Information

  • DHSV Dental Antimicrobial Prescribing Audit

  • Client / Site

  • Conducted on

  • Conducted by

  • Personnel

  • Location

DENTAL ITEM CODE 927 - ANTIMICROBIAL PRESCRIPTION AUDIT

Prescription 1

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 2

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 3

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 4

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 5

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 6

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 7

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 8

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 9

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 10

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 11

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 12

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 13

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 14

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 15

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 16

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 17

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 18

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 19

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 20

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 21

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 22

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 23

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 24

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

Prescription 25

  • Date of prescription

  • Dental Record Number

  • Clinician Name or Code

  • Reason for prescribing

  • If acute odontogenic infection, was definitive treatment provided first (e.g. open & drain, extraction etc.)

  • Primary antibiotic prescribed

  • Secondary antibiotic prescribed

  • Follow the "antimicrobial creed"?

  • Appropriately prescribed in line with the Therapeutic Guidelines Oral & Dental (2012)

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