Dental Procedure Prophylaxis Protocol



Dental Procedure Prophylaxis Protocol

Purpose: To establish a procedure by which a patient may have antibiotics for prophylaxis ordered without a provider visit.

Recipients: All Staff of the Lake Superior Community Health Center

Date Written: July 17, 2001

Date Initiated: July 17, 2001

Date Revised: June 12, 2008

1. A Lake Superior Community Health Center registered nurse is authorized to call in medication prescriptions for patients who are required to have antibiotic prophylaxis prior to a dental procedure.

2. Patients who qualify for the RN authorization are as follows:

a. Lake Superior Community Health Center patient with a chart that is active (seen within the past 12 months).

b. Stable medical condition

c. Documented need for dental prophylaxis

d. Not allergic to the authorized antibiotics

e. Not on Coumadin or other anticoagulant

3. Antibiotics authorized:

a. Not penicillin allergic-Amoxicillin 2 grams orally one hour prior to procedure

b. Penicillin allergic-Clindamycin 600 mg orally one hour prior to procedure.

4. The nurse will record the date of the dental procedure, the antibiotics prescribed, and the nurse’s signature in the patient’s chart.

5. A provider must manage other procedures requiring prophylaxis.

Planned review: June 12, 2015, Medical Director

Gail E. Baldwin, MD Date

Medical Director

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