Rhogam Review

[pbaker]

Our pathologists review and sign every case of Rhogam candidacy investigation. This includes when the physician orders Rhogam to be given with no testing by the blood bank or if the infant is Rh negative and the mother is not a candidate.

What is the practice in your facility? Does the pathologist review any or all of your Rhogam workups?

[John C. Staley]

There was no pathologist review of RhIG at my previous facilities. They had trust in our education and training to allow us to perform as we were expected to while knowing full well that anything odd, strange or unusual would be brought immediately to their attention.

[Eagle Eye]

same here. we have a policy and procedure in place so my staff follows it. if anything out of norm, they would bring it to me. If Rhogam was given with in 72 hrs then we would consult medical director and based on FMH, we do not give another dose but we do consult MD for those cases as we do not want to make medical judgement.

[Malcolm Needs ☆]

Same when I worked in hospitals.

[Deny Morlino]

It is blood bank responsibility here as well. Mechanisms are in place in the ED and OB to assure all expecting women are checked for Rh status on each admission. Works well here.

[khalidm3]

In our hospital, blood bank has no concern with Rhogam. It is dispensed by pharmacy on the order of obstetricians. Required laboratory tests other than Rh are done by haematology department.

Is it mandatory for blood bank to include it in blood bank responsibility?

[BUGGIE]

Ah the RhoGam debate again. I started a thread earlier about where RhoGam was to held Blood Bank or pharmacy. The latest JC rule, and they are at my lab today, is that RhoGam must be treated as a drug. So we gave it all to pharmacy. We put a message on each box to say go to lab and confrim all testing has been done so lot numbers can be recorded and the product issued and charged to the patient. We are to buy the RhoGam from the pharmacy but we can not touch it, or apparently know what lot numbers have been received (working on that). We do not have the pathologist review the order, our techs do that, and tell the doctor how much to order.

Intrestingly enough the first RhoGam order came from Medical/Surgical for a 80 year old man who received Rh positve platelets about 700 mls. I was not really worried about sensitization to Anti-D as much as we were giving an A neg, O pos. What do you think?

My manager wants to know how labs who do not keep RhoGam in the Blood Bank handle tracking the product. My pharmacy says they do not track lot numbers to patients,nor do they review the orders.

Why does this bother me so much?

Also- my manager wants to know where do you store your blood boxes from your supplier, the JC says we can not keep cardboard boxes witch have been used as shipping boxes in the lab. It gets so complicated.

[Likewine99]

Same as John C. Staley.

[Mary**]

:bonk:What's with the boxes issue????

[Lori McClintock]

I think we have a bizzare scenario. Because of a JACHO inspection more than 5 years ago, it is now required that Pharmacy reviews our results before we hand out RhoGam. The Blood Bank gets the order, does the work, then we let the nursing unit know that testing is completed. They fax a "RhoGam Protocol" to Pharmacy, then Pharmacy indicates in the computer, that they've reviewed the testing. We have to check in the computer that pharmacy did their review before we issue the Rhoganm! Way too many steps!

[Malcolm Needs ☆]

I think we have a bizzare scenario. Because of a JACHO inspection more than 5 years ago, it is now required that Pharmacy reviews our results before we hand out RhoGam. The Blood Bank gets the order, does the work, then we let the nursing unit know that testing is completed. They fax a "RhoGam Protocol" to Pharmacy, then Pharmacy indicates in the computer, that they've reviewed the testing. We have to check in the computer that pharmacy did their review before we issue the Rhoganm! Way too many steps!

Totally and utterly bizarre.

With this many steps, this is an acident waiting to happen.

:ohmygod::ohmygod:

[LaraT23]

Our pathologist does not have anything to do with Rhogam, we do the type and screen and the fetal screen and stain.