Flores, Baby Girl .

HRN: 24-56-64  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
02/17/2024
AMPICILLIN 250MG (VIAL)
02/17/2024
02/23/2024
IV
95mg
Q12h
Potentially Septic Newborn
Waiting Final Action 
02/17/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
02/17/2024
02/23/2024
IV
9.5mg
OD
Potentially Septic Newborn
Waiting Final Action 

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: