ISMP Survey on Patient Harm from the Drug Shortage Crisis

ISMP is conducting a nationwide survey to learn about patient harm that has occurred as a result of the ongoing drug shortage crisis. All aggregate information provided will be contextually de-identified so details of the events cannot be traced back to your organization. We are conducting the survey as a federally certified Patient Safety Organization, so the information you provide can be designated as patient safety work product and afforded additional federal protection from disclosure. We plan to use the aggregate information to advocate for legislative action to help reduce the adverse effects of drug shortages.

We are asking a representative from every healthcare facility to participate in this important survey if any of your patients have been harmed in any way by the drug shortage within the past 5 years! Your participation may contribute to much needed reform at a national level. Please provide your responses to ISMP by February 29, 2012.

Please provide the following information about each event related to a drug shortage that harmed a patient within the past 5 years. Use a separate form/entry to report each event.

1. List the medication(s) not available or in short supply that were involved in the event.

Medication
Manufacturer

2. List any alternative medication(s)/dosage form(s)/strength(s) used in place of the medication in short supply associated with the event
(enter NA if the patient did not receive an alternative medication).

Medication
Manufacturer

3. List the month and year that the event happened.

4. Describe the type of patient harm that resulted.

5. Provide a narrative description of the event, including how the drug shortage contributed to patient harm.

6. Select the description(s) that portrays the type of error or problem that resulted in patient harm (select all that apply).

a. Omission of vital medication/non-treatment of the patient
b. Alternative medication provided but not the drug of choice, which led to inadequate treatment
c. Error with an alternative drug or form/strength of a drug used as a substitution for the drug in short supply
d. Error when a healthcare provider’s internal pharmacy attempted to compound a drug/product/strength that was no longer available
e. Error when an external compounding company prepared a product
f. Drug sterility problem
g. Stability of compounded product
h. Other: describe briefly

7. Indicate the age range and gender of the patient harmed.

Male Female

8. Indicate the region of the country where the event occurred.

Region 1 (CT, ME, MA, NH, RI, VT)
Region 2 (NJ, NY, PA)
Region 3 ( DE, DC, KT, MD, NC, VA, WV)
Region 4 (AL, FL, GA, MS, PR, SC, TN)
Region 5 (IL, IN, MI, OH, WI)
Region 6 (IA, KS, MN, MO, NE, ND, SD)
Region 7 (AR, LA, OK, TX)
Region 8 (AZ, CO, ID, MT, NM, UT, WY)
Region 9 (AK, CA, HI, NV, OR, WA)