Mastitis Infection in Postpartum Women Standing Order
APPROVED FOR USE AS A POPULATION BASED STANDING ORDER BY: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PURPOSE: To provide a population-based standing order for postpartum women with classic symptoms of mastitis without complications: severe breast pain and fever over 103 or other suspicion for serious complication, and who are able to take oral medication.
POLICY: This standing order follows AAFP guidelines in addition to Schmitt-Thompson nurse triage protocols and is to be implemented by the registered nurse as part of the telephone triage encounter.
- The RN will follow Clear Triage software assessment pathway using Schmitt-Thompson approved protocols for nurse triage to include “Postpartum: Breast Pain and Engorgement” and “Breastfeeding - Mother's Breast Symptoms or Illness”
- The RN will screen the patient for complicated symptoms or history to include fever over 103 and severe breast pain. If the patient answers “yes” to any complicating factors or history the RN will advise the patient according to the care advice found in the selected protocol. If the patient answers “no” to any complicating factors or history the RN may continue with procedure for standing order.
- Symptomatic women without complicating factors or history will be treated with Dicloxacillin 500mg every 6 hours for 7 days. Dispense #28. No refills. (upon confirmation by patient of no known penicillin allergy)
- RN will provide the patient with care advice as indicated by Schmitt-Thompson protocols in Clear Triage software to include reasons to call back i.e., fever, severe pain, increased redness or swelling, new/worsening symptoms, no improvement within 3 days on antibiotic.