Bonane, Baby Girl -.

HRN: 23-76-56  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/21/2023
AMPICILLIN 250MG (VIAL)
10/21/2023
10/28/2023
IV
100mg
Q12H
PSNB
Checking Final Appropriateness 
10/21/2023
GENTAMICIN 40MG/ML, 2ML (AMP)
10/21/2023
10/28/2023
IV
12mg
Q24H
PSNB
Checking Final Appropriateness 

AMS Audit Form


Start Date: End Date:

 Indication:

              

 Type of Infection:

                             

           

 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: