Management of Ill or Compromised Patients Policy

Policy Owner: Associate Dean for Patient Care & Clinic Services

Policy Contact: Quality & Compliance Officer

POLICY STATEMENT

1. Patients who appear to be ill or have indications of a communicable condition, including but not limited to respiratory viruses, TB, herpes, chickenpox, parasites, or unknown rashes, will be assessed by supervising or attending faculty present in the clinic where the patient is being treated to determine whether the appointment may proceed.
2. The faculty may recommend that the patient consult their primary care physician before they can reschedule in the school. Medical consults may be required before care can continue.
3. Patients who are compromised due to the use of alcohol or recreational drugs will be required to reschedule their appointment. Students who suspect that a patient is under the influence of drugs or alcohol will request a faculty evaluation of the patient before beginning the appointment. If the behavior disrupts the clinic operations, they may be dismissed from care at the University of Minnesota School of Dentistry.
4. Patients who appear to be under the influence of drugs or alcohol will be told that they must be sober and not under the influence of other substances during their dental appointments.
5. Patients who arrive at subsequent appointments under the influence of drugs or alcohol after being warned may be dismissed from the school.
6. Imminent medical emergencies, such as if a patient becomes unresponsive, will be handled following the Medical Emergency Protocol.

REASON FOR POLICY

This policy aims to protect all students, staff, faculty, patients, and others within the University of Minnesota School of Dentistry from communicable diseases, transmittable conditions, and dangers posed by others who are compromised by illness or other substances. The policy also minimizes risks of dental treatment to patients of the School who may be compromised due to illness, chronic conditions, medication, or other substances including drugs and alcohol.

PROCEDURES

1. Illnesses and Chronic Conditions

• If a patient reports or displays signs of illness or a communicable condition, the supervising or attending faculty present in the clinic where the patient is being treated will determine if the patient should be rescheduled. The faculty will determine if other precautions should be taken such as calling the patient’s PCP, ordering a medical consult, or driving restrictions.

• If deemed necessary by the faculty, the patient’s “emergency contact” will be notified.
• The School may assist in arranging transportation such as a family member or emergency contact. If neither are available and the situation is unmanageable, we may contact University police for assistance with the patient.

2.  Parasites

• If a patient displays signs of parasites such as lice, bed bugs, mites, or scabies the supervising or attending faculty present in the clinic where the patient is being treated will remove the patient from the clinic.
• The area will be cleaned and disinfected before the clinical space can be used again.
• Contact The Compliance Office (612-626-7820) or Dental Engineering (612-625-7112) if a pest control service is required.

2. Compromised due to Drugs or Alcohol

• If a patient displays signs of being under the influence of drugs or alcohol, including if they smell of drugs or alcohol, the supervising or attending faculty present in the clinic where the patient is being treated will determine if the appointment should proceed. The faculty will ask the patient if they drove themselves to the clinic and will determine if a physician’s assessment is necessary.
• The person listed as their “emergency contact” may be notified and may be asked if they can provide transportation for the patient.
• The School may assist in arranging transportation such as a family member or emergency contact. If neither are available and the situation is unmanageable, we may contact University police for escort off the premises.

FORMS/INSTRUCTIONS

Appeals Process 

1. Illnesses, Chronic Conditions, and Parasites

• Patients for whom a Medical Consult has been requested will not be treated until the response to the request has been received.
• Patients who have a parasitic condition, including bed bugs must show proof that the condition has been treated. This can be done through a medical consult, a doctor’s note attached to their chart, or a note from an extermination service that their property is rid of bed bugs.
• Patients who document that they have a condition that makes them appear to be under the influence will have an alert placed on their charts so that all providers can be aware of the patient’s condition.
• Conditions that may cause a person to seem to be under the influence Include:
  • Diabetes/Alcoholic Ketoacidosis
  • Hypoglycemia
  • Epilepsy
  • Stroke
  • Hypoxia
  • Brain Injuries
  • Reactions to other medications

2. Compromised due to Drugs or Alcohol

• Patients who deny that they are under the influence of drugs or alcohol may appeal the decision not to treat them at their appointment. Color group leaders or division directors may use their discretion to determine if the appointment can continue.
• Patients who have been dismissed due to arriving for appointments under the influence of drugs or alcohol may appeal their dismissal through the Patient Management Team, with evidence of alcohol or drug abuse treatment or a letter from a physician stating why the patient is deemed safe for the SoD to treat. Subsequent arrivals at the school while under the influence of drugs or alcohol will result in immediate and permanent dismissal.

APPENDICES

There are no appendices associated with this guideline.

FREQUENTLY ASKED QUESTIONS

There is no FAQ associated with this policy.

DEFINITIONS

There are no definitions associated with this policy. 

RESPONSIBILITIES

There are no responsibilities associated with this policy. 

RELATED INFORMATION

There is no related information associated with this policy. 

HISTORY

ADDITIONAL CONTACTS