Lasula, Vynz Aries A.

HRN: 22-33-64  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
12/15/2022
AMPICILLIN 500MG (VIAL)
12/15/2022
12/22/2022
IV
140mg
Q12
Pnsb
Waiting Final Action 
12/15/2022
GENTAMICIN 40MG/ML, 2ML (AMP)
12/15/2022
12/22/2022
IV
14mg
Q24h
Pnsb
Waiting Final Action 
12/15/2022
ERYTHROMYCIN 0.5%, 3.5G EYE OINTMENT (TUBE)
12/15/2022
12/22/2022
IV
Topical
Once
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: