Kimster

I posed the question to JCAHO online and this is their response:
No, this is not a mandatory practice. Rho Immune Globulin is a "blood derivative". Our practice is to survey blood derivatives (albumin, Rhogam, factor concentrates, etc.) under either the Immunohematology or Medication Management standards, depending on which of the two hospital departments is overseeing it. Specifically, if managed by the blood bank, we would survey it under our Immunohematology standards in the laboratory manual. If managed by pharmacy, we would survey it under the Medication Management standards in the hospital manual . The former has stringent tracking requirements (see QSA.05.01.01 and AABB standards 5.1.6.1 & 6.2.3) ; the latter requires sufficient tracking to determine who may be impacted in the event of a recall (MM.05.01.17).
Note that full compliance with the intent of the standards can only be assessed during an onsite survey. Please feel free to contact me directly with any further questions or discussion for clarification purposes.Megan SawchukJoint Commission

We gave up our RhIg about 10 years ago. It's stored in pharmacy. After the work is completed in the LIS we order the RhIg in PowerChart (the hospital's Cerner program) which prompts Pharmacy to issue. We can use one or more doses as needed. It's given an obscure pneumonic to keep the physicians from being able to locate it and order it without the appropriate blood bank work first.

First and foremost how does one not remember having an amnio? Second those administering the RhIG should be giving these moms the patient ID card that all of the products on the market have within the product insert.
 
Next for your ER docs that keep administering RhIG for bleeding they should discuss with the Chief of OB and the Blood Bank Medical Director the protocol set in place by ACOG for multiple bleeding episodes.

I met this lovely gentleman at the CABB meeting after he had given one of his great presentations on Rh, I talked to him after the presentation was just knocked over by his patience for with my questions.

We actually got rid of the micro-dose because first it was ordered for patients that were not candidates for a mini dose. Second the price was almost the same as a full dose and why worry about the having two to stock. It is always better to give more than not enough, many OB patients due dates may be changed after the first trimester to an earlier date. Look at Ramsey et al in Arch of Pathology Lab Med, March 2009 regards to underdosing, I'd rather be safe than sorry.

We actually got rid of the micro-dose because first it was ordered for patients that were not candidates for a mini dose. Second the price was almost the same as a full dose and why worry about the having two to stock. It is always better to give more than not enough, many OB patients due dates may be changed after the first trimester to an earlier date. Look at Ramsey et al in Arch of Pathology Lab Med, March 2009 regards to underdosing, I'd rather be safe than sorry.

We actually got rid of the micro-dose because first it was ordered for patients that were not candidates for a mini dose. Second the price was almost the same as a full dose and why worry about the having two to stock. It is always better to give more than not enough, many OB patients due dates may be changed after the first trimester to an earlier date. Look at Ramsey et al in Arch of Pathology Lab Med, March 2009 regards to underdosing, I'd rather be safe than sorry.

We actually got rid of the micro-dose because first it was ordered for patients that were not candidates for a mini dose. Second the price was almost the same as a full dose and why worry about the having two to stock. It is always better to give more than not enough, many OB patients due dates may be changed after the first trimester to an earlier date. Look at Ramsey et al in Arch of Pathology Lab Med, March 2009 regards to underdosing, I'd rather be safe than sorry.