Module 2: Managing Intravenous and Subcutaneous Immunoglobulin Inventory - Dispensing

Dispensing

! To ensure accurate dispense reconciliation in BloodSTAR, product should be allocated to patients at the time of dispense and not upon receipt into inventory.

Ig must only be dispensed against planned infusions or dispense requests for authorised patients, except in exceptional circumstances as outlined in the national policy. The dispenser should review the dispense request for accuracy and take into account any past or current variations noted in the planning sheet/infusion plan. Product should only be dispensed where:

  • it is for a patient with a current authorisation
  • the requested product type is the authorised product type
  • the quantity matches or is less than the authorised quantity
  • the interval since the last infusion matches the authorised interval  OR
  • there is a justifiable reason to which a dispense request is outside of the infusion plan. i.e. the patient fails to turn up on time (Note: this will require action in BloodNet as it will result in a dispense discrepancy).

When dispensing Ig product, Dispensers should issue product in accordance with the Immunoglobulin Governance National Policy.

It is important to record dispensing information in BloodNet via the Authorisation tab to ensure the patients’ treatment plan in BloodSTAR is updated and there is traceability of product dispensed to patients in case of product recall and to reconcile dispense records with authorisations to identify, investigate and correct anomalies. Dispensers will need to perform reconciliation of dispense records where that dispense episode does not match details of an authorisation in BloodSTAR, because the timing, dose or product is not as expected. This will involve the dispenser regularly checking both the Dispense Discrepancies and Unmatched Fate Episodes (for LIS facilities only) on a regular basis and ensuring that any pending items under both menu items are actioned.

! Reconciliation of dispense records should be done as frequently as possible to ensure appropriate follow-up of dispense episodes that cannot be matched to authorised dispense requests.

Any Ig product that has been dispensed but not used should be returned to the Dispenser, deallocated and returned to stock against that patient via the BloodNet Authorisation module. Clinical areas, other than the Dispenser, should not hold an inventory of Ig product. Dispensers should consider regular audits of clinical areas to ensure all unused Ig product has been returned.

Dispensing product where patient authorisation has not been obtained
Refer to the Ig Governance National Policy 

Where Ig product is dispensed and patient authorisation has not been obtained for the approved supply of funded immunoglobulin product under the national blood arrangements:

  • where the dispenser holds imported product, imported product only should be dispensed.
  • an authorisation request must be submitted within seven business days through BloodSTAR and supply approved under the national blood arrangements otherwise the hospital/ health facility may be invoiced directly for the full cost of the product in accordance with the jurisdictional direct order (JDO). 

For more information about JDO and other supply arrangements, please refer to the NBA website at http://www.blood.gov.au/Intravenous-Ig. Please ensure you refer to local state/territory policies, where these exist.
 

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