Hello colleagues,

I have had a couple of events recently with inappropriate administration of HBIG to a newborn. Currently, HBIG is available on a special care nursery order set (not a newborn order set) as a "once" order according to maternal HBsAg status. My recommendation to eliminate the risk is to remove HBIG from the order set to prevent inadvertent administration; thereby placing the onus on the provider to order it when the provider deems it clinically appropriate. My pediatric hospitalists feel this is a drastic measure. I had previously suggested changing the order to PRN, but I think the order is wordy/complicated and still poses risk for inadvertent administration.

Would appreciate insight into how your organization manages the ordering of HBIG (Part of an order set...if so, how is it ordered? Ordered ala carte by the provider when clinically appropriate?)

Thank you kindly,
Megan Fragale, PharmD, MS, BCPS
Medication Safety Officer
Skagit Regional Health