STANDARD WORK OBTAINING PASTEURIZED DONOR HUMAN MILK (PDHM) OUTPATIENTS

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C-0506-16-60895 Standard Work: Obtaining Pasteurized Donor Human Milk Outpatients/ Community Requests


STANDARD WORK OBTAINING PASTEURIZED DONOR HUMAN MILK (PDHM) OUTPATIENTS STANDARD WORK OBTAINING PASTEURIZED DONOR HUMAN MILK (PDHM) OUTPATIENTS

Standard Work: Obtaining Pasteurized Donor Human Milk (PDHM): Outpatients/ Community Requests

Document Owner(s): Maternal newborn Program, BCWH

Department:

Created: March 3, 2020

Last Revised:

Date Approved:

Performed By: Registered Nurses; Milk Bank Clerk

Other Roles Involved: Providers (community; hospital); client

Process Summary: PDHM for community use can be ordered prior to discharge or after discharge from community providers using the Prescription to Receive Donor Milk form

Objective:

#

Major Steps

Details/Pictures/Visuals

Rationale, Quality or Safety Considerations

Resources

1

Physicians/Midwives/NPs write a prescription for PDHM

Prescription to include the following information:


  • Amount of donor milk required per day (estimated)

  • Date of order

  • Diagnosis or the reason the donor milk is requested

  • Feeding plan (i.e. is the mother breastfeeding)

  • Length of anticipated need for donor milk

  • Mother's/caregiver’s name and phone number

  • Recipient infant’s name and birth date

Information is required to allow BCW Provincial Donor Milk Bank to release PDHM according to eligibility criteria and patient specific need (volume).


Post-discharge prescription form available:

Prescription to Receive Donor Milk from the BCW Provincial Milk Bank Post-Discharge

2

Prescription is faxed or emailed to the Milk Bank

Milk Bank – 604-875-2424 ext. 7634

Fax: 604-875-2871

Email: [email protected]




3

Milk bank confirms availability of PDHM with client, confirms order and arranges pick up time

Milk bank confirms availability of PDHM with client based on eligibility criteria.


Provincial Donor Milk Bank Use and Eligibility: Protocol

4

Client comes to Milk Bank (desk 1) in BCWH and pays processing fee

For additional milk, client call milk bank: 604-875-2424 ext. 3743 before coming to the hospital







Cross-References























Version History

DATE

DOCUMENT NUMBER and TITLE

ACTION TAKEN

01-Dec-2020

C-0506-16-60895 Standard Work: Obtaining Pasteurized Donor Human Milk Outpatients/ Community Requests

Approved at: CW Best Practice Committee


DISCLAIMER

This document is intended for use within BC Children’s and BC Women’s Hospitals only. Any other use or reliance is at your sole risk. The content does not constitute and is not in substitution of professional medical advice. Provincial Health Services Authority (PHSA) assumes no liability arising from use or reliance on this document. This document is protected by copyright and may only be reprinted in whole or in part with the prior written approval of PHSA.


C-0506-16-60895 Published Date: 30-Dec-2020

Page 2 of 2 Review Date: 30-Dec-2023

This is a controlled document for BCCH& BCW internal use. Refer to online version. Print copy may not be current. See Disclaimer at the end of the document.


SEKTOR ZA SPLOŠNO METODOLOGIJO IN STANDARDE ŠTEVILKA 007492007 DATUM
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Tags: donor, outpatients, standard, pasteurized, obtaining, (pdhm), human