Lecture Notes: Rescinding the Standard for Authorization to Self-Initiate Profession Specific Acts

Introduction

• Speaker: Tasy Panni, Practice Adviser at CDHO
• Topic: Impact of rescinding the standard for authorization to self-initiate profession-specific acts

Background

• On September 22, 2023, the CDHO Council rescinded the standard for authorization.
• This allows active registered dental hygienists to perform scaling and root planing without needing a standing order, client-specific order, or CDHO authorization.

Decision-Making and Contraindications

• Medical Clearance Requirement: Required if a contraindication is identified or if there is doubt about a client's medical or oral history.
• Dental hygienists are trained and expected to use their knowledge, skills, and judgment.
• Employers may have additional approval processes.

Importance of Medical History

• A detailed and comprehensive medical, dental, and drug history is crucial in decision-making and safe practice.
• Helps identify contraindications listed in the regulation.

Specific Contraindications

1. Cardiac Conditions:
   • Conditions requiring antibiotic prophylaxis as per AHA guidelines.
2. Infective Endocarditis:
   • Prior episodes or conditions requiring prophylactic antibiotics.
3. Unstable Medical Conditions:
   • Consultation required if conditions are unstable.
4. Chemotherapy/Radiation:
   • Consultation with healthcare provider required before procedures.
5. Immunosuppression:
   • Collaborate with healthcare provider to assess severity and plan care.
6. Blood Disorders:
   • Investigate further and consult as needed.
7. Active Tuberculosis:
   • Delay treatment until disease is inactive.
8. Substance Influence:
   • Reschedule if the client is impaired.
9. Unknown Conditions/Medications:
   • Further investigation and consultation.

Scenarios

• Scenario 1: History of angina, current chest pain, undecided medications. Recommendation: Do not proceed without consultation.
• Scenario 2: Recent cancer diagnosis, undergoing chemotherapy. Recommendation: Do not proceed without consultation.
• Scenario 3: Unfamiliar condition (Polycythemia). Recommendation: Do not proceed, consult healthcare provider.
• Scenario 4: Client with a hip replacement two years ago. Safe to proceed if no contraindicating conditions exist.

Resources

• CDHO Knowledge Network: Contains advisories and fact sheets for decision-making.
• CDHO Guidelines: Important for understanding medical history and contraindications.
• Registrant Handbook: Discusses controlled acts and regulations.
• Contact Information: CDHO available for consultation via phone or email.

Conclusion

• CDHO promotes safe, effective dental hygiene care by providing resources.
• Encourages use of provided resources and consultation for decision-making involving client care.

For further questions or assistance, reach out to CDHO practice advisers.