AMS Audit

Toremotsa, Efefania P.

HRN: 26-95-50 Sex: Female

Patient Encounter

AMS Audit List

Audit Date

Antimicrobial

Start Date

End Date

Route

Dose

Frequency

Indication Documented

CEFTRIAXONE 1G (VIAL)

Infected Wound Left Foot

Waiting Final Action

CLINDAMYCIN 150MG/ML, 4ML (AMP)

Infected Wound Left Foot

Waiting Final Action

CLINDAMYCIN 150MG/ML, 4ML (AMP)

Abscess Right Foot

Checking Initial Appropriateness

PIPERACILLIN + TAZOBACTAM 4.5G (VLS)

Checking Initial Appropriateness

PIPERACILLIN + TAZOBACTAM 2.25G (VIAL)

Abscess Right Foot

Checking Initial Appropriateness

LEVOFLOXACIN 500MG (TAB)

Checking Initial Appropriateness

CLINDAMYCIN 150MG/ML, 4ML (AMP)

S/P Wound Debridement

Checking Initial Appropriateness

CEFTAZIDIME 1GM (VIAL)

Checking Final Appropriateness

CEFTAZIDIME 1GM (VIAL)

Dm Foot; Cap -mr

Remove - Pending Acceptance

MUPIROCIN 2%, 15G (TUBE)

Apply On Affected Areas

Remove - Pending Acceptance

CEFUROXIME 500MG (TAB)

CAP MR; DM Foot

Remove - Pending Acceptance

MUPIROCIN 2%, 15G (TUBE)

Apply Thinly On Affected Areas

Checking Initial Appropriateness

MUPIROCIN 2%, 15G (TUBE)

Remove - Pending Acceptance

AMS Audit Form

Start Date: End Date:

Indication:

Prophylaxis Empiric Culture-directed Empirical Escalation Empirical de-escalation Empiric then culture-directed

Type of Infection:

Urinary tract Pneumonia URTI Bloodstream Bone & joint Skin & soft tissue Intra-abdominal Eye, ear, nose, throat, & mouth Cardiovascular Reproductive tract Central nervous system

Febrile neutropenia Disseminated systemic infection Unspecified sepsis Multiple infections (tick all sites) Prophylaxis

Compliance to guidelines:

Compliant to guidelines Non-compliant to guidelines Guideline not available

Initial appropriateness:

Yes No

If inappropriate:

No infection Wrong choice Wrong route Wrong dose

Final appropriateness:

Yes No

Overall appropriateness:

Yes No