Isa, Nursima S.

HRN: 21-23-03  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
04/12/2022
AMPICILLIN 1GM (VIAL)
04/11/2022
04/18/2022
IV
2G
Q6
PROPHYLAXIS

AMS Audit Form


Start Date: End Date:

Indication:

              

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Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



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Overall appropriateness: