecessary second IV bags.
• Operational adjustments: Initiatives like fully utilizing IV bags started by paramedics and encouraging patient self-hydration with drinks like Gatorade could reduce environmental waste and improve efficiency. However, sources cited in the article remain cautious about long-term effects.

Challenges and risks remain, KFF reports. Nurse workload is one concern, with push medications requiring more time for administration and patient monitoring. Another is seasonal pressures, with hospitals facing rising demand for IV fluid amid increases in respiratory virus cases and demand for end-of-year-surgeries.