Health systems are grappling with effects from the BD BACTEC blood culture media bottle shortage.
The FDA sent a letter to healthcare providers July 10 regarding the shortage, and the CDC released updated conservation strategies in a July 22 statement. The FDA estimates the shortage will continue into the fourth quarter of 2024.
Michelle Bösewicht, chief administrative officer of system lab services at Renton, Wash.-based Providence, told Becker's the health system is monitoring the situation closely.
"We are communicating with other healthcare systems, [the American Hospital Association], CMS and the CDC on any potential impact that this shortage would have on certain measures and guidelines relating to conservation strategies," she said. "We feel confident as a system that we are taking all the right steps to mitigate this shortage and continue to deliver the excellent care our patients expect and deserve."
Ms. Bösewicht said the health system has experienced some effects of the shortage but has pivoted quickly to implement conservation measures.
"Providence was impacted at 15 of our 51 ministries that utilize the affected vendor," she said. "Our lab executive leaders worked with our system microbiology leader, infection preventionist clinical decision teams, emergency medicine steering committee and sepsis committees to ensure a comprehensive, risk-based mitigation plan, using current inventory amounts on hand to guide ordering practices. This early conservation work has ensured we currently have an adequate inventory as of this week."
Ms. Bösewicht said conservation measures at Providence include:
- Eliminating drawing blood cultures as a "hold" or part of a "rainbow draw" in the emergency department.
- Avoiding use of nursing-based protocols and using lab phlebotomists when possible to reduce potential contamination.
- Immediate guideline changes when inventories drop to two-week and one-week thresholds. Potential changes include using only one set of blood cultures for eligible patients and sending low-risk outpatient cultures to reference labs.
- Having lab leaders partner with chief nursing officers and chief medical officers to reinforce communications and procedures.
These strategies have resulted in a 10% to 50% decrease in blood culture media bottle usage at Providence's ministries affected by the shortage, allowing the health system to not fall below its implemented two-week inventory safety threshold, Ms. Bösewicht said.
She sees the potential for this shortage to change future procedures.
"This event has catalyzed discussion and reassessment of current potential waste, such as cultures drawn as ‘hold’ or as part of a ‘rainbow’ venipuncture, as well as reemphasizing our work on blood culture contamination reduction," she said. "I imagine that will persist past this current crisis."
Barbara Osborn, vice president of public relations at New Hyde Park, N.Y.-based Northwell Health, told Becker's the health system has not felt any effect of the shortage yet.
"Northwell is carefully monitoring our current supply and usage of blood culture media bottles daily. At this time, we have not changed our clinical care practices," she said. "However, this national shortage highlights the opportunity to optimize the utilization of our blood culture resources. We continue to follow our existing guidelines for blood culture collection."
Ms. Osborn said guidelines at Northwell are to:
- Perform blood culture collections when medically necessary.
- Verify that there is an existing order before obtaining a blood culture.
- Perform routine disinfection protocols to minimize contamination risk.
- Avoid performing multiple blood cultures by ensuring proper blood volume collection.