How to Prescribe
The prescription is the first link in the chain of events leading to a patient receiving a blood product. Errors or omissions in the prescription can lead to major adverse events and even death.
The key elements of any prescription are identifying:
|Full name, gender, date of birth. The NHI number should be used whenever available. The patient's weight is also important if the dose is weight-based or the medicine is for a paediatric patient.|
|"Blood" is not a product name as it can mean resuspended red cells, whole blood, plasma-reduced red cells, red cells for IUT, neonatal red cells, etc. Similarly IVIG is not a product name as two different forms with different rates of administration are in use in New Zealand, rather use Privigen or IntragamP.|
|e.g. 1 unit of red cells. NB: mL for paediatric patients instead of units. For regular medication, e.g. Evogam, the dose; frequency; and duration of the prescription or maximum number of doses. Note prescriptions are only valid for three months' worth of medication.|
|IV for blood components, IM for most immunoglobulin concentrates, subcut for Evogam and Hizentra.|
|For single units, this would be the duration of administration and the date & time of transfusion. Note: transfusions of blood components must be completed within 4 hours of leaving controlled storage (Blood Bank or a blood fridge). Prescribing a unit over four hours leaves staff no time to set up the transfusion. Overnight transfusions are strongly discouraged as they put the patient at increased risk of errors and complications as well as disturbing precious sleep|
For regular medication, e.g. Evogam, the dose and frequency of the medication
|As well as a legal requirement, if there are problems, staff know who to contact. The only blood products that midwives are only allowed to prescribe are RhD immunoglobulin and hepatitis B immunoglobulin.|
For inpatients, Blood Bank does not require a prescription but the staff administering the product will.
For outpatients where Blood Bank give the product directly to the patient (e.g. Evogam, serum eyedrops, RhD Immunoglobulin), Blood Bank will require the prescription. Although dispensing can take place use a faxed/scanned copy, the original prescription must be promptly sent to the department dispensing the product.
Please see the complete requirements for prescribing as listed in the Medicines Regulations 1984 and NZBS's Dispensing Policy.