Clavejo, Meriam A.

HRN: 22-00-72  Sex: Female

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
09/27/2022
AMPICILLIN 500MG (VIAL)
09/27/2022
10/04/2022
IV
2gm
Q6
PROM X 24 Hours
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: