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:

• The patient

  • 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.

• The product's correct name

  • "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 PrivigenNZ.

• The dose and quantity

  • e.g. 1 unit of red cells. NB: mL for paediatric patients instead of units. For regular medication, e.g. HizentraNZ, the dose; frequency; and duration of the prescription or maximum number of doses. Note prescriptions are only valid for three months' worth of medication.

• The route

  • IV for blood components, IM for most immunoglobulin concentrates, subcut for HizentraNZ.

• Instructions for use

  • 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. HizentraNZ, the dose and frequency of the medication

• The prescriber's signature, name and contact details

• As well as a legal requirement, if there are problems, staff know who to contact.

• 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. HizentraNZ, serum eyedrops, RhD Immunoglobulin), Blood Bank will require the prescription. Although dispensing can take place use a faxed/scanned copy, the original signed prescription must be promptly sent to the department dispensing the product.

• The only blood products that midwives are only allowed to prescribe are RhD immunoglobulin and hepatitis B immunoglobulin.

Please see the complete requirements for prescribing as listed in the Medicines Regulations 1984 and NZBS's Dispensing Policy.