Factor Concentrates: Pharmacy or Blood Bank?

[DFields]

In 2010, do you store and issue factors in the Blood Bank, or are they kept in the Pharmacy?

What about Factor VII concentrate, does Blood Bank issue and is there a protocol at your institution?

[Deny Morlino]

Pharmacy handles all factors plus albumin. Blood bank handles cryo, FP, and RhIG. Has been this way here for many years. Hope this helps.

[L106]

Our Pharmacy handles all factors plus albumin plus Rh-Immune Globulin. Our Blood Bank handles FFP & Cryo.

[BBK710]

Pharmacy handles all factors and albumin. We handle Rh Immune globulin.

[bmarotto]

Blood Bank handles factors, albumin, and RhIg. Pharmacy handles IVIg and WinRho.

After 30 years of trying, we expected pharmacy to take albumin but again they declined. The reasons were (1) they have no space to store it in the existing Pyxis machines on the patient floors or in the pharmacy and (2) they can not track lot numbers in either their current or soon to be new pharmacy computer system. All they use is the NDC code which identifies the product type.

If pharmacy handles albumin in your hospital, do you know if they track lot numbers? Is it required? Our hospital is implementing a new EMR which requires that albumin be handled as a med. One option was to have blood bank use the pharmacy system to process the order but still track it in the Blood Bank system as we are now. The other option is to have pharmacy process and verify the request in their system then print a "medication label" in Blood Bank. Blood Bank will then order and dispense in the Blood Bank system. Either way doubles the amount of time spent filling the order. :explosion

[SusanM]

Pharmacy handles albumin, IVIG, and all factors!!! :-) Was such a relief to hand that (the factors) off...

Last i heard our docs wanted Factor VII here, but i don't know if they ever got their way...

BB does do the RhIG.

S.

[Joanne P. Scannell]

Pharmacy handles them ... they are pharmaceuticals! We don't need to determine compatibility and they have NDC numbers ... they are handled, billed and adverse reaction reported as pharmaceuticals, not Blood Components.

Following the argument, the have blood factors in them ... why doesn't the Chemistry department distribute insulin then?

[tbostock]

We have RhIg, Pharmacy has albumin, IVIG, and factor concentrates.

[bmarotto]

...and Microbiology can dispense the antibiotics!

[Ann Viernes]

Our pharmacy finally accepted the factors about 2 years ago when they upgraded their computer system. This has improved timely delivery of the products to the patients. Efforts to control off label use of FVII (NovoSeven) include gatekeepers, policy to prevent issue of a second dose without consultation with a gatekeeper, and improved restrictions and education in CPOE. Blood bank handles RHIG, we keep only one brand on hand for prevention of sensitisation to D antigen and for ITP treatment, the brand that can be used for both IM and IV administration. Pharmacy also handles albumin. When blood bank uses albumin for plasma exchanges, we keep track of lot numbers. I do not know whether Pharmacy tracks lot numbers when they issue to patient floors.

[Eoin]

We handle anything which is of human origin - Pharmacy the rest.

Seems to work well.

Cheers

Eoin

[skopti]

Pharmacy handles all factors and albumin. Blood Bank handles Rhogam

[PammyDQ]

NEITHER! We rarely have the need with our patient population and it's too expensive to stock just incase. However we have quick access to all factors and recently needed a ton of NovoSeven.

A company called BioCare, a division of Blood Systems Inc, consigns a large assortment of Factor products to RIBC, our local blood supplier. When we need factors, we just call the hospital service department who we order our blood product inventory, and they deliver what we need. BioCare bills us direct. This system worked out great.

Previously we would call another hospital BBK and they'd suppy it to us, then we'd order it through our pharmacy and replace what we borrowed. Then that hospital ended up finally sending Factors to their Pharmacy, and we discovered the BioCare arrangement.

http://www.biocare-us.org/vbs/home.asp

[tamoore]

Our blood bank dispenses Factor VII (NovoSeven) as part of our Massive Transfusion Protocol for adult trauma patients. Pharmacy replenishes our supply when it is used and is responsible for patient billing. They handle distribution of NovoSeven in any other situations and consultation with a "gatekeeper" is required.

[LaraT23]

Definitely pharmacy! they can keep up with dispensing and have a much better computerized way to log patients, nurses and lot numbers than we do. Plus, let them purchase and balance their own budget. Just my opinion, I am getting my budget sucked in to just with blood products.

[AMcCord]

We handle RhoGAM only. Pharmacy does the rest, including NovoSeven.

[PaulSunV]

We handle RhoGam only. Pharmacy does the rest.

[adiescast]

Pharmacy handles all of them (Factors, RhIg, Albumin...antibiotics and insulin)!

[KarenJ]

We keep RhoGam, pharmacy handles everything else.

[JEMarti]

We handle all factors and RhIg (excepting WinRho) and skin. Factor VII requires Med Director approval (ie resident). Approval for F7 is pretty well controlled and the Blood Bank is able to turn around requests rapidly even on third shift.

[MsDuffy]

Pharmacy has control of factor products, albumin and IV RhIG (WinRho). The Transfusion Service has RhoGAM.

[MJDrew]

When I was in a hospitals service, we handed off factor concentrates to the pharmacy in about 1999. Pharmacy also took on albumin around that time. Transfusion service was left with RhIg until handing that off a couple of years later after a pharmacy computer system upgrade allowed the floors to order it directly after receiving instruction from the transfusion service as to how much to order. MJD

[Likewine99]

Pharmacy has it all and the assoicated expenses!

[Langolier]

In New Brunswick Canada, all factors, albumin, IvIg and RhIg and most immune globulins are handled by the Blood Bank. But then, we don't have a "billing" to the patient