Escalante, Honie, JR.. D.

HRN: 22-05-22  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
10/03/2022
CEFTRIAXONE 1G (VIAL)
10/03/2022
10/09/2022
IV
2G
OD
Prophylaxis
Waiting Final Action 
10/03/2022
MUPIROCIN 2%, 15G (TUBE)
10/03/2022
10/09/2022
TOPICAL
2%
BID
Wound Infection
Waiting Final Action 
10/04/2022
MUPIROCIN 2%, 15G (TUBE)
10/04/2022
10/10/2022
TOPICAL
2%
BID
Wound Infection Prophylaxis
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: