University Patient Safety: Drug and Medical Supply Shortage Report

This report provides an in-depth analysis of the critical issue of drug and medical supply shortages and their profound impact on patient safety within the Irish healthcare system. The report begins by defining the scope of patient safety issues, highlighting the role of the Medical Council in Ireland. It then delves into the escalating problem of drug and medical supply shortages, affecting approximately 400 generic drugs and causing significant challenges in healthcare practice. The report explores the various causes of these shortages, including manufacturing issues, raw material scarcity, and the impact of industrial consolidations. The report discusses the strategies implemented by the Health Products Regulatory Authority (HPRA) to manage these shortages, including therapeutic consultations and importation of essential drugs, and emphasizes the need for continuous care and patient protection. The report concludes by underscoring the indirect costs and potential life-threatening consequences of these shortages, while also mentioning governmental strategies to mitigate these challenges, such as subsidizing the production of organic medication to reduce costs. The report also references several studies and journals to support its findings.

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DRUG AND MEDICAL SUPPLY SHORTAGE
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Introduction
The patient safety problem is where the patient develops a disease, especially during the
provision of medical services or when the problem could have occurred, but it was prevented. In
Ireland, the role of patient safety lies in the heart of the Medical Council. There have been
several issues of patients with medical mistakes, this has been a challenge to the healthcare
system and several strategies to look into the matter of patient safety have been put in place,
including all the patient safety issues like nurse-patient ratio, drug, and medical supply shortage,
resurgent diseases, physician burnout, mergers acquisition as well as quality reporting (Virginio
and Ricarte, 2015).
Drug and medical supply shortage
Drug shortage threatens the healthcare in Ireland and as well the public health by creating
barriers to optimum care. This issue of drug shortage has risen over the recent past and is now
influencing a wide area of healthcare practice. Approximately 400 and above generic drugs have
been affected, causing institutions to purchase costly drugs to substitute alternative diseases.
Scarcity and cost have a negative impact on the patients and the ability of healthcare
organizations to respond to the patient's needs.
Although the constant fluctuation and shortage have influenced the high cost of health care
facilities, this shortage is being looked into, and therefore the ongoing shortage is being reduced
(Slawomirski, Auraaen, and Klazinga, 2017). The variable deficiency has made planning to be
very difficult. Most times there is lack of medication and its equivalent alternative is not also
available for instance the succinylcholine for anesthesia, resulting in surgery cancelation when
an alternative paralysis is not appropriate. There are some other patients who are required to use

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aminocaproic acid during open-heart surgery but end up not using it due to its limited supply.
The decisions to reserve drug supply for emergency use and prefilling syringes with pharmacy
supervision to extend the stability of the patient has been adopted, which is a short term solution
to more significant systemic issues. Most of the time, this reduces positive health outcomes and
disrupts patient health. This drug supply shortage has been experienced, particularly in
emergency medicine and chemotherapy. However, the impact of drug shortage has been
analyzed due to unique procurement procedures.
Drug shortage has affected patients' ability to manage their sickness and leaving pharmacists to
scramble for essential drug supplies. There have been issues with patients who are being
supplied with erratic drugs. The most affected drugs include the blood pressure pills and anti-
inflammatory drugs which treat arthritis. Most patients who are not able to get their medical
supplies are always advised by their patients to take second option pills or to ration their supplies
so that it can serve them for a longer period. According to the review journal of pharmacists in
Ireland, the pharmacists believe the problem of drug supply shortage goes more profound than
the problem of hoarding of drugs because of the fear that there will be low stock after Brexit.
The reason why there is drug price fluctuations is the way some of the pharmaceutical plants
now produce one kind of medicine before going on to batch another, creating depletion of stock
hence the gap between delivery and product. Supplies most times as well are slowed down due to
false medication directives. The management of drug shortage is responsible for the health
products regulatory authority which is the medicine watchdog (Enright et al, 2016). However,
the drug shortages only reflect a small portion of gaps in supply at any time.
Drug rationing affects most of the population as we spend time trying to plead with the various
functionaries to release drugs for patients with urgent needs and require essential medications

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(Daker-White et al, 2015). This multifaceted shortage of drugs is mostly caused by the shortage
of raw materials, difficulties in the manufacturing industry, several quality defects, industrial
consolidations and parallel trade in the medical market (Bowie et al, 2015). There has been a
continuous response to ensure patient safety problem is being looked into, for instance,
continuous care and protection in public health.
The Health Products Regulatory Authority (HPRA) has a coordinating function in Ireland's
response to the medicine shortages. They say information regarding shortage on the HPRA
website is dynamic and changes depending on the information given at hand, including removal
from the list when shortage has been resolved (Leisy and Ahmad, 2016). In the cases where
patients were not treated as a result of lack of proper medication or deficiency, and the
medication prescribed is unavailable patients are being switched to proper therapeutic
consultation as directed by the healthcare professionals.
The patient safety strategy has adopted six commitments that ensure the patient safety problems
have been addressed in order to prioritize patient safety in the Ireland government (Nevin and
Byrd 2016). There have been reactions toward a shortage of critical medications like the cancer
drugs Doxil. Pharmaceutical Industries as well have been given mandate with the provision of
raw materials to produce generic drugs. Though there are no clear indications on when the
shortages will ultimately end, as well as their impact since they are predicted to be available for a
little longer and advances are being put in place to mitigate them a bit faster.
In assessing the patient safety concerns, facilities have identified a history of transferring patients
to the best alternative site where they are likely to be provided with the required medical
attention which is not provided locally (Magrabi et al 2015). There are also other strategies that

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have been put in place that provide for this shortage like the importation of essential drugs to
help mitigate the extent of the impact of shortage to the patients (Illingworth, J., 2015).
Conclusion
Drug and medical shortages has presented a barrier to quality and efficiency across health care
institutions. The indirect costs have also impacted further the healthcare system as well as patient
health which might lead to death since not so many of them are able to afford costly medication
and even so the medications most times are not readily available due to shortage. This has an
impact on altering the health protocol. However, several governmental strategies have been put
in place to look into the matter of shortage by importation and even subsidizing the production of
organic medication to reduce the cost for the drugs.

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References
Bowie, P., Forrest, E., Price, J., Verstappen, W., Cunningham, D., Halley, L., Grant, S., Kelly,
M. and Mckay, J., 2015. Good practice statements on safe laboratory testing: A mixed methods
study by the LINNEAUS collaboration on patient safety in primary care. European Journal of
General Practice, 21(sup1), pp.19-25.
Daker-White, G., Hays, R., McSharry, J., Giles, S., Cheraghi-Sohi, S., Rhodes, P. and Sanders,
C., 2015. Blame the patient, blame the doctor or blame the system? A meta-synthesis of
qualitative studies of patient safety in primary care. PLoS One, 10(8), p.e0128329.
Enright, A., Merry, A., Walker, I. and Wilson, I., 2016. Lifebox: a global patient safety
initiative. A&A Practice, 6(12), pp.366-369.
Illingworth, J., 2015. Continuous improvement of patient safety. The case for change in the NHS.
London: The Health Foundation.
Leisy, H.B. and Ahmad, M., 2016. Altering workplace attitudes for resident education
(AWARE): discovering solutions for medical resident bullying through literature review. BMC
medical education, 16(1), p.127.
Magrabi, F., Baker, M., Sinha, I., Ong, M.S., Harrison, S., Kidd, M.R., Runciman, W.B. and
Coiera, E., 2015. Clinical safety of England's national programme for IT: A retrospective
analysis of all reported safety events 2005 to 2011. International journal of medical
informatics, 84(3), pp.198-206.

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Nevin, R.L. and Byrd, A.M., 2016. Neuropsychiatric adverse reactions to mefloquine: a
systematic comparison of prescribing and patient safety guidance in the US, UK, Ireland,
Australia, New Zealand, and Canada. Neurology and therapy, 5(1), pp.69-83.
Slawomirski, L., Auraaen, A. and Klazinga, N.S., 2017. The economics of patient safety.
Virginio Jr, L.A. and Ricarte, I.L.M., 2015, August. Identification of Patient Safety Risks
Associated with Electronic Health Records: A Software Quality Perspective. In MedInfo (pp. 55-
59).