Kaizen, Quiamco F.

HRN: 26-29-85  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/11/2024
AMPICILLIN 500MG (VIAL)
12/11/2024
12/18/2024
IV
300
Q12 Hrs
Infected Umbilical Cord
Waiting Final Action 
12/11/2024
GENTAMICIN 40MG/ML, 2ML (AMP)
12/11/2024
12/18/2024
IV
15 Mg
Q24 Hrs
Infected Umbilical Cord
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: