Esparcia, Rosilyn L.

HRN: 22-83-28  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/28/2023
AMPICILLIN 1GM (VIAL)
10/28/2023
10/29/2023
IV
2 Grams
Loading Dose
Leaking BOW
Checking Final Appropriateness 
10/29/2023
CEFUROXIME 1.5GM (VIAL)
10/28/2023
10/30/2023
IV
1.5 Grams
Q8hrs X 3 Doses
S/P Primary LTCS
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

 Indication:

              

 Type of Infection:

                             

           

 Compliance to guidelines:



 Initial appropriateness:



 If inappropriate:

           

 Final appropriateness:



 If inappropriate:

              

 Overall appropriateness: